Whether
they’re
taking
club
drugs,
HIV
medications
or
sleeping
pills,
a
good
number
of
gay
men
fancy
themselves
as
at-home
pharmacologists.
In
smaller
doses,
drug
use
indeed
equips
a
person
with
a
certain
knowledge
of
how
a
substance
interacts
with
his
or
her
body,
said
Petros
Levounis,
director
of
the
Addiction
Institute
of
New
York.
But
the
confidence
that
comes
from
casual
drug
use
can
leave
people
unaware
of,
and
unprepared
for,
the
potentially
dangerous
ways
different
chemicals
are
processed
in
their
body
simultaneously,
Levounis
said.
“The
biggest
thing
we’re
seeing
is
the
issue
of
synergy,”
Levounis
said,
describing
instances
of
one
drug
plus
another
drug
equaling
the
effects
of
three.
“When
you
have
two
drugs
that
have
similar
results,
but
they
do
that
through
different
pathways
in
the
body,
we
have
a
much
bigger
effect
than
either
of
the
drugs
would
have
by
itself,”
said
Levounis,
who
is
also
the
chief
of
the
division
of
Addiction
Psychiatry
at
St.
Luke’s
&
Roosevelt
Hospitals
in
New
York.
The
death
of
actor
Heath
Ledger,
28,
who
reportedly
had
prescription
drug
bottles
for
sleeping
pills
and
anti-anxiety
medication
surrounding
him
when
police
found
his
body
Jan.
22,
is
a
vivid
reminder
that
chemicals
can
take
an
unexpected
toll
even
on
those
in
the
prime
of
their
life.
An
official
cause
of
death
for
the
“Brokeback
Mountain”
star
has
not
be
determined,
but
the
tragedy
renewed
discussions
about
accidental
overdoses.
“It’s
especially
important
for
people
to
really
be
honest
with
their
doctor
with
what
they’re
taking,
and
how
they’re
taking
it,”
said
Mark
Tanner,
a
physician
at
Family
Health
Care
of
Atlanta.
“Don’t
think
over-the-counter
drugs
don’t
count.
Just
because
it’s
over-the-counter
doesn’t
mean
it’s
harmless.”
For
example,
the
non-prescription
St.
John’s
Wort
is
known
for
reducing
the
metabolism
of
some
anti-HIV
drugs,
lessening
their
affect
and
putting
a
person
at
risk
for
developing
a
drug-resistant
strain
of
HIV,
Tanner
said.
HIV
medications
often
slow
or
increase
the
metabolism
of
a
variety
of
prescription
and
street
drugs,
which
may
cause
someone
to
mistakenly
compensate
their
drug
use
or
avoid
taking
HIV
meds.
Popular
party
drug
combinations
also
carry
some
risk,
like
a
string
of
deaths
in
gay
men
that
were
attributed
to
using
Viagra
and
“poppers,”
both
of
which
drop
a
person’s
blood
pressure.
“The
result
is
you
can
actually
deprive
your
brain
of
blood,”
Levounis
said.
Complications
can
also
arise
from
using
cocaine
with
ecstacy,
since
both
drugs
speed
up
a
person’s
heart
rate
but
through
different
mechanisms,
or
from
combining
cocaine
use
with
crystal
meth,
he
said.
“Especially
in
the
context
of
dehydration,”
Levounis
says
of
mixing
popular
club
drugs.
“When
you
combine
uppers
and
you
dehydrate
at
the
same
time,
you
send
your
heart
into
a
particularly
dangerous
position.”
Increasing
the
gamble
of
combining
street
drugs
is
that
sometimes
neither
dealers
nor
users
are
fully
aware
of
the
make-up
or
potency
of
pills
like
ecstacy,
Levounis
said.
“It’s
a
huge,
huge,
huge
variance
of
dosing
from
one
little
packet
to
another,”
he
said.
The
combination
of
“downers”
—
such
as
the
sleeping
and
anti-anxiety
drugs
reportedly
found
at
Ledger’s
death
scene
—
has
been
one
of
the
most
dramatic
developments
in
overdosing
in
recent
years,
Levounis
said.
Taking
prescription
drugs
like
Valium,
Xanax
or
Klonopin
alongside
other
downers
like
heroin,
methadone
or
GHB
can
depress
a
person’s
respiratory
system
to
dangerous
levels.
Alcohol
in
particular
should
be
avoided
when
using
anti-depressants
or
sleeping
medications,
while
marijuana
has
a
relatively
benign
interaction
with
most
prescription
and
street
drugs,
Levounis
said.
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