Large numbers of homosexual men, and a smaller number of heterosexuals, are combining Viagra with illicit drugs to achieve a potentially deadly "sexual high," a new study finds.
The men combine the popular impotence drug with illicit "club drugs" such as ecstasy, ketamine, amphetamines, GHB, and "poppers."
The study, discussed last week at the Centers for Disease Control's HIV Prevention Conference, focuses on high-risk behavior among gay men who use Viagra to heighten their sexual experience.
San Francisco epidemiologist Andrea Kim, who conducted the study, says it and other studies in California and London have shown that "gay men are combining Viagra with other drugs much more frequently when compared to heterosexual men" and that puts them at higher risk.
Her survey of 844 male patients at a clinic to treat sexually transmitted diseases showed that 32 percent of gay respondents used Viagra, while 7 percent of heterosexual men used the drug.
About 75 percent of gay men using Viagra were under the age of 35 and received the drug from a friend. Many have found that Viagra can easily be obtained at clubs or through the Internet.
Kim and other doctors agree the trend appears to be widespread.
"This is not just a problem in San Francisco and it is not just a homosexual issue," says Dr. Paul Pepe, Chief of Emergency Medicine at the University of Texas Southwestern Medical Center.
"My suspicion is that this could happen in any city where young people are experimenting with drugs and sex. Unfortunately there are consequences."
The Price of a Sexual High
Many of the illicit drugs being abused at clubs and parties give people a euphoric high, making them more open to experimentation with risky behaviors. But a common side effect of club drugs is loss of erection.
"We know that ecstasy and methamphetamines reduce sexual function, so the men are using Viagra to enhance their sexual ability," Kim says.
Partygoers often combine Viagra with amyl nitrite, an inhaled stimulant commonly referred to as "poppers."
University of Texas Southwestern Medical Center Chief of Toxicology and emergency room physician Dr. Daniel Keyes says that "amyl nitrite makes the heart race and combining these drugs can cause cardiac events."
Like Viagra, amyl nitrite causes blood vessel dilation and a drop in blood pressure. Combining two blood pressure lowering drugs can be fatal if a person has a heart attack or stroke.
Although rare, another medical condition that can occur is priapism, a severely painful problem that can result in permanent damage caused by the penis being erect for many hours.
Risky Behavior and AIDS
Men engaging in sexual activity while using Viagra and illegal drugs are more likely to contract sexually transmitted diseases as well.
Gay men in the study who used Viagra had more sexual partners when compared to straight men (5.4 vs. 3.5), and were more likely to engage in sex with individuals who do not know their HIV status or were HIV positive.
Many of the men using Viagra in combination with other drugs are getting it from friends and therefore "they are not getting the information they need from a doctor" who might warn them about potential risks, says Kim.
Keyes points out that "ER physicians may need to start asking younger patients about Viagra use when they come in" because this behavior can lead to serious health problems.
Experts agreed that future work must be done to target prevention strategies at groups engaging in this potentially deadly behavior.