Information on Substance Abuse Treatment for Addicts with HIV/AIDS

Created On Thursday, 07, June 2018
Modified On Friday, 17, September 2021

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Someone abusing drugs or alcohol is at risk of contracting HIV or AIDS, and there are many reasons for this. Intravenous drug use and sharing needles are linked to countless infections, along with unprotected sex. However, numerous drug and alcohol treatment centers across the nation are equipped to offer treatment resources for patients with HIV or AIDS. The most common way most drug users become affected with HIV or AIDS is through intravenous drug use and sharing needles. However, others become infected through high-risk sexual intercourse while under the influence of drugs or alcohol.

Abusing drugs or alcohol can, directly and indirectly, increase the risk of becoming infected with HIV or AIDS. Most of the new HIV cases recorded each year within the United States are a result of intravenous drug use. Also, many other cases are linked to high-risk behavior under the influence of drugs or alcohol. When searching for a drug or alcohol treatment program when struggling with addiction and HIV or AIDS, the program should have the proper medical support and offer the necessary treatment methods. Across the United States are effective drug and alcohol treatment centers for HIV and AIDS patients. Many of these programs are designed in such a way that they will be administered along with antiretroviral therapy to treat HIV and AIDS.

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Someone who is abusing drugs and is infected with HIV or AIDS increases their risk of contracting other infections, especially with intravenous drug use. Like any other addiction, the rehabilitation process begins with detox and would follow with a residential rehabilitation center. The detox process should have the proper medical support to manage withdrawal symptoms, and the treatment facility should also have medical support when needed. The treatment process is essential because an addiction becomes worse without. Someone infected with HIV/AIDS increases their risk of sudden death. The risk is heightened and accompanied by the risk of other complications.

Drug users with HIV/AIDS have a compromised immune system, which means the common cold or the flu increases the risk. A weakened immune system also increases the risk of contracting other infections like hepatitis or pneumonia. Additionally, many HIV and AIDS patients adhere to a strict regiment of prescription drugs to combat the effects of the illness. Abusing drugs or alcohol makes it difficult for these medications to work and removes the benefit of taking them. Most addicts also struggle with higher rates of anxiety and depression, and patients with HIV/AIDS experience this much more, which is why proper rehabilitation is crucial. Addicts can access inpatient or outpatient services, offering varying modalities of therapy and counseling.

The History of the AIDS Epidemic in the United States

Acquired immunodeficiency syndrome was first recognized in the United States by clinicians in New York, Los Angeles, and San Francisco. The first report in the medical literature that alerted the world to this new immunodeficiency syndrome appeared in June of 1981. The reports described five homosexual men, followed by another report of 26 homosexual men from New York and San Francisco. Other reports followed, noting a similar syndrome among injection drug users—all of these individuals shared a profound immunodeficiency. Further reports released by the Centers for Disease Control reported infections in other states among Haitians, none of whom reported homosexual behavior. The first case in a transfusion was recorded in San Francisco in an infant in 1982.

Among the first cases of AIDS, cases involving sexual relations and injection drug user suggested an agent that was both bloodborne and sexually transmitted. Early speculation suggested that all the patients were immunosuppressed because they had a history of drug use, sexually transmitted diseases, and malnutrition, per the Epidemiology of HIV/AIDS in the United States. Most research during the early stages of discovering the virus in the United States thought it was sexually transmitted. However, per the report, HIV was first isolated in France in 1983, and HIV was eventually identified as the virus that causes AIDS.

Between 1981 and 1996, the AIDS epidemic grew in the United States—by the fall of 1981, more than 100 AIDS cases had been reported by the Centers Disease Control. In 1983, 1000, cases were reported, and this continued to grow throughout that year. By the late 1980s, cases had been reported from every state. The cumulative total through December 2001 was over 800,000. According to the National Institute on Drug Abuse, more than 1.2 million people in the United States are living with HIV.

When is the Best Time to Consider Substance Abuse Treatment with HIV and AIDS?

According to the same National Institute on Drug Abuse report mentioned earlier, since the 1980s, drug use and HIV have been linked together. Unfortunately, today illicit drug use is an important driver of HIV across the globe. Intravenous drug use continues to be the largest risk factor for transmission of the virus. In 2015, approximately six percent of HIV diagnoses were due to intravenous drug use. Across the United States, drug use plays a major role in the spread of HIV. The intoxicating effects of most drugs alter judgment and inhibition, leading to people engaging in risky behaviors. Drug and alcohol use also hastens the progression of HIV and its consequences, especially within the brain, per the National Institute on Drug Use. When someone is addicted to drugs and is affected by HIV, they must seek treatment immediately.

Much of the research indicates that drug use and addiction increases the viral load, accelerates disease progression, and worsens AIDS-related mortality. Unfortunately, addicts are also less likely to take HIV medication regularly, which also worsens the illness. Drugs also make it easier for HIV to enter the brain and trigger an immune response and release of neurotoxins. However, people with HIV are living longer due to effective treatments, but substance abuse and addiction make it difficult to maintain a healthy life. Drug and alcohol treatment programs provide effective resources to help addicts, treat the addiction, and begin to regain their physical and psychological health.

Noticing the signs of addiction is essential for a family, especially if they know their loved one has HIV. It is at this point where early intervention is important and offer substance use treatment. There is no bad time to get someone help who is struggling with addiction. Unfortunately, there is still a stigma attached to addiction and HIV, which makes it difficult for many addicts to ask for help and attend a treatment center. When friends and family begin to notice the signs of addiction, it is at that point to intervene. If the individual is not willing to accept treatment, a family intervention with the help of an interventionist is the most effective approach.

How are Drug Rehabilitation Programs Designed to Help Persons with HIV and AIDS?

Alcohol and other drugs can affect a person's judgment, which increases the risk of getting or transmitting HIV. Unfortunately, much of the HIV transmitted today is through intravenous drug use and lapsed judgment. However, some populations are at disproportionate risk for substance abuse and HIV. Also, social and structural factors make it difficult to prevent HIV among people who abuse drugs and alcohol. Substance abuse disorders are closely associated with HIV and other diseases. Many of the drug and alcohol rehabilitation programs across the United States are designed to help patients with HIV. People living with HIV, substance use hastens the progression of the disease and affects adherence to antiretroviral therapy.

According to the Centers for Disease Control and Prevention, there are a number of behavioral, structural, and environmental factors, making it difficult to control the spread of HIV among people who abuse drugs or alcohol. However, drug rehabilitation programs are there to address these issues, helping a patient with HIV become rehabilitated and improve the quality of life. Rehabilitation centers will address the complex health and social needs of someone who is dependent on drugs or alcohol. Many people who are abusing drugs struggle with unemployment, family problems, financial issues, and even homelessness.

The rehabilitation process will also help the patient address any stigma or discrimination they face surrounding substance use and being infected with HIV. Often times, illicit drug use is viewed as criminal behavior, and many addicts struggle with feelings of guilt and low self-esteem. Many of these issues often prevent people from remaining in treatment, which is why the program should offer effective counseling and support. Rehabilitation programs should offer proper care and access to appropriate health care. HIV testing involves questioning about use histories, and many people who abuse drugs feel uncomfortable getting tested.

Additionally, treatment programs ensure patients adhere to their HIV treatment. Someone abusing drugs or alcohol is less likely to take antiretroviral therapy due to the side effects of a drug interaction. Not taking the medication worsens the effects of HIV and increases the likelihood of spreading it to other people.

Injection Drug Use and HIV Risk

When drug users begin sharing needles, syringes, or any form of drug injection equipment, everyone involved is at risk of getting or transmitting HIV and other infections. The risk of getting or transmitting HIV is high when sharing needles and other injection equipment. The needles have blood in them, and the blood caries HIV—HIV can survive in a used syringe for up to 42 days, depending on the temperature and other factors, per the Centers for Disease Control.

People struggling with addiction increase their risk of contracting HIV through sex. Risk behavior is a common problem when under the influence of drugs or alcohol. Every time an HIV-negative person uses a needle that has been used by a person infected by HIV, there is a 1 in 160 chance of contracting HIV. Per the CDC, sharing syringes is the second riskiest behavior of getting HIV. Along with HIV, injection drug users are at risk of skin infections and viral hepatitis. The best way or reducing the risk of getting or transmitting HIV due to substance abuse is receiving addiction treatment. Unfortunately, people who continue to inject drugs contract HIV.

Substance Abuse Treatment Options for Persons with HIV and AIDS

Substance abuse treatment is the best option for someone addicted to drugs or alcohol who has HIV. According to the National Institute on Drug Abuse, behavioral treatments such as cognitive therapy and motivational interviewing not only reduce drug use but improves adherence to ART (antiretroviral therapy) regimes. Pre-exposure prophylaxis is also an important component of HIV prevention. The approach is used for people who are at significant risk but not infected with HIV. Individuals take a daily oral dose of medication to prevent them from contracting the virus. There is also the Seek, Test, Treat, and Retain Model of care, which is designed to address new HIV infections.

The approach involves reaching out to high-risk hard-to-reach drug users who have not been tested for HIV. The process helps provide testing, treatment, and opportunities to attend a drug or alcohol treatment program. According to an article published in Behavioral Medicine—Substance Abuse Treatment in Persons with HIV/AIDS: Challenges in Managing Triple Diagnosis. "Substance use and abuse are common among HIV positive individuals, with nearly 50% of persons living with HIV/AIDS reporting current or past histories of drug or alcohol disorders".

Unfortunately, persons with HIV/AIDS underutilize rehabilitation services. Integrated care such as substance abuse treatment is important in identifying and monitoring patients in high-risk populations, such as drug users. According to the article mentioned above, approximately 8% of those infected with HIV are heavy drinkers, and 30 to 40% are injection drug users. Substance abuse treatment is essential and is the best solution to help someone infected with HIV who is struggling with drug addiction.

Common Terminology Surrounding Drug Rehab for Persons with HIV and AIDS

Term Definition
HIV human immunodeficiency virus is a virus that attacks cells that help the body fight infection. The virus makes a person more vulnerable to infectious diseases. Drug and alcohol addiction does increase the risk of HIV infection.
AIDS acquired immunodeficiency syndrome is a chronic, potentially life-threatening condition caused by the HIV virus. HIV interferes with the body's ability to fight infection and disease.
ART (antiretroviral therapy) is the treatment that suppresses or stops a retrovirus like HIV. Substance abuse and addiction interfere with antiretroviral therapy.
Intravenous Drug Use IV drug use is the injection of chemicals into the body via a hypodermic needle into a vein. Intravenous drug use increases the risk of HIV infection.
Triple Diagnosis HIV is similar to a dual diagnosis or co-occurring disorder; a patient is diagnosed with substance abuse, HIV, and mental health issues.
HIV Transmission the transfer or spread of disease from person to person. HIV is spread by having sex or sharing injection drug equipment such as needles.
HIV Medication HIV treatment involves taking medication that slows the progression of the virus. The combination of drugs used to treat HIV is called antiretroviral therapy, which is important for someone in recovery and treatment to take.
HIV-Induced Inflammation People infected with HIV have a high risk of various health problems associated with aging. HIV gives rise to chronic inflammation, as the virus leads to dysregulation of the immune system, which further fuels the inflammation.

CONTRIBUTORS TO THIS ARTICLE

Marcel Gemme, DATS - Author

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Marcel Gemme has been helping people struggling with addiction for over 19 years. He first started as an intake counselor for a drug rehabilitation center in 2000. During his 5 years as an intake counselor, he helped many addicts get the treatment they needed. He also dealt with the families and friends of those people; he saw first-hand how much strain addiction puts on a family and how it can tear relationships apart. With drug and alcohol problems constantly on the rise in the United States and Canada, he decided to use the Internet as a way to educate and help many more people in both those countries. This was 15 years ago. Since then, Marcel has built two of the largest websites in the U.S. and Canada which reach and help millions of people each year. He is an author and a leader in the field of drug and alcohol addiction. His main focus is threefold: education, prevention and rehabilitation. To this day, he still strives to be at the forefront of technology in order to help more and more people. He is a Licensed Drug and Alcohol Treatment Specialist graduate with Honours of Stratford Career Institute. Marcel has also received a certificate from Harvard for completing a course entitled The Opioid Crisis in America and a certificate from The University of Adelaide for completing a course entitled AddictionX: Managing Addiction: A Framework for Succesful Treatment.


Michael Leach, CCMA - Medically Reviewed on September 17, 2021

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Michael Leach is a Certified Clinical Medical Assistant, who has over 5 years of experience working in the field of addiction. He spent his career working under the board-certified Addictionologist Dr. Rohit Adi. His experience includes working with families during their loved one’s stay in treatment, helping those with substance abuse issues find treatment, and teaching life skills to patients in a recovery atmosphere. Though he has worked in many different areas of rehabilitation, the majority of his time was spent working one on one with patients who were actively withdrawing from drugs. Withdrawal and the fear of going through it is one biggest reason why an addict continues to use and can be the most difficult part of the rehabilitation process. His experience in the withdrawal atmosphere has taught him that regardless of what approach a person takes to get off drugs, there are always mental and emotional obstacles that need to be overcome. He believes having someone there to help a person through these obstacles can make all the difference during the withdrawal process.