This gives us two ratings, a relative harm rating, and an active to lethal dose rating. Then, I used the recreated harm to dependency graph to get a rough number for how high of a dependence rating the different drugs have. Next, I took the relative harm and the active lethal dose, plotted them on an imaginary graph and calculated all of their hypotenuses. Now we can plot our dependence and total damage numbers to get a more accurate graph for assessing risk among drugs.
And another one similar to our first graph, with the bubbles representing their relative placement. And by using those, we can create a more rational mental model for assessing just bad each drug really is relative to others. Alcohol and tobacco are squarely in the middle of the graph. Whether or not a substance is legal for recreational use is not a good indicator of its safety. An overdose will. You could have a bit of weed to relax after dinner, have a cigarette after sex, take some mushrooms and go hiking, do a bit of cocaine before a party, take amphetamine before working adderall.
These are all essentially the same thing.
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Some are slightly more damaging than others, but everything can be done at a low dose, except heroin and maybe meth. But the chances of that happening are higher with alcohol than just about anything else. Why not? I think alcohol is more dangerous than we give it credit for, but that we also need to chill out about practically everything else. The most important takeaway, though, is that drug risk is not black and white. The same seems to be true for many of the drugs that we talk about being terrible, scary things. Should you do any drug, including alcohol, daily?
How Dangerous Are Drugs, Really?
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I also include new articles, book notes, and podcast episodes. How Dangerous Are Drugs, Really? By Nat Eliason in Health. You Might Also Like Negative Exercise Might be Killing You. Wohl explained that people most commonly miss antiretroviral medication doses because of events in their life that cause chaos or get in the way of pill-taking. Asking for help with adherence earns you cred and lets [your] provider find ways to help.
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Your provider is there to help, and wants to see you do well. Wohl said that providers can also provide medications that are less likely to lead to drug-resistant HIV. Genotype tests look for drug resistance mutations in relevant genes of the virus.
Most genotype tests involve looking at the reverse transcriptase RT , protease PR , and integrase IN genes to see whether there are mutations that are known to be associated with drug resistance. Because these genes are essential for HIV to take over cells and replicate, these are the same genes that the different classes of drugs take action against to stop HIV from replicating. This test is typically done in individuals who have been on treatment and who have more complicated drug resistance patterns.
Genotype testing should be done for all people living with HIV before they start treatment. However, in some special cases, such as for pregnant women or people with very recent HIV infection, treatment should not be delayed while waiting for resistance testing results; treatment regimens can be changed once results come back. The U. Your doctor should already know to give you a test before choosing a regimen, but if not, you should ask for it. This may be just a viral load blip , and continuing to take your HIV medications will bring your viral load back to undetectable. You and your HIV provider will make a decision based on your viral load and specific case.
If you develop drug resistance, Wohl advised taking the time to figure out if something went wrong, and to try to keep it from happening again.
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Did drug supplies run out? If missing doses was the issue, it can be difficult to change the things that made it hard to take meds every day. Fortunately, multi-drug resistance is uncommon, said Wohl.
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That means the resistant virus may still be affected by a med, just not as much. Combining meds with partial activity can work. Also, new drugs are still coming out that can work against drug-resistant strains.
Why quit drugs?
If a regimen can be constructed with two or more active drugs, then viral suppression is likely—though adherence to the next round of treatment is perhaps even more critical than before. But what about some of the worst-case scenarios? Is there still hope if you exhaust most or all of the treatment options? Warren Tong is a freelance health and science journalist, with an extensive background writing about HIV and hepatitis C. Skip to content. December 4, Reading Time: 9 minutes.
Creating a Better Assessment of Drug Harm
Warren Tong. Follow Warren on Twitter: warrentong. Related Stories. Research Treatment. What do people think of long-acting HIV meds?