Erection Reform

No one uses Lipitor recreationally. People aren't cramming into the bathroom stalls of nightclubs, combining it with cocaine and saying, "I'm doing Lipitor tonight, trying to see if I can get my cholesterol all the way down."

But recreational use becomes an issue, explains Steven Lamm, a clinical assistant professor at New York University, with any drug that improves performance. And that includes Viagra, the little blue pill that enhances the quality, hardness, and duration of an erection, as well as the ability to achieve a new erection following ejaculation. And as such, it holds a special appeal for anyone whose sexual performance is impaired for any reason.

As it turns out, this is a lot of people. "Viagra is to the drug world what Britney Spears is to pop music: Nobody will admit to actually being a fan, but somebody is buying all those albums," says Jayson Gallaway, author of Diary of a Viagra Fiend. "Somebody is buying $570 million worth of Viagra each year, and it's not just Bob Dole." When you factor in the numbers for Levitra and Cialis, chances are you know several people who routinely use ED pills of one type or another.

The problem isn't that Viagra is going to kill you, explains Lamm. The drug itself is safe. The problem is that many people who buy Viagra online or on the street and think they're using it recreationally are actually using it therapeutically, oblivious to why they need it in the first place. "A guy doesn't just get it into his head to pop some Viagra," says Lamm. "He's probably had a failure. And if you're having a failure, it doesn't mean you need to pursue recreational use. It means you need a time out."

For a man who's popping Viagra recreationally, the real question is why he needs it in the first place. Is it a problem with his health? Or is it a problem with his relationship? Like any drug that suppresses a symptom, Viagra can mask an underlying medical issue, such as heart disease or cardiovascular disease, a sleep disorder, or the fact that other prescription medications are interfering with sexual function. And for a healthy young man erectile failure may be an issue because he's a chronic marijuana smoker, a cocaine user, or an alcoholic.

The solution is to make men understand that sexual performance tends to be a barometer of overall health. A healthy performance level means being able to achieve and maintain an erection sufficient for intercourse. "We expect every man to be able to do this daily if he wanted to, maybe even more than once a day, depending on his age," says Lamm. "If you have the time, you have nothing else to do, you have the proper receptacle, be my guest."

But if sexual performance is impaired, it's probably an indicator that something else is wrong. "When a man stops the smoking, achieves a normal body weight, loses the gut, stops the marijuana, reduces alcohol, and gets proper sleep, all of those things are going to diminish the need for Viagra," says Lamm.

Another problem is that when used recreationally, Viagra is often combined with street drugs such as cocaine, meth, or ecstasy, which inhibit judgment. "Engaging in risky sexual behavior—such as unprotected sex with high-risk partners—is one of the chief side-effects of any street stimulant," explains Galloway. "But an equally powerful side-effect is the inability to perform sexually, which, while frustrating as hell, has probably prevented a lot of disease transmission and unwanted children."

But Viagra gives men the ability to engage in risky sex during periods of impaired judgment. "Viagra enables junkies to breed unchecked," says Galloway. "I suspect there are many men with somewhat checkered pharmaceutical pasts who now think temporary chemically induced impotence might have been a good thing after all."