Viagra Meets the Rave Scene

From the WebMD Archives

Aug. 18, 2000 -- The impotence treatment Viagra might seem an unlikely drug to find at nightclubs or raves, the all-night dance parties popular with teens. But experts say Viagra has begun making the club scene -- especially as an adjunct to ecstasy and "poppers," a combination that is questionable at best.

One rave fan says the combination of Viagra and ecstasy makes some sense. "Ecstasy makes it so you can't get an erection," says Soren Roinick, a Boston-based member of the group DanceSafe, which promotes "healthier" raves. At the same time, he says, it's not as if every raver's got his hand out for a little blue pill. "Ecstasy lowers all your aggression, including your sexual aggression," he says. "You might bond with someone per se, but generally, people at raves are not going home and sleeping with someone."

Still, researchers have taken note of the phenomenon. The practice of combining Viagra and ecstasy is mentioned in an article on the health risks of raves by Erica Weir, MD, a resident in community and family medicine at McMaster University in Hamilton, Ontario, in a recent issue of the Canadian Medical Association Journal. And in a letter to the British Medical Journal last year, researcher Judith Aldridge of the University of Manchester wrote that her study of 2,000 people found Viagra was being sold illicitly in English nightclubs within weeks of becoming available in that country.

Many nightclub-goers interviewed by the British researchers reported having taken Viagra along with illicit drugs and alcohol. The combination with "poppers" -- vials of amyl nitrate or isobutyl nitrite sometimes used illicitly as an aphrodisiac -- is particularly worrying, Aldridge writes: "Both drugs dilate blood vessels, which can result in a dangerous drop in blood pressure and possibly [heart attack] or stroke."

In the U.S., Roinick says he has seen Viagra use at raves on the West Coast -- though nothing too extensive -- and suggests it's probably more common with older crowds at sadomasochistic offshoots of the dance parties. "Normally, raves are a positive-vibe kind of place," Roinick says. "There's a big drug scene that's not part of the rave scene."

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Still, there's little doubt those positive vibes emanating from some of these dance parties have something to do with drugs -- in particular ecstasy, also known as MDMA. Roinick, who admits to being an occasional ecstasy user, says there's a good reason young people are attracted to the drug: "It just makes you feel really, really happy."

But there's little that's happy about the ultimate effects of ecstasy, one expert says -- and, although it's not entirely clear what happens when people take it along with Viagra, the results of mixing Viagra and poppers are definitely grim.

Ecstasy "is a bad, bad, bad drug, no matter what you read" says Wilkie Wilson, PhD, professor of pharmacology at Duke University Medical Center in Chapel Hill, N.C., and co-author of Buzzed: The straight facts about the Most Used and Abused Drugs. The drug, Wilson says, may very well have a long-term effect on mood. "What happens is, as we age, we lose serotonin function. So if you're kicking off a bunch of it when you're young, the end result is depression."

Roinick says the common "cure" for ravers who feel depressed after taking the drug is to lay off ecstasy for a couple of weeks to give the brain time to recover. But Wilson says some studies have shown there is no such thing as recovery from ecstasy -- and further, that the drug can dangerously increase both body temperature and blood pressure.

Viagra, on the other hand, can cause a decrease in blood pressure, and Wilson says he can't say whether combining the two drugs is necessarily dangerous. But psychiatrist Marshall Forstein, MD, medical director of Mental Health and Addiction Services at Boston's Fenway Community Health Center, warns that it's a bad idea.

"A lot of the ecstasy is not pure," he says. "It's a mix of different amphetamine salts. But even so, ecstasy affects the liver metabolism of Viagra ... they inhibit enzymes which metabolize each other." That can cause a potentially dangerous rise in blood levels of each drug. " He also says there have been reports of strokes in people who take the two drugs together.

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As for using Viagra with poppers, which are particularly popular in the gay community, there's no uncertainly as to the dangers. "The risks with the poppers is serious," Forstein says. "They lower blood pressure precipitously."

So why would someone want to take these two drugs together? "Poppers dilate blood vessels. So they make people get a rush," he explains. "The problem is, many men become sexually dysfunctional with constant use and that's when there's a tendency to want to use Viagra." Even men who don't intend to use the two drugs together can get into trouble in clubs, where vials of poppers sometimes get shoved under unsuspecting nostrils, Forstein says. Men who have used Viagra hours earlier can be affected, since the erection drug stays in the body for such a long time.

In an article distributed by the Canadian Press news service, a spokesman for Viagra manufacturer Pfizer says the company warns against using Viagra with poppers or ecstasy. "Viagra is not an aphrodisiac and has no effect on libido," says Don Sancton, director of corporate affairs for Pfizer, Canada.

No one can say at this point the extent of drug-mixing going on in the nightclub and rave scene -- and, in particular, the use of Viagra there. Conrad Roberson, of the Drug Identification section of the Georgia Bureau of Investigation, says it's unlikely authorities would take much notice of the illegal possession of Viagra when they're arresting someone for the far more serious offense of possessing ecstasy. And because Viagra falls outside the list of federally "controlled" substances, its use is not of legal concern to the Drug Enforcement Administration.

But according to one advocate, the very nature of the rave culture is not conducive to the widespread use of Viagra.

"The rave community is not a super, highly charged sexual community," says Jennifer Keys, media representative for DanceSafe's Seattle, Wash., office. "It's supposed to be based on mutual self-respect. There are very few rapes at raves. You're much more likely to have that at rock concerts."

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