Drug Interactions - Are patients being put at risk?

Doctors are used to providing information on the risks and side effects of the medications they prescribe, but often patients are not informed of the interactions between their prescribed medication and any recreational drugs they are taking. Greta Friedlander and Jess Bradley investigate.

According to the 2005/06 British Crime Survey, just over a third of adults admit to using illicit drugs at somepoint in their lifetime, this figure increasing when considering just young people. Despite this, pharmaceutical companies and doctors often fail to provide information on the interactions of prescription drugs with illicit recreational drugs, where it is commonplace for information to be provided on a drugs interactions with alcohol.

We spoke to one student, Anne, who has been prescribed with a low dosage of Nortriptyline, a triclyclic anti-depressant. Anne is an occasional user of recreational drugs, and had not had any negative drug experiences prior to starting on her medication. Recently she decided to take some space cakes with a few friends and discovered an unexpected interaction with Nortriptyline, which had not been explained by her GP or within the information leaflet the medication came with. Anne describes her experiences below:

“I suffered nearly 24 hours of vivid hallucinations, which were far more intense than I have previously experienced on much stronger hallucinogenic drugs. I had vivid flashbacks, synaesthesia and paranoia, none of which I have never experienced on any other drugs. I spent the entire trip being terrified, the whole world became reduced to pixels of colour and I felt like the walls were moving in to crush me. At the start of my trip I watched TV for a while and believed all of the people on screen were people who I knew and were talking directly to me. I saw my own reflection and shadow trying to murder me. I had eaten space cakes a few times before, in similar quantities, and never experienced anything like this.”

“It hadn't occurred to me that my prescription drugs might interact with cannabis, although I had been avoiding alcohol on the GP's advice. I am now angry that I was not provided the information I needed by my doctor to make an informed decision about my drug use.”

Websites such as Erowid, which act as a depository for information on the interactions between different drugs and our bodies, have been created to meet the need of providing information on drug interactions in the absence of a coherent, unbiased information service by health professionals - a service which is lacking due to the drugs legal status. Many of these websites provide "trip reports", collections of experiences from drug users, which act as useful resources even though they are anecdotal in nature.

The lack of information provided to patients on the interactions between prescribed and illicit drugs is just one of many unintentional negative consequences of the drug prohibition - and one that particularly effects the most vulnerable patients.

Follow SSDP UK on twitter and subscribe to our blog on the right.

See also: Harm Minimisation, Self-Medication and Pleasure Maximisation (video)

Canadian Drug-User Activist on Self-medication, Harm Reduction and Pleasure Maximisation

A long term drug user and now harm reduction activist, recently diagnosed with bipolar disorder, talks about the intersection of drug use and mental illness. She discusses how there is little space for dialogue on the pleasurable aspects of drug use in the mainstream harm reduction field.
Via TalkingDrugs

See Also: Mat Southwell talks about drug user activism

Sexuality and Drug Use: No place for homophobia in the ACMD

Dr Hans Christian-Raabe, the fundamentalist Christian GP who was sacked from the Advisory Council for the Misuse of Drugs (ACMD) is launching a legal bid to get his job back. The Manchester based GP was fired after the press discovered his earlier writings for a Christian health organisation advocating controversial “gay-cure” therapy and linking homosexuality with paedophilia, drug use and disease. Dr Raabe says he is a victim of liberal drug campaigners who dislike his strong views on the subject but the Home Office said he was fired because he failed to mention the controversial past work in interviews. Jess Bradley explores some of the issues around drug use, sexuality and the ACMD.

The LGBT community does indeed have a strong link to drug use; many of the “party drugs” are pioneered in the gay scene before filtering out into the wider population, LGBT people are more likely to take drugs, and much more likely to experience a problematic relationship with them than their straight/non-trans counterparts. What Dr. Christian-Raabe fails to realise are the reasons behind this link – it is not, as he would have us believe, some form of direct consequence of their sexuality or gender identity, but rather a consequence of the homophobia, biphobia and transphobia which is sadly still endemic in society.

The gay-rights charity Stonewall reports that two thirds of gay pupils in schools are subject to homophobic bullying, a figure that rises to three quarters in faith schools. Trans people are regularly denied access to essential healthcare. Homophobic, biphobic and transphobic hate crime is still a common experience, and most LGBT experience some level of street harassment. This undoubtedly takes its toll on the LGBT community - with 1 in 3 LGBT people being known to attempt suicide, and levels of self-harm and eating disorders within the community is significantly higher than the population as a whole. The link between mental health issues and drug use is well documented so it comes as no surprise that LGBT people are more likely to do drugs. Of course, not all LGBT drug use is motivated by mental health issues, but when a group is ostracised from society for breaking of norms around sexuality and gender, it seems likely that that group would also be more likely to break other social norms as well.

The appointment and subsequent firing of Christian-Raabe is just another controversy in a line of resignations since the last Labour government sacked the then chair Prof. Nutt for his criticisms of punitive drug policies. The Coalition government, in appointing the strict prohibitionist Christian-Raabe to the council, seems to be continuing the trend of treating the ACMD like a talking shop for polarised views instead of a council of academics and professionals providing evidence based analysis of drug policy. But unfortunately for us, the government will continue to treat the ACMD like a soap opera for as long as at it serves as a distraction to the fact that their own punitive policies are fundamentally failing to protect communities from the harms associated with drugs.

Hopefully, Dr. Christian-Raabe's legal challenge will be unsuccessful as his views on both homosexuality and drug policy are part of the problem not the solution, and will lead to the increasing unnecessary incarceration of LGBT people. We need to send a strong message about how prohibition disproportionately impacts on the community, and recognise the fact that the oppression of drug users and of other marginalised groups can only be meaningfully fought against if we fight together.

To find out more about our LGBT and drugs workshops, please email education[@]ssdp.org.uk Follow Students for Sensible Drugs Policy on twitter and subscribe to our blog on the right.

See also: NUS LGBT Campaign to fight against drugs stigma

NUS LGBT Campaign to fight against drugs stigma

This weekend (6-8th May), the National Union of Students' Lesbian, Gay, Bisexual and Trans (LGBT) Campaign voted to continue to work with SSDP in campaigning for specialist treatment programmes for LGBT people and against the stigmatisation of drug users. The policy, submitted by SSDP activists from the University of Manchester Students Union, also calls for LGBT awareness training for drug and alcohol counsellors.

Alan Bailey, NUS LGBT Officer (Open Place), said; "Its great that NUS LGBT and SSDP are campaigning together for LGBT specific drug and alcohol services. LGBT people, whilst more likely to use drugs, are less likely to get the help they need in a society where both drug users and LGBT people face stigma and oppression"

Last year, the NUS LGBT campaign voted to affiliate to the SSDP network and to call on the Home Office to produce an impact assessment of drug prohibition and how it effects the LGBT community.

Vicki Baars, the NUS LGBT Officer (Women's Place), said; “"Its fantastic that we have this policy to help fight against the unnecessary criminalisation of LGBT people, and for a more coherent understanding on how the war on drugs is effecting LGBT people."

To find out more about how drug use effects the LGBT community or about our workshops about drugs use aimed at LGBT societies and community groups, email education[at]ssdp.org.uk

See also: Sexuality and Drug Use: No place for homophobia in the ACMD

Follow Students for Sensible Drugs Policy on twitter and subscribe to our blog on the right.and subscribe to our blog on the right.