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Recreational abuse of ARVs

The Treatment Advocacy and Literacy Campaign national director Felix Mwanza says they are disturbed and saddened with the news that ARVs are being abused by drug addicts.

“As we look forward to further information regarding this matter (as reported by a psychiatric doctor at the Chainama Hospital in Lusaka), we would like to ask the Ministry of Health to further investigate this issue. Suffice to mention however, that, ARVs abuse in the manner reported by the psychiatric doctor is not uncommon especially here in Southern Africa,” says Mwanza.

Antiretrovirals have been increasingly reported among medications diverted to the black market, and have been categorised as emerging drugs of abuse.

Antiretrovirals have drastically reduced morbidity and mortality associated with HIV and AIDS. Increase in the global access to ARV medication, particularly within the past decade, has led to tremendous progress in stemming the HIV/AIDS pandemic. In recent years, however, there have been emerging reports that ARVs are being diverted and used both as recreational drugs – alone or in combination with other substances – and as unmonitored treatment for HIV infection. Although most epidemiologic surveillance of prescription drug misuse focuses on medications with clearly understood abuse potential, such as opioid analgesics, stimulants, and sedatives, many medications affecting neural systems, including ARVs, have been identified as additional culprits for misuse.
The emergence of ARV abuse adds complex public health challenges to the existing landscape of HIV/AIDS treatment, addiction medicine, and psychiatry.

The truth is that our health system is extremely corrupt. Kickbacks are being obtained at all levels. And drugs are being stolen by all and sundry.

Today, we have many people in this country addicted to morphine and pathedine – drugs that are supposed to be highly restricted and protected. How do they easily find their way to the open markets?

More work is needed to demystify the nature and scope of ARV abuse potential. Surveillance is warranted to establish the extent of antiretroviral diversion and misuse and characterise those who are most at risk for misusing these medications. Abuse liability testing in the laboratory is needed to illuminate the euphorigenic effects of ARVs among drug users and further understand the emerging problem of ARV misuse. Psychosocial and health-disparity-related ARV diversion is fuelling a significant component of the ARV black market and might be inflating off-label ARV use, contributing to risks of developing resistant HIV strains. Psychosocial factors and health disparities are known enemies in the fight against HIV, and they are amenable to existing interventions. It may be necessary to direct resources toward the most effective of these known interventions to significantly diminish the black market trade in ARVs and stem the serious consequences of off-label ARV use.

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