If you've just been diagnosed with HIV, you might be wondering what alcohol and other "recreational" drugs will do to your body. Recreational drugs are drugs that aren't being used for medical purposes, such as cocaine, amphetamines, and pot. This also includes prescription medicines that are being taken not as prescribed and synthetic drugs sold online or in stores.

You may be wondering whether these drugs are bad for your immune system. And what about your HIV medications--can recreational drugs affect those? Each person is different, and a lot depends on which drugs you use, how much you use, and how often you use them.

Most experts would agree that, in large amounts, drugs and alcohol are bad for your immune system and your overall health. Remember, when you have HIV, your immune system is already weakened.

Effects on your immune system

Drinking too much alcohol can weaken your immune system. A weaker immune system will have a harder time fighting off common infections (such as a cold), as well as HIV-related infections. A weaker immune system also increases the chance that you will experience more side effects from your HIV medications. Smoking marijuana or other drugs irritates the lungs. You may be more likely to get serious lung infections, such as pneumonia.

Other common recreational drugs, such as cocaine or crystal methamphetamine, can leave your body dehydrated and exhausted, as well as lead to skin irritation. These stimulants also shunt blood away from your extremities, risking higher rates of infection and significantly increased blood pressure.

If you also have hepatitis, your liver is working very hard to fight the hepatitis and using alcohol or drugs can cause additional damage to your liver.

Interactions with your HIV meds

When you are taking HIV medications, it is important that your liver works as well as possible. Your liver is responsible for getting rid of waste products from medications.

Certain HIV medications can boost the level of recreational drugs in your system in unexpected and potentially dangerous ways. For example, amphetamines (such as crystal meth) can be present at 3 to 22 times their normal levels in the bloodstream when mixed with an HIV drug called ritonavir (Norvir). That's because ritonavir affects the body's ability to break down these other drugs.

Many HIV medications can affect your kidneys. All substances in the blood are filtered through our kidneys. When drugs and alcohol are added, severe permanent damage can occur to our kidney function.

If you are going to take a recreational drug while you are on HIV medication, it is better to start with a very low amount of the recreational drug (as low as 1/4 the normal amount) and allow time to see how it affects you before increasing the amount. Keep in mind that recreational drugs aren't regulated, so you never know exactly how much you are getting.

Although you may feel uncomfortable at first, you should tell your provider what drugs you are using. That way, your provider will know how the substances you are using affect your HIV medications and your overall health.

Drugs, alcohol, and safer sex

Many drugs, including alcohol and methamphetamine, may affect your ability to make decisions. Even if you take your HIV medications regularly and practice safer sex when you're not high, when you're under the influence of drugs you may be willing to take more risks. For example, you might not use a condom or take your HIV medications.

These actions put your partner at risk for HIV and put you at risk for other sexually transmitted diseases or for pregnancy.

Remember to take your HIV medications every day, and to keep condoms handy in places where you might have sex. Also, try to limit the amount of drugs you use or alcohol you drink if you know you are going to have sex or be in high risk social settings.

HIV and injection drug use

Sharing a needle or any equipment when injecting drugs is dangerous for you and for your sharing partners. They could get HIV from you, and you could get another disease, such as hepatitis, from them.

The safest option is not to share. Use clean needles and syringes each time and keep your own equipment to yourself. There are sterile syringe programs that can help provide clean needles. For more information on sterile syringe programs, please visit the HIV.gov Website.

Because of the dangers of injection drug use, the best way to lower your risk is to stop injecting drugs. If you need help to stop using drugs, please talk to your VA provider or visit maketheconnection.net.

If you do inject drugs, follow these reminders:

• Never reuse or "share" syringes, water, or drug preparation equipment.
• Use only syringes obtained from a reliable source (such as pharmacies and needle or syringe services programs).
• Use a new, sterile syringe each time to prepare and inject drugs. If this is not possible, sterilize your syringe or disinfect your syringe and other equipment with bleach.
• If possible, use sterile water to prepare drugs; otherwise, use clean water from a reliable source (such as fresh tap water).
• Use a new or disinfected container ("cooker") and a new filter ("cotton") to prepare drugs.
• Clean the injection site with a new alcohol swab prior to injection.
• Safely dispose of syringes after one use.

Drugs and Alcohol: Resources

• VA Substance Use Resources
  Information about how to get help for substance use through VA.
• Substance Abuse Treatment Facility Locator
  Sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA)
• Information Page on Alcohol and HIV
  Information on short- and long-term effects of drinking, with specific information on people who are HIV positive. AIDSmap.
• Rethinking Drinking
  Research-based information on alcohol and health, with tools for evaluating drinking habits, and tips for cutting back or quitting. National Institute on Alcohol Abuse and Alcoholism.
• Harm Reduction Coalition
  Resources for accessing clean syringes, naloxone and additional tools for harm reduction.