It's my body . . .

It is very common for people taking antiretroviral medications to believe that they should not take them whenever they use alcohol or illicit drugs. I don't know whether this is true for other categories of medications, but I suspect it is.

In fact, however, physicians do not believe that. They will definitely tell you that if you drink, you should take the pills anyway. They will still work, and as I explained a few days ago, you really don't want to miss doses. I have interviewed quite a few people who have this belief. Most of them have not discussed the matter with their doctor, perhaps because they don't want to get into a discussion about their drinking. I did a focus group, however, in which one participant said, basically, that he totally trusted his doctor, his doctor was the greatest medical genius who ever lived; but he didn't take the meds when he drank. I asked if he had discussed this with his doctor, he said yes and the doctor told him to take the pills anyway, but he did not believe that.

Why? His body just can't take that. It's too much stress on the body. Some people are specifically concerned about their liver, but for most of them it's just a general feeling that it's not a good idea to mix toxins. And they know better about this than their doctors.

I once interviewed a guy with HIV who decided not to take a prescribed nutritional supplement because he could tell that it "fed the virus." He just knew. It was more important to starve the virus than to feed himself. Another guy decided not to take the meds because it was more important to bring "order and harmony" to his life.

I'm not talking here about specific side effects -- symptoms such as nausea, diarrhea, dizziness, dry mouth, whatever it may be. It's obvious (and very common) that when people ascribe such symptoms to medications, they may decide not to take them. Which, by the way, is why doctors often don't tell their patients about possible side effects, because they fear that if they put the idea in people's minds, it will be a self-fulfilling prophecy.

I'm talking about a more abstract reasoning. "It's my body, I know what's going on inside. I just know." Personally, I don't think we really do. If you can't be very specific about what adverse effects you think the pills are having, I would say don't worry about it. On the other hand, if you can be specific, I would say by all means do not be reluctant to talk to your doctor about it and don't stand still for a dismissive response.

I'll have more to say about side effects anon.