HIV/AIDS Skepticism

Pointing to evidence that HIV is not the necessary and sufficient cause of AIDS

Golden Fleece Award II: MENTAL ILLNESS MAY BE DISABLING

Posted by Henry Bauer on 2008/06/23

Mental illness and substance use delay HIV treatment” [March 18, 2008]

“People with untreated mental illness or substance abuse, or both together, start HIV treatment later than people without mental illness or substance abuse, according to a study published in the March 1 issue of AIDS Patient Care and STDs. People who are receiving drug treatment for a mental illness, however, do not delay starting HIV treatment. . . . Given that rates of mental illness and substance abuse are more common in people living with HIV, and that these conditions have been found to interfere with adherence to HIV treatment, Mary Tegger, P.A.-C, MPH, and her colleagues from the University of Washington in Seattle set out to determine whether these conditions may also delay the start of antiretroviral therapy.”

Did they take any bets beforehand, as to what the study would find?

Among “all HIV-positive patients receiving primary care at the university’s Harborview Medical Center HIV Clinic during 2004 . . . . Of the 1,744 patients included in the study, 63 percent were found to have a mental illness, 45 percent had a substance use disorder and 38 percent had both. Alcohol was the most commonly abused substance, followed by cocaine and amphetamine. Depression and anxiety were the most commonly diagnosed mental illnesses.”

“Tegger’s team theorizes that there are multiple reasons for the delay in antiretroviral treatment observed in people with mental illness and substance abuse disorders. The team proposes that such individuals are less willing, on average, to comply with treatment recommendations, such as starting antiretroviral treatment.”

On the other hand, any sane and sober person reading the official treatment guidelines might well be inclined to delay treatment forever — see also DEATH, ANTIRETROVIRAL DRUGS, and COGNITIVE DISSONANCE, 9 May 2008; TO AVOID HIV LATER, DAMAGE YOUR KIDNEYS AND LIVER NOW, 19 January 2008; HISTORY OF AZT, 1 January 2008; FIRST: DO NO HARM!, 19 December 2007; WHAT HIV DRUGS DO, 15 December 2007; OFFICIAL GUIDELINES FOR HIV TREATMENT, 14 December 2007; ANTIRETROVIRAL DRUGS: HISTORY AND RHETORIC, 12 DECEMBER 2007; BEST TREATMENT FOR HIV: THIS YEAR’S ADVICE, LAST YEAR’S, OR NEXT YEAR’S?, 10 December 2007.

——————–

Preview:

I’m working on several posts that call for much reading, and I’m away this week at the meeting of the Society for Scientific Exploration, presenting the data that show lack of benefit from antiretroviral drugs and absence of “latent period”, see “HIV DISEASE” IS NOT AN ILLNESS, 19 March 2008. Then I’ll get back to working on a deconstruction of the claim that treatments for AIDS have saved at least 3 million years of life; see Anthony S. Fauci, “Twenty-five years of HIV/AIDS”, Manila Times 29 May 2007, relying on Walensky et al., Journal of Infectious Diseases 194 [2006] 11-19; mentioned, unsurprisingly enough, among the News Items on the website of Fauci’s Institute.

8 Responses to “Golden Fleece Award II: MENTAL ILLNESS MAY BE DISABLING”

  1. Martin said

    “Mental Illness”, what a quagmire. If you refuse to take an HIV antibody test, you’re mentally ill. If you refuse to take your meds (poisons), you’re mentally ill. If you’re anxious and unhappy because of your “positive” status, you’re mentally ill. “Substance abuse” and “alcoholism” are both listed as mental disorders (illnesses) in the DSM (Diagnostic and Statistical Manual of Mental Disorders). Funny how the quacks differentiate one “mental illness” (disapproved behavior) from another.

  2. CathyVM said

    The quacks won’t be happy until every human experience is classified as mental disease – some gems from the DSM-IV-TR
    Caffeine-related disorder
    Sexual aversion disorder
    Parasomnias (Yikes – that makes me mentally ill!)
    Parent-child relational problem (every parent of an adolescent must be mentally ill)
    NON-COMPLIANCE WITH TREATMENT (V15.81)
    Phase of life problem

    Imagine what the DSM-V is going to look like? Actually this stuff really is not funny; it’s just another dark facet of social control. We could all be locked up in a mental facility and put in a chemical straitjacket for refusing to believe HIV = AIDS.

  3. Frank said

    The New York Times today has an interesting article on overmedication:

    Doctors Say Medication Is Overused in Dementia

    Ramona Lamascola thought she was losing her 88-year-old mother to dementia. Instead, she was losing her to overmedication…

    …Some doctors point out that simply paying attention to a nursing home patient can ease dementia symptoms. They note that in randomized trials of antipsychotic drugs for dementia, 30 to 60 percent of patients in the placebo groups improved.

    “That’s mind boggling,” Dr. Jeste said. “These severely demented patients are not responding to the power of suggestion. They’re responding to the attention they get when they participate in a clinical trial.

    “They receive both T.L.C. and good general medical and humane care, which they did not receive until now. That’s a sad commentary on the way we treat dementia patients.”

  4. Michael said

    I’m a 35 y/o male who tested positive when I was 26. According to testing done at the time my T-cell count was 76, so I was not just HIV positive but already had AIDS.
    This was a huge shock. I had been in a relationship since I was 21. I tested negative 2 years into the relationship. There were 3 occasions where I had unprotected sex with my partner over those years. I was also in incredibly good physical shape. I ran marathons, had boundless energy, was muscular and the only physical problem I had was a prostate infection a year prior which was treated with Cipro.
    I waited more than a year from the time I was given this news before I began treatment for HIV. I was still healthy, physically, during this year but psychologically a decline began.
    I hid my diagnosis from my friends. My attitude toward life began to change. “Why pay my bills ? I’ll be dead soon”. In general long-term goals seemed ridiculous. My relationship ended. I turned from a spontaneous, fun, loving, generous person to someone who began building “walls” around myself. “Conserving” my energy and sabotaging my friendships. The beginnings of isolation were just taking hold. I began to feel pain, in my neck, back, legs.
    At the time I didn’t have the perspective I have now. In my mind this pain was AIDS.
    I did not use “poppers”, party drugs, divert to unprotected risky sex (the last thing I wanted was to share my body with other people) or any of those alternative reasons for immune system breakdown.
    I went to a general practice physician however, who prescribed LARGE quantities of Vicodin for the pain I was feeling. When a friend I confided in was concerned about my severe personality changes every couple of hours while on Vicodin, went with me to a Dr. visit was told by the physician (I told the physician my friend was a family member and could speak freely to them and I would like the friend to be allowed in for my visit) that she treated her AIDS patients as she did her dying, cancer patients, “with medications to keep them comfortable” I felt justified in my by-then physical addiction to Vicodin and had further psychological assault by those haunting words.
    Having now experienced “severe” pain I can assure you that the pain I had at that time was most likely stress-induced and by no means “severe”. The pain of “withdrawal” from vicodin I began to experience in a matter of hours, as I became tolerant to the drug left me in agony however. I would set my alarm in the morning an hour before having to get out of bed so I could take a vicodin in order to be able to get out of bed.
    I faced the fact that this was not my AIDS acting up but that I was addicted to Vicodin. I attempted withdrawal 3 times unsuccessfully. I switched physicians and was given a new, miracle pain drug, that was non-addictive to ease my way off of Vicodin. The drug was Tramadol. I was given a huge sack of free samples. I did get off of Vicodin. Tramadol was great! It even eliminated the social anxiety I had began to experience.
    I believed the tramadol was non-addictive. I was working 40-60 hours a week through all of this, by the way. On tramadol I began my workout regimen again. My personality changes subsided. I got into the best physical shape of my life, my social life improved and I even began dating again. I didn’t have sex, however, unless I felt there was potential for a relationship and I gained the trust to 1st disclose my status. This was painful psychologically in many respects, revealing that behind the beautiful, happy facade was a dirty, disease-ravaged, dying, monster. Immediate rejection wasn’t the result I got, instead often safe sex would ensue followed by a “talk” shortly after that about becoming attached to someone who was dying wasn’t something that they could cope with. Keep in mind that I had still not started antiretrovirals and my “dying symptoms” were not thrush, PCP pneumonia, Kaposi sarcoma (never have had any of these, BTW) but was the repeated psychological insult and the symptoms involved with opiate addiction. I really wish I could have seen things from that perspective at the time.
    I decided to start HIV therapy on January 1st, 2000. I took vacation time for a week in case I had some side effects I’d need to adjust to. I was given AZT, epivir and zerit. I was healthy, had a wonderful New Year’s Eve party and began the regimen the next day.
    From day 1, I threw up everything, including water, I couldn’t get out of bed aside from when I crawled to the bathroom to throw up. I had never been bed-ridden. I extended my vacation and tried to keep taking the medication in hopes I’d adjust. I was given Compazine suppositories after the 5th day to control the nausea. What a nightmare! I’m one of those people who have reactions to drugs like compazine, reglan, phenerghan, etc., that included uncontrolled muscle spasms, my legs kicked in quick succession, my body twisted, I felt as if I were dying. The compazine took 3 days to get out of my system and in the meantime I had 3 ER visits to get shots of benadryl, adrenaline and lorazepam. The shots lasted several hours and I took oral benadryl at home but the kicking would return, I guess when the lorazepam wore off.
    After 2 weeks I stopped the regimen. I had to work and the medication that was suppose to help me left me 22 pounds lighter (in 2 weeks), bed-ridden in pain and the closest to what resembled AIDS I had experienced. It made no sense. I was traumatized, confused and to say the least felt like a psych. patient.
    I recovered quickly when I stopped the meds and waited 6 months before I began a regimen that didn’t include AZT that I could tolerate. The bag-fulls of tramadol samples became sparse and I realized that Tramadol is ADDICTIVE. I checked myself into a rehab center to get off the tramadol. I was flat, unsocial and felt as if life were all unreal for about 6 months after the initial horrific withdrawal from tramadol.
    I was given what I was told was an anti-seizure medication to help with those symptoms and my increased anxiety — Klonopin. I have been on Klonopin for many years now and have had increased symptoms of social isolation, I don’t answer the phone, I have agorophobia. It worked well for a couple of years at 1 mg a day. However after having endured neuropathy for several years which subsided after I got off of zerit (fortunately), then having everything go down-hill after being started on the PI Reyataz and Norvir and in short order developing enlarged lymph-nodes, which came and went. Then being sent to a surgeon who excised a golf-ball-sized lymph-node on my neck and being told I had Hodgkins disease, the Klonopin was increased. I had debilitating chemotherapy for 3 months, asked for a CT scan and was told I would need a minimum of 6 months of chemo, was hospitalized for sepsis among other issues related to chemo. I quit. I stopped taking HIV meds, waited 6 months, went to a new oncologist and was told I had no tumors (although at the time of diagnosis I had them, including a 14 cm tumor next to my liver, from my neck to my groin). A year later I was still clear.
    The chemo caused long-term effects including extreme fatigue, heart-valve issues, and in the meantime my klonopin was increased to 6 mg a day. I have definite issues with speech, remembering things, depression, anxiety, complete social isolation which I know comes from several different sources. One being that I have driven myself nuts trying to understand how medications work, the controversy of treatment or not for HIV, sorting out what is and is not caused by HIV, dealing with the fact that people treat you as a radical nut if you listen to your own body and stop taking medications that you know are killing you, trying to find a physician that is willing to really look at you (the patient) wholistically. Dealing with the fact that although I have printed paper after paper citing the fact the Kloopin can act paradoxically over long-term use and increase in dosage results in increased anxiety, depression, social isolation, agoraphobia far worse than original symptoms and the difficulty in safely helping the patient detox. Being dependent on the physician to prescribe the Klonopin who also insist that you take HIV meds that cause physical symptoms including my deformed face and body, increase in lymph-nodes which go down shortly after stopping the meds, bone and muscle pain. Yes, I can assure you I am CRAZY. I am desperate, alone, angry, distrusting, paranoid, if you like. I unfortunately am too self-aware, am intelligent, can look at the whole picture instead of the insignificant pieces, but have much more time where I can’t express any of the ideas I have expressed here and even so people are not solution oriented. I am NOT a conspiracy theorist, there is NOT ONE SINGLE EVIL ENTITY out to kill everyone and make all the WORLD’S MONEY. That viewpoint is as ridiculous and stupid as the view point that everyone is good-willed and wants to help. It’s not Black and WHITE.
    WHY CAN’T ANYONE USE THEIR ENERGY, TIME, INTELLIGENCE and VOICE to look at more than the problem with all of it’s complexities but also the solutions in all of their complexities? Let me reassure you MENTAL ILLNESS IS DISABLING!

  5. Henry Bauer said

    Michael:

    I can only admire your strength in several withdrawals and trusting your own good sense. Are there any HIV support groups within geographic reach for you? Have you looked at websites like http://www.helpforhiv.com/? http://www.aliveandwell.org/, I think, suggests looking for naturopath physicians if you can’t find a mainstream physician who is reluctant to use antiretrovirals.

  6. CathyVM said

    Michael:
    I am very sorry you have experienced all these terrible things.
    I was given Klonopin by the pain clinic for neuropathic pain. It worked well for nearly 2 years (1 mg/day taken at bed-time) and allowed me to return to full-time work. Then it became a liability –– hair loss, agitation, irritability, increasing intolerance to stress (and worse). A CADS [Community Alcohol & Drugs Service] nurse I know said she thought I was experiencing withdrawal, all day and every day and that I needed to take a day-time dose. This was not an option because my job required concentration and the Klonopin made me sleepy. Instead I increased the night-time dosage to 2 mg but had a horrible psychotic reaction. I realised I was faced with the potential loss of my job and relationship if I didn’t get off the stuff. My GP switched me to 10 mg valium to make it easier to titrate downwards. I contacted a support group but found their “most people never get off benzos” doom and gloom negative and unhelpful. It took six months of feeling like absolute crap –– all I could manage was to go to work and then go to bed as soon as I got home –– to fully get off it. I’m telling you all this so you know it is possible to get off this horribly addictive medicine. The only thing I found helpful was kava kava –– it is calming and relaxing without being sedating or addictive (not supplements but the drink made in the traditional way –– you can order it online). I also react paradoxically to phenergan and other drugs in the same class but the kava kava was fine.
    If you do decide you want to get off it, I would gladly provide you with e-mail support.

  7. Michael said

    The HIV support groups I have researched so far seem to have rather singular points of view and seem more like dating/social get-togethers (which is great but not the kind of support I can deal with), but I will definitely take a look at the links.

    CathyVM, I completely agree with your assessment on the “never get off benzos camp”. I realize I have a tough road ahead of me in terms of withdrawal but the alternative is NO ROAD. I have read about switching to valium to titrate down. Did you use that in conjunction with the kava kava or did the valium not help out?

  8. CathyVM said

    Hi, Michael:
    I switched to valium first, and tapered that down to zero, but it was a struggle when I was off completely. One of the nastier effects is that the removal of the drug’s dampening of the sympathetic nervous system means it kicks back in with a vengeance once the suppression is removed. Because ,as a medical writer at the time, I was very cautious about interactions, I didn’t want the two to overlap. However, I have since discovered that the 2 or 3 liver deaths reported for kava were 1) solvent-extracted supplements and 2) people concomitantly drinking alcohol. I suspect the solvent-extraction methods used for supplements dissolve alkaloid kava-lactones that are not soluble by traditional soaking in water only. I can confirm this anecdotally; by trying two differing methods of extraction — one using BP-grade alcohol and water and the other using water only, the alcohol mix was absolutely disgusting, bitter and undrinkable, but the water only was drinkable (if not exactly lovely — I added black-currant concentrate).
    I live in an area with a high percentage of Pacific Island peoples. It is culturally a male pastime here and there is no addiction issue whatsoever. The limited literature agrees; apart from a dry-skin condition caused by massive overuse, there are no addiction or adverse effects issues (unless you count my GP relating that when she drank it in Fiji she found it difficult to walk back to her bure).
    My offer of email support stands — I have no time for naysayers who tell you how “impossible” it is. I officialy give Prof Bauer permission to provide you with my email address as long as you give an undertaking you are asking for it for these very valid reasons.

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