What do all drugs have in common? *
Abstinence * Addiction * Effects on behavior
INTERACTIONS
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Excessive dosages * Interactions * Personal & fetal health * Set & setting
Substances are taken concurrently for many reasons. Recreationally, users often do it to boost the effects of some or all of the drugs or to simply see what the experiences would be like together. Other times, it’s to compensate for one of them, such as when sex partners on ecstasy take Viagra as well (ecstasy itself prevents erections and orgasms for many users). What’s most common is people on some sort of medication who then, within that period, take drugs for recreation or consume something relatively casual such as a cigarette, glass of liquor, or cup of coffee. In all of these cases, interactions are occurring between the combined substances, and as with any drug combo, the interactions may increase risks or produce whole new dangers that wouldn’t exist with each of the substances by themselves.
One of the most dangerous combos currently known is GHB and alcohol. Both of these substances are dose-sensitive depressants that can produce relaxation and sociability at lower doses, but at just slightly higher doses produce dizziness, nausea, and fainting. Both GHB and alcohol also slow down breathing, which is a common cause of fatality in cases of each drug. But when combined, these same risks increase exponentially as if taking multiple dosages of just one of them. Many users taking GHB and alcohol together have died from respiratory failure. Taking different stimulants together can produce similar results where the effects strengthen more quickly than taking more of the same stimulant. This can lead to heatstroke, seizures, heart attacks, and other conditions common with taking too much of any stimulant.
In regards to ecstasy (MDMA), a lack of effects is usually reported from users who are also taking medications such as Prozac or Zolof. This is because the major class of anti-depressants called SSRIs (selective serotonin reuptake inhibitors) bind to the same receptor sites in the brain as MDMA does, and for a much longer period, thus pushing MDMA to diffuse in the synapse before having an impact on the neurons. Also, the liver enzyme CYP2D6 which breaks down ecstasy is the same enzyme that breaks down the cough suppressant DXM (dextramethorphan). Thus, when these two drugs are taken together, CYP2D6 may get overworked and cannot metabolize either of the substances as quickly as usual, leading to a possible overdose due to an intensified, prolonged experience. For the most part, however, the risks of interactions between different categories of drugs are not as well-studied. This is especially true with illicit use where limited research is available on each of the illegal substances themselves.
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