Viagra and Friends:
Recreational Use of Erectile Dysfunction Drugs

Thousands of young, impotence-free guys are popping erection pills to become wayward weekend warriors. But at what cost?

"A few years ago, I got offered a Viagra at a party" says Mike Rodriguez, 26, recalling the first time he took the blue pill. "I was with this girl I met the week before and I was pretty sure I could take her home. I popped the pill a half-hour before we left the party. We had sex until she literally made me stop."

Rodriguez, a network engineer from New York City, had never suffered from impotence or performance anxiety. Yet he was using Viagra anyway, in this case as an insurance policy against the effects of alcohol.

Xavier Motley, a 27-year-old soldier from Pennsylvania, buys Viagra from an online pharmacy in Mexico. "I take it to enhance my endurance," says Motley, who has never had performance issues, either.

Viagra and its newer rivals, Levitra and Cialis, are erectile-dysfunction drugs, which were developed and intended for old salts who had trouble hoisting their sails. But in the last few years, these pharmaceuticals have caught on as recreational drugs with the under-30 crowd.

A new study published in the International Journal of Impotence Research (yes, it's a real publication) found that, while the largest group of Viagra users are still in the 56-and-older age group, there's been a 300% increase in prescriptions for men under 45 since the drug was launched in 1998. Add to that the untold thousands who buy it online, and it's clear that the country is in for some hard times.

But there's a dark side to this invisible helping hand. The consequences of large numbers of men taking potency pills they don't need are raising eyebrows in the medical community. For one thing, Viagra works for four to six hours, which, when combined with alcohol, can open the door wider to making unwise late-night choices. "Alcohol promotes uninhibited behavior," notes Andrew McCullough, M.D., a Manhattan urologist. "All of a sudden, an inebriated guy might decide, 'I'm not gonna wear a condom tonight.'"

The same goes for men who get all revved up and have no place to go. Desperately searching for release with any matter of partner can also lead to less-than-smart lifestyle decisions. "If I'm out and I pop a pill and I can't get sex," admits Rodriguez, "I usually call an escort service."

These pharmaceuticals are creating another potential set of dilemmas. Scientists have found that, while men don't develop physical dependencies on the medications or loss of normal function if they stop taking them after extended use, psychological dependence on erectile-dysfunction drugs is a different matter altogether. The recreational user might take Viagra to help sell himself as a sexual superman early in a relationship. But once things get serious, he has to perform without the support of his little diamond-shaped friend.

Says Motley, "I worry that not taking it will cause my girlfriends to notice a drop-off in my performance."

All erectile-dysfunction drugs work in the same way. Each blocks an enzyme called phosphodiesterase-5, relaxing smooth-muscle cells to allow increased blood flow to the penis. (All three also have similar possible side effects, the must common being headaches and facial flushing.)

Each of the three drugs has also targeted the same demographic: younger men. Though Viagra is still far and away the industry leader, Cialis and Levitra have made serious inroads in market share, especially in Europe. So tar, Viagra has been prescribed 170 million times to 23 million men worldwide. Since Cialis and Levitra were launched last year, they have claimed 24% and 12%, respectively, of the European marketplace, compared with Viagra's 64%. In France, Cialis has been dubbed "Le Weekender,' as it stays potent for up to 36 hours. Cool. But imagine the problems posed by an almost two-day stiffy.

"I saw a 22-year-old with a prolonged erection," says McCullough. "I saw another with a penile fracture. He had had rodeo sex. She came down on him and it broke" Ouch.

Buckin' broncos aside, there are many young males who have legitimate erectile dysfunction. For them, Viagra and the other drugs may mean the difference between knocking down three pointers from the top of the key and warming the bench. But other than for reproductive sex, what is Viagra for if not recreational use?

"The problem in our society is, if good is good, why not be better than good?" says McCullough. "We haven't studied the effect in men without erectile dysfunction--there may be consequences. Enhancing sex for the sake of enhancing sex should not be condoned."

by Jonathan Yevin, a Brooklyn-based writer and photographer

Written in 2004. Last reviewed: 9/05

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