Recreational Viagra -- meet Mr. Blue

Eleven years ago, life as we know it truly began - when the unselfish, profit-blind humanitarians at Pfizer thrust upon an unsuspecting world a little blue pill guaranteed to get lazy Johnsons firm and peppy again. Men breathed a sigh of relief, straight women got more of the one thing men are truly good for, and some middle-aged gay men let out a squeal at the thought of being able to get back into action.

But a strange (although many say not entirely unexpected) thing happened about a minute after Viagra roared onto the market: men not necessarily plagued with medically diagnosed erectile dysfunction (ED) began to use the drug as a sort of sexual Hamburger Helper - whose miracle effects made a good thing last longer and perform stronger (to say nothing of helping tweaked out queens cope with erectile complications from the use of other recreational drugs).

From Bob Dole to Viva Viagra

In short order Pfizer was raking it in - and marketing their new wonder drug as a tonic guaranteed to put the spark back in your bedroom. At first it was marketed at the older set, with Bob Dole as its spokesperson. (That he may be best remembered as the pitch-person for erectile dysfunction relief and not as a Senator and Presidential candidate is one of those ironies of modern celebrity.) It didn't take long for Pfizer to realize that Viagra was not just for AARP set and a new set of ads -- with spokesperson All Star first baseman Rafael Palmeiro -- hit the airwaves to sell the drug to a younger demographic in 2002. The following year Palmeiro's contract was not renewed. (Two years later it was revealed that Palmeiro was dropping more than the little blue pill when Baseball Commissioner Bud Selig revealed that tests of "Palmeiro's blood samples taken during this season have revealed the presence of the muscle-growth-enhancing substance stanozolol," )

In 2004 Pfizer found itself under fire when an ad campaign that featured a middle-aged man returning to his previous sexually active self, replete with an image of him spouting little blue horns, was pulled from broadcast for suggesting that the drug was promoting sexual activity. The most recent ad campaign uses the Elvis standard "Viva Las Vegas" reworded as "Viva Viagra." There are also some celebrities who are promoting the drug without authorization: in China where laws governing the copyrighted use of images are lax, soccer star David Beckham, and actors Sean Connery and Keanu Reeves have been seen in television spots promoting ED drugs. The text to Beckham's ad reads ""Want to know how I can keep being strong and running on the football field? USA Selikon capsules help me a lot. It's also the secret weapon with which I can satisfy Victoria."

Pfizer’s no comment

The success of "Mr. Blue" (as Viagra was nicknamed on the street) led to the marketing of Cialis and Levitra, which help solidify the use of ED drugs in the American marketplace and throughout the world.

Asked to comment on Viagra's embrace by those who fall outside of yhe demographic represented by former pitchman Dole, Pfizer spokesperson Rebecca Ham assured Edge last Friday that an official statement on Viagra's recreational use by gay men was coming by the end of the business day. The Pfizer overlords must work poor Rebecca like a show pony - because as of Sunday evening's deadline for this story, she had yet to send that statement as to how they felt about everyone (from hip urban gentry to tweaked out club kids) taking Viagra like Pez.

Pfizer spokesperson Daniel Watts did address the issue to reporter Helena Olivero in a Cox News Service story published in April, 2004. He described the portion of young and presumably healthy users of Viagra as "peripheral," and said that the drug is "not to blame" for issues related to its recreational use. ""This is not about Viagra," he said. "It is about individuals taking responsibility for their actions - practicing safe sex and taking appropriate actions."

What's in a Word: "Recreational" use?

Although the recreational use of ED drugs crosses the full spectrum of sexual preferences and practices, it's (as usual) the gays who are at the forefront of taking the drug for "recreational purposes" - and layering it with a wealth of illegal party drugs.

Like many in the medical and social services community Michael Siever (of the San Francisco AIDS Foundation) bristles at the term "recreational use" - because it stigmatizes the user by bestowing a tone of morality to the activity (as well as the fact that such sensational, popular terminology is ultimately inaccurate). Stripped of its judgmental tone, "recreational use" means nothing more than the user is one who self-medicates with erectile dysfunction drugs not obtained by prescription.

Risk factors

Siever cautions that any drug not obtained by prescription likely means nobody is giving the user "advice about when to do it or not to do it, what the proper dosage is; all the appropriate warnings a doctor or pharmacist would give them."

Whether they obtain the drug from Internet sites or borrow from friends, Siever points out the hard fact that they're still consuming it "for the use for which it is intended." The term 'recreational' "implies that people are using it for some other purpose. It's not like they're using it to get high. They're using it for erections - which is its purpose."

Oh, if only Erectile Dysfunction Drugs came with a buzz on top of the boner they deliver. What a world that would be! Instead, gay men are making up for ED drugs' lack of packing a high to go along with that prolonged pecker by doing the only rational thing a horny gay man can do: combine it with everything from meth to GBH to LSD to any other number of drugs so powerful they require three letters in their abbreviation.

Taken alone, even for morally transgressive 'recreational" purposed, ED drugs pose little risk to those without preexisting heart conditions; but when combined with party drugs, they open up a Pandora's Box of psychological complications and medical risks.

Dr. Gal Mayer, medical director of New York City's Callen-Lorde Community Health Center, points to legitimate use of ED drugs by "Men with HIV, who commonly suffer from low testosterone - which can lead to ED; so we prescribe Viagra to our patients." He also notes legitimate use by "Gay men who have sometimes, like anybody, psychological erectile problems. Although Viagra is not strictly indicated for that, it's sometimes prescribed for that reason."

But when it comes to healthy men who use ED drugs, Mayer notes "Any time people use medications recreationally there is potential for abuse." Although ED drugs carry no physical addiction potential, "people can become psychologically dependent upon it and feel too anxious to have sex without it."

Dr. Juan Paredes is a psychiatrist practicing in South Florida, where the club culture in the gay community possibly reaches its zenith.�Dr. Paredes frequently treats men who have become accustomed to an enhanced sexual life with drugs and such, and are unable to achieve intimacy without them afterward.

Increased sexual contact

Speaking about his clients, and the Miami Beach nightlife scene in general, Paredes acknowledges the poorly-kept secret scandal that the local gays "love to party; and when they do, they're adding Viagra into their repertoire." The result? A potent cocktail of illegal whose combined effects "stimulates their libido so they're more primed for sex; but that can lead to impulsive sex, and correlates to a higher frequency of HIV."

A San Francisco study cited in the Cox News Service story concluded that the use of Viagra led to increased sexual activity -- and chance for riskier sex practices -- amongst those who use it. "In fact, a study of 844 men at a San Francisco STD clinic found that Viagra users had had an average of 5.4 sexual partners during the past two months, compared with 3.5 partners for non-Viagra users. The study also found that more than half the men using Viagra had obtained it through a friend, not a doctor."

As if the potential catching a STD wasn't a good enough reason not to mix Viagra with other drugs, Paredes repeats the warnings heard during every omnipresent ED TV commercial: "ED drugs, like any medication, has some side effects. It can damage the optic nerve and cause blindness, which happens in a very small number of cases. Even if it happens one to three percent of the time, that's still a lot of people."

Mayer also points to a problematic interaction with ED drugs-which, deepening upon who you talk to, is something between an urban legend and a fatal accident waiting to happen. Mayer: "When you use ED drugs with poppers, there is a real danger - because both drugs drop your blood pressure. Poppers are in the same family as nitroglycerin, which people with heart disease get prescribed" (that's why those ED commercials warn against taking their drug if you take "nitrates for chest pains").

The combined effect of taking two drugs, each of which cause a sudden drop in blood pressure, can lead to fainting and, in some cases, death. Yet although Mayer says Callen-Lorde always warns patients of this risk, "I think people must be using them safely, because I haven't heard of too many cases in our population where someone runs into problems combining these drugs." Still, he makes it clear the fact that popper and Viagra-fueled gays aren't dropping like flies is hardly an endorsement of the practice.

Dr. Dennis G. Fisher, professor and director of the Center for Behavioral Research and Services (California State University, Long Beach) has participated in two studies of Viagra (2006's "Recreational Viagra Use and Sexual Risk among Drug Abusing"Men and 2009's "Methamphetamine and Viagra Use: Relationship to Sexual Risk Behaviors"). He's also set to publish an article about ED and its recreational use in an early 2010 edition of Current Opinion of Infectious Diseases.

Speaking about the conclusions reached by previous risk behavior assessment and designer drug trailer studies, Fisher notes that "gay men were more likely to use Viagra in general, especially white gay men. We also found those who used Viagra were also likely to use amphetamines immediately before or during sex."

These studies do manage to use the cold hard facts to "point out that there's this combination of meth and Viagra - which we saw leads to higher rates of Hepatitis B, HIV and long term syphilis. We also found those who use both meth and Viagra are much more likely to be infected with HIV." Those who combine coke and Viagra "are more likely to be white, to have paid for sex, to have had a few more sex partners, and less likely to be straight."

That the door to unsafe sex seems to be opened when Viagra and party drugs are mixed is why Paredes sub specializes in sexual medicine which teaches patients how to achieve emotional balance (and sustained erections!) through the use of exercise, meditation, visualization, and behavior modification. The goal is to restore sexual satisfaction without drugs - of any kind.

That's easier said than done, he acknowledges; but as with so many things in life, it's worth a little hard work to achieve something that's hard.

"Yes," Paredes said, "it's an extra effort" to achieve and maintain drug-free erections. But "If we put an emphasis on educating this community, the long term results are going to be satisfying." The best way to get the desired results so far as one's southern tip is concerned, is to "live properly. Exercise daily and maintain a good diet. When they listen to that advice, it leads to increased testosterone"-which even Pfizer hasn't found a better substitute for when it comes to getting, and keeping, it up.