Special Considerations and Clinical Management of HIV in Patients With Substance Use Disorder

  • Author: Frederick L. Altice, MD (More Info)
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 2/5/20 (What's New)


  • Illicit drugs most closely associated with HIV infection globally are heroin and cocaine, although methamphetamine use is an evolving problem[Colfax 2010; Degenhardt 2013; Atluri 2016; Degenhardt 2017]
  • Heroin
    • Heroin is a short-acting, semisynthetic opioid that may be smoked, inhaled, or injected
    • Peak heroin euphoria begins shortly after injection and lasts approximately 1 hour, followed by 1-4 hours of sedation; withdrawal symptoms commence several hours later
    Illicit Fentanyl
        Club Drugs
            3,4 Methylenedioxymethamphetamine (Ecstasy)
                Gamma Hydroxybutyrate
                  Flunitrazepam (Roofies)
                    D-Lysergic Acid Diethylamide (LSD or Acid)

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