Substance Abuse Resources & Disability Issues

Josephine F. Wilson, D.D.S., Ph.D., Director

Substance Abuse and Living with HIV/AIDS: What You Need to Know

Sponsored By:
Substance Abuse Resources & Disability Issues (SARDI).
SARDI is funded by the National Institute on Disability and Rehabilitation Research (NIDRR)

Prevention & Support Services, AIDS Foundation Miami Valley, 937/461-AIDS


Cigarette smoke and other tobacco by-products contain thousands of chemicals that are harmful to the body including carbon monoxide, nicotine and tar. Cigarette smoke irritates and damages the throat, lungs, heart and circulatory system, and the digestive tract. Even for people not infected with the HIV virus, smoking is deadly. Tobacco is related to at least seven different types of cancer and is the leading cause of death from heart attacks and strokes. Emphysema and chronic bronchitis are almost always associated with smoking and smokers suffer from colds, infections and other illnesses more than non-smokers. In addition to these implications, smokers living with HIV need to know that smoking:

  • increases the incidences of oral complications of HIV such as candidiasis (thrush).
  • increases the likelihood of contracting PCP for people living with HIV.
  • causes smokers living with HIV to progress to symptoms twice as fast as non-smokers living with HIV.


The use of alcohol can have severe adverse effects for people living with HIV. Besides impairing judgment when used in large quantities, people living with HIV need to know that alcohol:

  • when used in moderation, significantly reduces the effectiveness of most anti-viral medications (such as AZT) by blocking absorption in the stomach
  • causes side-effects from medications for HIV by blocking metabolism in the liver.
  • contributes to weight loss for some people living with HIV by blocking normal nutrient absorption.
  • when used in large quantities, significantly increases the growth rate of the HIV virus.


Marijuana smoke contains hundreds of chemicals that are harmful to the body. All the complications caused by tobacco smoke, in particular compromises in the mouth, digestive tract, and respiratory system, also appear as a result of marijuana use. Besides impairing judgment, chronic abuse of marijuana has been associated with decreases in motivation, cognitive skills and perceptive skills. Some research studies suggest that, although not physically addictive, marijuana may be psychologically addictive. Some medications used to treat HIV may cause general malaise, loss of taste, stomach cramps, mouth sores, malabsorption and diarrhea. Some people living with HIV choose to smoke marijuana to stimulate their appetite. Healthier alternatives include:

  • Eating bland foods while avoiding your favorite foods when nauseated.
  • Taking a short walk before eating.
  • Asking your health care professional about medications that can stimulate your appetite.
  • Asking a nutritionist about nutritional supplements.

Common HIV Medications and Potential Drug Interactions

Types of drugs Why prescribed Potential drug interactions
Antibiotics Prevent/delay MAC, PCP, URIs, UTIs and other bacterial infections Alcohol, tobacco and other drugs (ATODs) can interfere with liver metabolism
Antivirals Prevent/delay Herpes, EBV, chicken pox, CMV, hairy leukoplakia ATODs can interfere with liver metabolism and stomach absorption
Antinauseas Counteract nauseating effects of other meds Masks symptoms of overdose of barbiturates, narcotics and sleeping pills
Antifungals Treat oral thrush, skin infections, and toe nail fungus Adverse reactions with alcohol consumption

CONDENSED FROM: Positively Aware, May/June 1995, p.12


  • AIDS Foundation Miami Valley Prevention & Support Services
    P.O. Box 3539, Dayton, OH 45401-3539
  • (AIDS); Fax: 937/277-7619 Substance Abuse Resources and Disability Services (SARDI)
    Wright State University School of Medicine, Dayton, OH 45401-0927
    937/259-1384; Fax: 937/259-1395
  • Family Service Association Living With AIDS Program
    184 Salem Avenue, Dayton, OH 45406
  • Ohio AIDS Hotline
  • National AIDS Hotline (24 hours)
  • Alcohol Abuse Crisis Center
  • Drug Abuse Action Help line