Rise in Viagra Abuse Spells Trouble

Gay men mixing erectile drug with illegal substances, health officials say

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By
HealthDay Reporter

MONDAY, Aug. 20, 2001 (HealthDayNews) -- Young gay men in San Francisco seeking a drug-assisted sexual high are taking Viagra without a prescription and in combination with illegal drugs, warn local health officials. A study found that homosexuals who visited a health clinic were almost five times as likely as heterosexuals to use the erectile dysfunction drug.

A variety of potential complications are possible when Viagra is mixed with mind-altering drugs. Side effects range from loss of consciousness to an extraordinarily painful erection and even death.

"It's a very powerful drug and really needs to be used under medical supervision," said Dr. Jeffrey D. Klausner, a medical director with the San Francisco Department of Public Health.

Viagra, first released in 1998, makes it easier for impotent men to develop and sustain erections. More than 7 million men have used it legally, but "a lot of people are using and abusing it," said Dr. Sanjay Kaul, a Viagra expert who is a cardiologist at Cedars-Sinai Medical Center in Los Angeles.

Health officials in San Francisco surveyed 844 men who visited a clinic that treated sexually transmitted diseases from 2000-2001. The results were released earlier this month at the federally sponsored National HIV Prevention Conference in Atlanta.

Thirty-two percent of gay men in the study reported using Viagra over the past year, compared to only 7 percent of the heterosexual men.

Some of the men, including HIV-positive ones, are using Viagra under a doctor's supervision to counteract legitimate impotency problems, Klausner said.

"Many other people are HIV-negative and are using Viagra to enhance and prolong their sexual activity and to heighten their sexual pleasure," he says.

A third group takes Viagra to counteract the effects of illegal drugs, which dampen a man's sex drive and function, he said. The gay men reported taking Viagra with the mind-altering club drug Ecstasy (43 percent), with "speed" methamphetamines (28 percent), with blood vessel-expanding nitrates (15 percent) and with the veterinary anaesthetic ketamine (8 percent). About three in every four of the men who used several drugs reported getting Viagra from friends.

Men with impotency problems can normally take Viagra with few risks, Kaul said. "It's a wonderful drug for most patients who are not at high risk, which means a vast majority of patients."

But the drug is not for everyone. Many patients with heart abnormalities shouldn't take Viagra because it may dangerously lower blood pressure and cause heart attacks or strokes, Kaul said.

Researchers have found that hundreds of men with heart problems have died after using Viagra. But the manufacturer, Pfizer Incorporated, says the death rate is tiny, considering that more than 22 million prescriptions have been written since it went on the market,

As for its use as an aphrodisiac, Kaul dismisses anecdotal reports that Viagra boosts sexual performance and endurance. Studies have never proved that it does anything for men who function normally, he said.

"I know it's being abused by weekend warriors to enhance their sexual potency," Kaul said, but he thinks the effect is a matter of mind control, not the actions of the drug.

Taking the drug by itself is risky, experts said. An overdose of Viagra could lead to priapism -- an erection that lasts for hours. Although the condition sounds amusing or even enjoyable, it actually causes extreme pain and could lead to permanent sexual disability.

For gay men, interactions with illegal drugs could cause a variety of other problems, Kaul said. Some of the most dangerous reactions may come if a man takes Viagra with amyl nitrate or nitrite, drugs that are better know as "poppers."

Poppers, which are taken by inhaling fumes from a vial of liquid, cause a sharp drop in blood pressure. Gay men use them because they cause relaxation and lead to a powerful head rush. Viagra can counteract the relaxation, Kaul said.

Poppers and Viagra both cause drops in blood pressure, and when combined, they can cause fainting or, at worst, a heart attack or stroke, Kaul said. But the exact level of risk isn't known in a sexual context, and the bodies of young gay men, because of youth and resilience, may be more immune to the side effects of the dangerous drug mixture, he said.

In San Francisco, health officials hope to educate gay men about the risks of Viagra, and Klausner is trying to enlist Pfizer in the effort. Although the Viagra Web site doesn't specifically address gay men, it does warn about the possible side effects when the drug is used with poppers.

What To Do

To read more about Viagra and its possible side effects, visit the drug's official Web site created by Pfizer.

Learn more about poppers by visiting this fact sheet presented by the Aberdeen, N.C., Police Department. And here's some information on methamphetamines and Ecstasy.

SOURCES: Interviews with Sanjay Kaul, M.D., cardiologist, Cedars-Sinai Medical Center, Los Angeles; Jeffrey D. Klausner, M.D., director, STD prevention and control services, San Francisco Department of Public Health

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