How to beat A Drug Test Vice
Getting High On HIV Medication (Full Documentary)
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[Music]
are you ready with most drugs is a long
pre-established history of what the
activity is going to be like that is not
the case with efavirenz really the only
way to crack that kind of a mystery is
to take the drug that is what
psychopharmacology is they don't
necessarily think it's going to be
mind-blowing but time will tell
[Music]
South Africa has one of the planets most
unique drug cultures it is a realm where
the quaaludes still abounds and heroin
has emerged only recently not in its
familiar guise as an intravenously
administered powder but as a component
in a mysterious smoking mixture called
Niobe a drug that's torn communities
apart made from a fairy tale cocktail of
red poison heroine and AR fees the drug
efavirenz was first approved by the fda
in 1998 and has since become a vital
component of the antiretroviral drug
cocktails that are used to treat HIV
internationally apparently some people
don't go to clinics now to go and get
their ARVs because they are scared they
get robbed and those are then added to
this concoction as well although
prescription drug abuse is not uncommon
this was the first I'd heard of an
antiretroviral drug being used
recreationally and the suggestion that
had behaved like a classical psychedelic
further kindled the fires of my
obsession and so I traveled to South
Africa to find out what role if any
efavirenz plays in the niobe cocktail
and what effect it might have on the
recreational user
venturing into the township so at OU i
met with a local group willing to share
their expertise on drug acquisition and
consumption they mix know with the
understand I'm saying with my job yes
yeah so they put it inside there they
make some of it yes as I entered the den
I could smell the remnants of heroin and
methamphetamine and meth cathinone and
meth a cologne and cannabis we're
currently in the home of Niobe users and
we're gonna get a walk through the
process of how Niobe is formulated we're
going to see all the different
components that go into the mixture and
maybe even watch some people ingesting
it this is the home of the parents of
the users who've since passed away and
now this has become something of a drug
den or so I've been told
Mootoo yeah you must educate other
Americans it's not marijuana it's
marriage
ladies nice but others they won't meet
Wendy a lot of people have been saying
that Niobe contains some kind of HIV
medicine to poison our children you take
a rat poison yeah why would you put rat
poison in that yeah but I think it also
has a high or something do you
personally put the rat poison as soon as
you take a first shot you feel great
because the morphine and the strychnine
they are cancelling out and so you're
getting the effect on the morphine but
when the morphine wears off the those
products the the strychnine is killing
your body causing the pain and it's
every four hours that they have to have
a shot because the body hurts since the
1960's reports of street drugs laced
with the rat poison strychnine have been
perpetuated by the popular media most of
these claims are false but when I read
that an analytical chemist in Durban had
detected strychnine in an IOP sample I
decided to pay him a visit
do you have anything from the analysis
or from previous analysis that you could
show us no we we did that we have to get
permission to do that we did that stuff
and that data was given to these people
I guess just given how dangerous
strychnine is it seems like there'd be a
huge potential for killing people
especially that's what I don't get
that's the other thing I even ask myself
why are these people not dying yet
because strychnine is the ancient poison
that thing's been used to kill kings and
royalty and important statesmen for a
long long time but you did this analysis
and I found a strychnine you know but if
you want to fish
analysis it's possible for me to do it
now that you've brought up this question
and this point about that you don't
think that it's there that the
strychnine is there and I found a
strychnine here from these ones I'm also
curious and for us to run the analysis
for you would not take more than a few
hours if I take you now to buy some are
we off-camera
under the cover of night it we went to
obtain a fresh Niobe sample from a
recent drug bust over here in the oven a
college sugars because it looks like
brown sugar so they sell it in straws
they take a straw and they put a little
amount in it and then you you twist it
so if you buy it now you're buying it in
that straw and it's it's really a dirty
color
fresh niobe in hand we returned to the
laboratory to look for the presence of
strychnine or efavirenz if you think
about it the sample set that they
brought us was just from one dealer and
it just so happens that we know who the
single dealer is and it's a big
dealership so I really find it hard to
believe that you could get that large
amount of ARVs to be adding to this to
get the significant effect of it out of
an ARV this contour plot here shows you
the UV activity yeah okay off the
molecules if it's an ARV it's gonna have
decent UV activity and the only four
compounds that have this UV activity are
these things so clearly this is just
dirty heroin no strychnine heroin is a
very well covered well-established drug
of abuse and it's not something I'm
particularly interesting in rehashing
but here's the thing you know heroin
exists all in the world what I'm
interested in specifically is the ARV
thing even if it's fake or whatever I
just want to understand it
it's not even as your decision they
don't see things they just become
full-time they just become hi
that's what it sounds like to me as well
like they get really high really crazy
but it doesn't quite sound like they're
tripping to me and you know there's all
these stories in the Sun that are
talking about how people will rape women
so they can get HIV so they think that
they are these to smoke all this stuff
it seems really sensational to me
tabloid easy to understand but I won't
necessarily say it's lies because
there's truth to everything you know
this is South Africa my men there's a
lot that goes on you know but you must
go yeah
the concrete information the Mazon
Belarus any coupling of sickness with
Social Welfare money in a very resource
poor setting is often fertile grounds
for these kind of rumors in order to
gain further insight into the psycho
activity of efavirenz I met with South
African anthropologist Isaac neihaus do
you have any idea how much of these
things are potentially some kind of
journalistic or tabloid fabrication or
construction do these there's always an
aura of fact reality in these stories
and I think the reason for that is that
when people who are HIV positive use
efavirenz one of the side effects is
extremely bizarre dreams of standing on
mountains of being attacked by animals
of
deceased people walking around in their
house many Africans believe that the
ancestors would send you dreams that God
would communicate through dreams and
then as I see here is a drug that can
simile the induced dreams and can create
images and so so there is a kind of a
mystical power to this drug
I had already spoken with active users
but I wanted to meet with niobe addicts
in recovery
to hear their perspective on what the
Niobe mixture might contain it's a
concussion of heroine in other
substances your red poison chemicals to
use within the trailheads
chemicals they used to clean the dishes
in the kitchen your family planning
tablet they are adding family planning
tablets to you yeah and they call it now
okay
they don't have HCC or HIV and red
poison in amateur rates you see those
things are not good for me actually I
think a lot of people they think they're
buying heroin you know pure heroin but
never comes pure because you know from
where it comes from
that's it wig makes it way through
Africa you know they keep adding all
this because the volume decreases so
they want to make more profit and they
edit stuff you know so you might find
maybe it's 50% heroin and the rest is
you know all these added stuff
slowly it became clear that Niobe was a
complex mixture containing near infinite
combinations of heroin cannabis
brodifacoum efavirenz emtricitabine
strychnine Pinot fovea and oral
contraceptives I called the Ted legit a
UN researcher who studied drug abuse in
South Africa since the mid 90s 1995
which is just up to the end of apartheid
and it wasn't a lot of air went around
in two places it started up whatever
reason was in white communities in
Pretoria and Cape Town and was being
dealt primarily by East Africans at that
time the primer area areas of Pakistan
Iran and where the drugs were coming
from wasn't there I mean you have to
keep in mind it wasn't because the
borders weren't permeable people lose
money and guns and drugs it wasn't
because you couldn't get it across the
border it was because quite a culture or
a supporting culture I mean one of the
things that really struck me is when
when heroin started getting into some
parts of the black community they had no
context for it at all I just didn't they
hadn't seen trend-spotting they didn't
think about these things it has you know
they didn't have his history written
back in Soweto we met with a local man
who had been robbed of his money and
plates by a gang of niobe addicts they
just did anything and money plates
anything that they can lay their hands
on as you can see this tab was stolen so
that's why there is this water I've
replaced it three times only the people
who would do this and get money from
your OB not it's for no other purpose
can you talk about crime crime crime but
I've been living in South Africa for I
mean my entire life and the first time
that I'm being a victim of crime world
a few months ago where someone broke
into my house and stole my my video
games that was it and that's only
because of this drug problem that we are
having because take people things to
housebreaking me why she made when
people watch their coding but if they
you sleep difficult you see that's why
these people got mad now even if they
find you stealing and they know that you
asthma can help it they hit you to kill
you kill you
mob just easy basic criminals sometimes
smoke these drugs so that they do not
have any fear that they can be fairly
ruthless in their crime we just arrived
at the clinic where there was recently a
Niobe related robbery and we're about to
meet with the doctor who's in charge of
dispensing the antiretroviral drugs that
have been stolen in order to be used as
a component in the mysterious nioh P
mixture at last August two guys came in
and then they known as if they were
patients and then they were armed and
then the first thing that they said is
where is the medicine cabinet they
wanted the air is this
as hold a favor and 600 million I tried
it myself
I'm just experimenting yeah and I felt
what to pull a filly you feel
light-headed and then there's that
feeling of inhibition you can do
anything you want I mean I can just
urinate here in front of you you know
you've got all the powers you can
bulldoze everyone that's why these boys
I mean they come and do a Korean order
because they feel that you know what
they are on top of the world we can do
anything
mixing it with other stuff the potency
was higher you can have one thank you
[Laughter]
no no no no no does that mean I don't
have to tell it to Dennis - oh wow thank
you so much yeah okay yeah good never
know another public yeah good table of
them that's actually the first
authoritative description I've heard of
the effects of efavirenz it's so
interesting it sounded like it had a
disinhibited effects but it didn't sound
like a classically psychedelic effect so
I you know I was hesitant to try it
because the idea of taking an
antiretroviral drug recreationally in a
country where HIV is a massive problem
just seems like the sort of thing that
would make people go crazy but because
the doctor actually gave me 30 tablets
and specifically instructed me to take
one I feel like I have no choice but to
try it once and and characterize the
effects right ready 12:43 start a timer
I have certain expectations based on the
published binding data that it will
behave like a classical psychedelic it's
certainly been connected with disturbing
dreams or tense dreams or nightmares in
certain instances but really the only
way to crack that kind of a mystery is
to take drug tip one tablet at the time
only
yeah that's disgusting right and then
you you will understand what I'm talking
about
[Music]
[Music]
Beks coming in stronger no not really
talk to a cop on the phone there is
definite activity but then the actual
character of the activity is unclear and
the duration of the activity is unclear
all I know is that there is a drug
effect going on so my interest in this
came from a news report that I had seen
on a Saturday afternoon where there was
a report on people in South Africa using
a fab Rian's recreationally at the
University of Texas
I met with John such a pharmacologist
who published a groundbreaking paper
that demonstrated the unexpected
activity of efavirenz as a classical
psychedelic dr. Zetsche found that effo
virus can substitute for LSD in
specially trained rats basically they
trained a rat and a lever press task and
they can discriminate or tell the
difference by pressing a lever so you
train them up on let's say LSD versus
saline sore one lever when they would
press it if they are experiencing saline
or they would press the other lever if
they're experiencing LSD what you do in
those trained animals is then you
substitute in let's say your
experimental drug in this case it would
be a favor ends and so in rats trained
to discriminate LSD from saline when we
substituted in two Fabri in the drugs
they had never experienced they pushed
the lever saying that it was like LSD we
were prevented from testing even higher
doses but at higher doses with favor and
the animals don't press levers and so
you're you're sort of limited by how
high in dose
I mean there's a little maybe the little
trailing activity would be a tiny bit of
trailing a tiny nude because the effect
is already so subtle I'm going to go
forward and take the full nine hundred
milligrams
although there's no way to evaluate
whether or not a rodent is hallucinating
scientists have discovered that
classical psychedelics induce a unique
effect in mice and rats that effect is
called the head twitch response they
mark with an asterisks to alert you that
the head twitch responsible occurs very
rapid there it was thought looking
you'll miss it you see that application
the same concentration of a favor n't
produce head twitch in the knockout
Mouse suggesting that head twitch
response is being mediated through the 5
Hz to a receptor v HT to a is a subtype
of serotonin receptor that plays an
important role in the activity of
classical psychedelics when activity at
five HT to a is blocked genetically or
pharmacologically rodents no longer
display the head twitch responds
[Music]
Warren Linville near wit Bank on our way
to meet some niobe dealers who are going
to be cutting at their product with
antiretroviral drugs supposedly whether
or not this will actually take places on
the layer especially because they're
using the word cook somewhat ambiguously
know what cooking really means in this
context as we approach the lair of the
clandestine Niobe cooks I prepared
myself to finally understand the logic
behind their strange recipe how did you
come upon this particular formula how
did you decide that all of these
different ingredients would be useful in
the final product
she never nation did to pass through
lately you see when we are together
people with different ideas we combine
them we come up with one pp though I had
remained skeptical throughout my
research when I saw the ARV tablets on
the table of the cutters I was forced to
confront the possibility that the
stories were true the guy that came from
[Music]
who do you think taught him he said he
taught by his uncle uncle he was
not a Chinese guy who wants to enjoy
these guys learn the recipes and then
when they have the recipe that's their
stock and trade
because it's a secret is no Darwinian
action to the idea so they don't really
understand how it happened just like so
many style analogies when Landon attacks
we don't talk to the eternal Jeffrey
that they do you they do occasionally
by the gym with me but your mind
everyone the other side you see her
detail was actually having a
pharmacological effect in how much if
it's just tradition or folklore these
pills they give it them and power dinair
to make mood drank these Tony that the
Phoenix and the horse be clear then
resupply us completely intuitive I was a
minor part of the orchestra later
because it is available despite the fact
it's actually very very expensive drug
it's a round people got access to this
big pot that in this to move as well and
I see that you have three different
antiretroviral drugs there do you think
that one of them is better than the
others is just when you take these well
maybe this will make a nice change
becomes the poet of peace one after
introducing a teaspoon of rat acts
pellets and saturating the crush powder
with apple cider vinegar the Niobe cooks
wrapped the pink paste in aluminum foil
and placed it in a microwave
I think this this is largely drug use
born out of poverty and foreign people
well I was experimenting with a lot of
things until they get it right Missy to
avoid certain things you took the foil
out and so if you had a choice between
pure heroin or the niobe mixture that
you make which would you choose I would
choose this one because this little bit
bitter
so if you use the pure opium tar from
the poppy plant you would expect very
bad stomach pains but if you put rat
poison into that tar it actually makes
the stomach pains less severe yes not
too much of heat because we are cooking
this thing it's affect us more than the
one I smoked you see my original body is
not like this my original colors a big
nsima photos before now sometimes I cry
journey continues so we make the
assumptions that the studies that we do
in animals will translate one to one
into humans in that that may not be true
it may only be partly true we've never
had the tried to simulate having the
rats smoke the drug because recreational
users smoke efavirenz the temperature
could transform the chemical into an
entirely different molecule to test this
hypothesis I met with the medicinal
chemist Jason Wallach to burn efavirenz
under controlled conditions for this
experimental thing is the entirety of
the pill simulate the exact conditions
that the tablet is smoked in South
Africa
yeah what's really cool is that this lab
that I'm working at we're building a
machine that's like a machine that will
smoke a tablet and then we can collect
all of the smoke and chemically analyze
it to see how the drug is changed when
it's burned it's kind of like a series
of bombs they use for smoking weed it
all connected to one another with a
vacuum on one side and a pipe on the
other and then you're able to just take
out the water and analyze what's in it
our hypothesis was correct when heated
under certain conditions efavirenz is
transformed into an entirely different
molecule the pharmacology of which is
unknown even the activity of the drug
when it's consumed orally is something
I'm just beginning to understand
I am fully efavirenz
oh man is it is it
[Music]
psychedelic in a certain way feel
sedated I feel relaxed but I feel a
connection to every other time that I've
attempted to articulate a psychedelic
experience in front of the camera right
now it feels like it's part of a
continuum a strange eternal camera
articulation continuum know if you look
if you feel the effect of weed you can
say I'm stoned and people will know I am
under the influence of cannabis if you
say I am drunk from alcohol people will
understand what that feels like but if
you say I'm F of I rinsed
I mean you have to imagine there are
literally thousands of targets for drugs
in your body I would venture to say that
most drugs are interacting on more than
one target we would certainly hope to
develop drugs that wouldn't have some of
the side effect profiles that you
currently see and that might also we
believe we could probably simultaneously
engineer out any abuse potential for the
compounds I would argue that in South
Africa adherence to antiretroviral drugs
is actually been quite high and I think
the bizarre images and the very vivid
dreams they seem to create the
impression that the antiretroviral drugs
are very potent and very powerful and
that they potent and powerful enough to
fight a very powerful disease like the
tingly stuff in their you know the anti
dandruff shampoo or whatever some people
whether it has an actual effect on the
condition or not that actually lets
people know okay your experience in the
medical a pharmacological effect now
[Music]
when you consider that possibility it
seems like it could actually be
detrimental to redesign the drug in such
a way that it doesn't have any
psychoactive properties anymore sure
yeah I haven't seen any controlled
studies done on that so I'd have to
evaluate that that data in terms of of
compliance all right - discriminated
that stimulus correctly whole world
opened up a whole new Formica for a
whole new scaffold this could be a
completely new base structure to make
new psychedelics it could be an entirely
new class everything inclusive the
computer I started being a big computer
now we carry it's a laptop the next time
it won't be a laptop it's just a wash no
everything changes fo Byron's is
psychedelic at the beginning of the
piece I said that you had to take the
drug in order to understand it and
that's what psychopharmacology is all
about which is a little bit of an
oversimplification but it's true that
there are certain questions in
psychopharmacology that can't be
effectively answered by a rodent I
hadn't seen anyone write I've taken it
it is psychedelic it's comparable to LSD
nothing like that existed and for that
reason I wanted to take it and for that
reason it was useful to take it because
I answered my question it is classically
psychedelic that said it's not pleasant
at all although the acute effects were
somewhat enjoyable and comparable to
mescaline
I was bedridden and totally
incapacitated for almost two days
afterwards so this is something I've
actually been very conflicted about
reporting on on one hand I understand
and feel a responsibility for conveying
accurate information about this
substance but the possibility that
anyone would divert this drug away from
its intended medical purpose is actually
very frightening it is psychedelic but
so are lots of other things that
more potent less expensive and less
toxic and dangerous to use at high doses
