Switch On Your HIV Smarts.

Too many HIV meds, a small-town judge, and 10 days in jail

, by David Duran

About 6 months after I was diagnosed with HIV, I found myself being pulled over by a police officer on my way home after meeting friends at a comedy club.

“Thank God you pulled me over, officer, something is really wrong,” I slurred.

David Duran

David Duran

I wasn’t drunk, or high. I was stone-cold sober, but something was definitely wrong. Something went wrong with my medications. And the startling consequences of mixing up my HIV medications put me in a world of trouble.

Ten different people called 911 after seeing me on the road that night. It turns out I had been driving way too slowly for being on the highway—like 30 miles per hour—and had been changing lanes without signaling, for hours. When the officer pulled me over, I was given a breathalyzer test on the spot, and asked to perform some basic field sobriety tests. And then I was put into the back of a police car.

Back at the police station, I was asked to take a urine test. I quickly complied with the request, knowing I wouldn’t test positive for anything. At this point, I felt like I was waking up for dream—or coming out of some kind of mental fog that had settled after I had taken my meds that day. The officers allowed me to sit at a desk, to lay my head down, instead of sitting in the holding cell. I think they felt sorry for me—after all, I was in tears from confusion and exhaustion.

It took my parents over three hours to get to me that evening, pick me up, and take care of my car. Long story short, I was charged with driving under the influence (DUI) and was given a court summons to appear back in the tiny town I had ended up in.

The next day, I retraced my steps to figure out what might have happened. Here’s what I figured out.

In a rush to meet my friends at the comedy club, I gulped down the new set of medications I had been prescribed since testing positive for HIV. There were at least seven or eight different medications that I had been prescribed, and was trying to keep track of. Some were for HIV since my doctor was still trying to figure out the right HIV medication combination after one regimen made me ill. Others were for anxiety, depression, and other ailments I was told I had. One was a sleeping pill, something new that I had just started taking to help me get a solid night’s sleep.

I accidentally swallowed one of my sleeping pills along with my other daily medications.

Once I got to the comedy club, that’s when I think I started acting a little strangely—I remember my friends asking me if I was feeling OK at one point during the night when I was staring blankly at the performer and not cracking any smiles. That’s where my memory of the night fades a bit.

HIV experts actually have a term they use to help describe the situation my many medications put me in. It’s called “polypharmacy,” and “pill burden.”

Lots of HIV meds spilling out of bottleWhen people are prescribed more and more individual pills that they need to take—whether to treat the same condition, or separate conditions—there are definable consequences.

For people living with HIV, higher pill burden is associated with worse adherence to antiretroviral regimens, and a decreased likelihood of being able to maintain an undetectable viral load. I think that probably comes as no surprise to those of you out there, that like me, have been prescribed so many medications that you start to lose track of when, where, and how often you’re supposed to take each one.

Adding insult to injury, the punishment I faced as a result of driving “under the influence” was severe. I had a court hearing, in a small room attached to the post office, with a judge and no public defender (you apparently have to request one by mail, ahead of time). The judge sentenced me with the maximum punishment for a DUI in Arizona, which included a felony charge, a one-year suspended license, 10 days in jail, a $5,000 fine, 60 hours of drug and alcohol counseling (at the rate of $100 per hour), and an alcohol monitoring system in my car for a year (at the rate of $99 per month) after my suspension was lifted.

And this was after the judge read a letter from my doctor and my psychiatrist explaining the medication mix-up.

I still remember the look on the judge’s face after he read my letter explaining my HIV diagnosis. I went in to my hearing confident that I would be fine. I left feeling unsettled, shamed, and humiliated by the look of disgust I saw on the judge’s face before he sentenced me.

After all of this, there have been some take-aways. I think the first was about over-prescription of medications. When I was first diagnosed with HIV, the depression and trouble sleeping wasn’t out of the ordinary. I’ve talked to lots of people who have felt that an HIV diagnosis impacted their mental health.

Instead of connecting me to an HIV community, or suggesting I see a counselor to talk about issues related to living with HIV, my doctor referred me to a psychiatrist, who ended up being the one to prescribe medications for depression, anxiety and sleep. I’m generally trustworthy of medical professionals, and believe that it’s important to get the right medical care for things you’re diagnosed with. But I honestly believe if my providers had taken the time to listen to what I was going through, their first response wouldn’t have been to open their prescription pad.

My second take-away from this experience is about taking the time for yourself after an HIV diagnosis. Yes. Your life is going to change. Yes, you might feel differently than you did before you were diagnosed. It’s OK to be sad, angry, depressed or just plain pissed off after you’ve been diagnosed. Let those feelings play out—but don’t let them take over. Get online or pick up the phone. There are so many places where you can get support from people who’ve been through what you’re going through.

Get more info and advice on what to do when the HIV test comes back positive in my recent article on BETA.

David is a nationally recognized HIV advocate and writer who contributes to HIV focused publications including POZ, Plus, Positively Aware and The Body. Additionally, he focuses on travel writing and spends approximately 90% of each month traveling the world on different assignments. To read more of his HIV writing, visit his online portfolio, or follow him on Twitter.



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