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Rx Drug Abuse: Common and Dangerous

What are the most abused prescription drugs, and what are the risks?

Erectile Dysfunction Drugs

Some men are abusing erectile dysfunction (ED) medications, such as Viagra, Cialis, and Levitra, as recreational drugs to enhance sexual performance. "It's taken by men who don't need it," says Craig Comiter, MD, associate professor of surgery (urology) at the University of Arizona. Often, they mix the medications with other drugs, such as methamphetamine or Ecstasy. "Those drugs do change judgment," Comiter says.

Perhaps that explains why one study found that men who use Viagra while having sex with other men engaged in unprotected sex up to six times more often than nonusers.

As a result, those who abuse ED drugs may dramatically increase their risk of sexually transmitted diseases and HIV infection. Comiter adds that among men who abuse ED drugs, there have also been anecdotal reports of severe nosebleeds that require hospitalization.

Drugs to Enhance Athletic Performance

Some people abuse anabolic steroids, synthetic versions of the male hormone testosterone, to improve athletic performance and physical appearance. According to the NIDA, most of these steroids are smuggled from abroad, made in covert labs, or illegally diverted from U.S. pharmacies. They can be taken by mouth or injected.

In the U.S., steroids are a prescription drug that doctors use to treat various conditions, such as delayed puberty or muscle wasting from AIDS.

Who's most likely to abuse steroids? Mostly young males, although the problem is growing among young females. Many are athletes, but not all. "There's a huge population of kids who just want to look good," says Robert Dimeff, MD, primary care director of sports health at The Cleveland Clinic. "They're really trying to get this aesthetic look of being big, lean, muscular individuals."

Steroid Side Effects

Steroid abuse can lead to liver tumors and cancer, jaundice, high blood pressure, increases in "bad" LDL cholesterol, and other problems. In men, steroids can cause shrinking of the testicles and breast development. In women, they can cause masculinization of the body. In adolescents, steroids can halt growth prematurely.

What concerns Dimeff more than physical problems are the potential effects on behavior. "In males, the testosterone tends to make them more aggressive and violent, and it increases libido." Hence, the term "roid rage."

If adolescents have a personal or family history of psychiatric problems, steroid abuse makes them especially vulnerable to behavioral or emotional problems, he adds. Such a psychiatric history would include alcohol or drug addiction, violent or criminal behavior, and bipolar disorder, among others, Dimeff says. "That's what I worry about the most. You give them something intense, and you can put them over the edge."

Some athletes may also abuse erythropoietin (a drug that doctors use to treat anemia, also known as Epogen and Procrit) to boost production of red blood cells. Athletes hope that the increased numbers of red blood cells will deliver more oxygen to muscles and improve endurance. Erythropoietin abuse can alter the body's regulation of red blood cell production. Once the drug is stopped, the number of red blood cells may drop suddenly.

Human growth hormone can be abused, too. The brain produces growth hormone to help the body control growth. But growth hormone also comes in drug form to help children grow if their own bodies don't make enough of the hormone. Sometimes athletes abuse growth hormone in an attempt to build muscle and strength while reducing body fat. But long-term abuse carries risks, such as increases in blood fat levels, diabetes, and heart enlargement that may end in heart failure.

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