Men's Sexual Health Section

The agony and the sextasy

Viagra and crystal meth cocktails are hot in the gay community ? and they're increasing traffic in the STI clinics

By Julia Cyboran

It's 3am and the ER at Montreal's General Hospital is bustling. The paramedics have just wheeled in a new patient ? a young man who's lying limp on the gurney, convulsing and moaning in a delusional paranoid state. His temperature is high and his body is covered in clammy sweat ? it's obvious he's overdosing. The one odd symptom the ER doctors notice is that the patient has an erection ? and it's bent.

The patient, Franco, is 26-years-old, and he's hooked on sildenafil (Viagra). That might sound odd considering that the average sildenafil user is typically a middle-aged man with erectile dysfunction (ED). But Franco's relationship with sildenafil is different from the average user. He isn't looking for something to get him back in the ring, rather something that will keep him coming back for more. Franco is part of a growing population of sildenafil users ? young gay men ? who are mixing the ED med with popular street drugs like crystal methamphetamine (crystal meth) or ecstasy in order to heighten their sexual experience.

New research released last month reports that sildenafil combined with other drugs may be a factor behind the increase in HIV and other STIs like syphilis and gonorrhoea. The study, conducted by the San Francisco Department of Public Health (SFDPH) and the US Centers for Disease Control, looked at 1,200 gay men and found that 17% of those who visited a local STI clinic had used crystal meth in the last four weeks. They were twice as likely to have HIV, 4.9 times more likely to have syphilis, and reported more sexual partners than nonusers. Another study, also from the SFDPH, found that gay men on both crystal meth and sildenafil were 6.5 times more likely to have syphilis ? very likely connected to the fact that they were much more likely to have sex without a condom.

"The situation here in Canada is similar to that in the US," explains Dr Pierre-Paul Tellier, of the McGill Student Health Centre. He's volunteered at many of Montreal's notorious circuit parties, like the Black and Blue, which draw thousands of partygoers, and he's very familiar with the problem. "It was slower starting and anecdotally I don't think it has reached the same proportion."

The practice of mixing the common ED drug with street drugs isn't new. Since sildenafil's introduction to the US market in 1998 it has been a mainstay on the gay club scene. The trend originated in southern California, where crystal meth has always been a popular drug. "The gay community has been warning people about the risks for several years now and the straight media has been essentially slow on the uptake," says Dr Tellier.

The reason people are mixing sildenafil with street drugs is simple ? sexual pleasure. Crystal meth and ecstasy stimulate sexual desire, but the downside is it's difficult to get an erection. That's where sildenafil comes in. All these drugs are relatively easy to come by, thanks in part to internet pharmacies, and they're cheap as illegal substances go. But the side effects to the combo drugs are anything but pleasant. Many US ERs are reporting a higher incidence of anatomical damage due to prolonged erection, elevated body temperature, paranoia, convulsions and even death due to the use of sextasy ? as the sildenafil/ecstasy combo is known ? or the crystal meth/sildenafil cocktail.