Data from this study may be flawed, however, as a methadone dose of 5 grams, about one tenth of the standard dose, was used in the study. More studies of specific interactions are necessary, as the nature of specific interactions cannot be anticipated or presumed. Dr. Richard Gold spoke briefly about the issues of adherence and barriers to care for substance users. As an introduction, he made several comments about specific recreational drugs, and suggested Drugs in Partyland, a brochure produced by GMHC, as a resource for anecdotal evidence regarding drug interactions. On autopsy, blood levels of ecstasy were discovered to be ten times higher than they would have been without Norvir present.
Recreational drugs can also affect the virus directly.
It has been shown that HIV replicates twenty times faster in the presence of cocaine than without it. In his practice, Dr. Gold usually divides drug users into two categories, and has different treatment priorities for each group. Dr. Gold views HIV infection as secondary to drug addiction, and believes that the treatment of HIV is feasible, especially with regards to adherence, only after substance abuse issues have been addressed. Effective education can lead to better adherence. Interestingly, most of the literature is at least twenty years old and often conflicting reports can be found, occasionally by the same author.