Methadone Treatment Linked To Lower Viral Loads

Opiate addiction is an ugly beast. Physically, opiate withdrawals are typically reported as being the worst and hardest to endure among all drug classes.

Addicts will go to great lengths in search of the blissful release of dopamine or to end suffocating withdrawal symptoms. Fortunately, drugs like methadone are tailor-made to bypass some of the worst parts of opiate withdrawal.

But people living with HIV who take methadone to reduce heroin or morphine withdrawals may have an added bonus: lower viral loads.

Last month, a study was presented at the 22nd International AIDS Conference in Amsterdam. The study demonstrated that methadone maintenance treatment is associated with less time spent with a high viral load.

“We observed that engagement in [methadone maintenance therapy] was associated with significantly less person-time with a VL above 1500 copies/mL among a large and long running cohort of PWUD,” researchers wrote. “These findings suggest that low-threshold MMT is an effective intervention in lowering the risk of onward viral transmission among this key population.”

People living with HIV strive for an undetectable viral load, which means the virus is so suppressed that it becomes impossible to transmit to an HIV-negative partner. High viral loads lead to a weakened immune system and complications down the road.   

"These findings demonstrate the important role of evidence-based addiction treatment in optimizing individual and community-level impacts of antiretroviral therapy among HIV-positive patients with comorbid opioid dependence,” researchers added. “Efforts to address barriers to the use and availability of MMT will likely improve HIV outcomes and reduce new infections among this population and should therefore be prioritized.”

Data was extracted from the AIDS Care Cohort to evaluate Exposure to Survival Services (ACCESS), a cohort of HIV-positive people that use drugs in Vancouver, Canada.

For the study data, 867 HIV-positive people on antiretroviral therapy, and who use drugs were observed. At the time of the follow-up, 60.2 percent were engaged in MMT at least once. Time periods spent on MMT were independently associated, researchers said, with fewer days with a VL above 1500 c/mL.

Reportedly, methadone is safer than heroin, simply because heroin off the street can come in any form of potency, and any level of purity. Clinical methadone goes through rigorous regulations and is closely monitored. Beyond that, it is an opiate and therefore can stop breathing in certain doses, and should be treated as a powerful opiate.

Additionally, for people who are on methadone maintenance therapy, the drug can help keep your viral load from going out of control and leading to symptomatic HIV.