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Viagra's Not For Playing Around

Recreational Use of Impotence Drugs Can Be Risky

May 26, 2005
Although the drugs used to treat erectile dysfunction have generally been proven safe, recreational use of these drugs is associated with higher risks of sexually-transmitted diseases (STD's), including HIV. In a study in the current issue of The American Journal of Medicine, researchers from the San Francisco Department of Public Health evaluated 14 studies of Viagra use among men who have sex with men.

• FDA Seeks Recall of 'All Natural' Potency Drugs • FDA Requires Label Changes for Cialis, Levitra and Viagra • Public Citizen Wants Stronger Blindness Warning on Erectile Drugs • FDA Issues Blindness Warning for Viagra Users • FDA Knew of Viagra Blindness Link for More Than a Year • Viagra Linked to Blindness • Viagra's Not For Playing Around • Devilish Viagra Ads Pulled • Actra-RX May Be Dangerous, FDA Warns • FDA Warns that Mexican Viagra May Be Counterfeit --- • Consumer Complaints

Viagra users engaged in unprotected sex with partners of unknown HIV status from twice as often to almost six times as often as non-users. HIV-positive men having sex with other men were almost twice as likely to be diagnosed with an STD if they were also Viagra users and the newly HIV infected were 2.5 times as likely to be users.

Further complicating the situation, 54% of users mixed Viagra with other drugs to enhance the sexual experience. One study reported that 36% of all Viagra users combined its use with other drugs, including methamphetamines (23%), ecstasy (18%), poppers (15%), ketamine (11%), and GHB (8%).

A study among men who had sex with other men and who were seeking STD clinic services in San Francisco found Viagra to be used concurrently with ecstasy (43%), methamphetamines (28%), and amyl nitrate (15%).

Writing in the article, Jeffrey D. Klausner, MD, MPH, suggested that "Focused action is needed to target this ongoing public health problem. Although the current evidence of association exists only for Sildenafil (Viagra), likely due to the relatively recent approval of Tadalafil (Cialis) and Vardenafil (Levitra), the needed action should focus on all three phosphodiesterase inhibitors (PDIs), as the observed associations with Sildenafil (Viagra) use most likely would occur with drugs of identical nature.

"The labeling for PDIs should be modified to warn users of an increased risk for STDs, including HIV infection," Klausner wrote." Educational programs, particularly among physicians, men who have sex with other men, and methamphetamine users, should be implemented to increase awareness as to the use of these medications and their association with STDs, including HIV infection," he advised.

In an accompanying editorial, Joseph S. Alpert, MD, University of Arizona Health Sciences Center, Tucson, expressed concern about the public health implications when Viagra and its relatives are abused or used recreationally with illegal drugs.

He pointed to a recent article published in The Lancet in which investigators from Rockefeller University reported on a patient who presented with a new strain of HIV virus that was considerably more virulent and progressed more rapidly to AIDS than any HIV virus previously found.

Dr Alpert wrote that "This patient had been abusing both Sildenafil (Viagra) and methamphetamine. The question that immediately leaped to mind was: What effect did the combined abuse of these drugs have on the patient? Could this have resulted in the development of the highly virulent HIV mutant? Does this combination drug abuse increase the likelihood of STD transmission and/or the propensity for unsafe sex?"

Dr. Alpert also questioned whether the risk of STD and unsafe sex is also increased in male heterosexual patients who use Viagra. He pointed to the need for increased physician and patient education as well as further exploration of the multiple implications surrounding abuse of Viagra.

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