Approximately 128 people in the United States die every day as a result of overdosing on opioids, according to the National Institute on Drug Abuse (NIDA). Compounding the problem? That contaminated injection drug equipment remains the primary driver of the world’s HIV/AIDS epidemic. In other words, people who inject drugs and share needles are not only more likely to suffer from addiction but are also more susceptible to life-threatening viruses like HIV. And while there are treatments for both opioid addiction and HIV, the situation is complicated by potential pharmacological interactions between medications.
Here’s a closer look at treatments for opioid addiction and HIV, possible interactions, and the role played by integrated care in supporting the journey to recovery.
Treatments for Opioid Addiction and HIV
Methadone and buprenorphine are drugs commonly used for the treatment of opioid dependence. When integrated into a medication-assisted treatment (MAT) plan, they have significantly improved treatment prospects and can lead to beneficial outcomes for many people struggling with opioid addiction.
On a similar note, advancements in HIV therapy have significantly altered the clinical course of HIV with researchers more hopeful than ever about the prospects of a cure.
Furthermore, researchers have determined there to be a link between methadone and buprenorphine treatment and reduced risk behaviors, including reductions in both injection drug use and needle sharing.
Because of the vast potential of both MAT and HIV therapy, efforts are underway to expand access to both. However, there are challenges here, too — specifically, harmful interactions between MAT and antiviral therapies, according to “A Review of Pharmacological Interactions Between HIV or HCV Medications and Opioid Agonist Therapy: Implications and Management for Clinical Practice” published in the Expert Review of Clinical Pharmacology.
MAT and Antiviral Therapies: Pharmacological Interactions
A drug interaction occurs when one medication changes the effect of another medication. In some cases, these changes are negligible; in other cases, they can lead to problems.
According to NIDA, “There are several known interactions between medications used to treat HIV or HCV and both methadone and buprenorphine.” For example, some antiretrovirals used in the treatment of HIV may lead to decreased methadone effects. In this case, monitoring for signs and symptoms of methadone withdrawal is critical as some patients may require an increased dose of methadone and/or a revision of the treatment plan. This can be especially vital for patients who are concerned that antivirals will interfere with their methadone treatment.
The converse can also be true: Methadone may also decrease the effects of HIV medications, or lead to elevated blood levels or other complications. Again, adjusting the dosages of medications can facilitate optimal therapy.
The conclusion, according to researchers in the Expert Review of Clinical Pharmacology piece? “It is of paramount importance for the medical provider to remain alert to the possibility of a drug-drug interaction even when current existing data may not support such an interaction.”
What not to do meanwhile? “There is no need to supplement methadone with heroin, stop antiretroviral medication, or stop other HIV-related medications. Stopping or missing doses of antiretroviral medications can lead to ineffective treatment and/or the development of resistance,” contend Barb Falkner, B.Sc. (Pharm.) and Bradley Kosel, Pharm.D. in “Methadone and HIV Medications: Drug Interactions.”
While doctors and researchers are always pushing the boundaries of modern knowledge regarding treatments for opioid addiction and HIV, most agree that there is tremendous dual therapeutic potential. At the same time, interactions between medications can lead to complications. The more people are aware of the possibility of interactions, the better prepared they’ll be to recognize them. Furthermore, undergoing treatment under the guidance of a trained healthcare team can support a proactive approach to minimizing interactions and maximizing optimal outcomes.
Harris House has been providing individualized substance abuse treatment in the St. Louis area for more than 50 years. If you or someone you love need LGBTQ addiction treatment or another targeted treatment plan, call us today to learn about admissions.