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Abstract
Background: There is anecdotal evidence of misuse of erectile dysfunction medication, particularly to counteract some of the unwanted effects of recreational drugs on erectile function. However, there is little data from the United Kingdom (UK). Aim: To evaluate the prevalence of sildenafil misuse in a UK population that has previously been shown to have high recreational drug use. Design: Questionnaire survey. Methods: Individuals attending nightclubs catering for the men who have sex with men (MSM) community in South London were asked about lifetime and last year use of recreational drugs and sildenafil. Results: 313 individuals were surveyed over four nights in 2013: 282 (90.1%) were males and 248 (79.2%) were MSM. Last year use of recreational drugs was high: mephedrone (74.1%), cocaine (61.3%), MDMA/Ecstasy (59.2%), GHB/GBL (52.8%), cannabis (51.8%), and ketamine (50%). 136 (49.1%) MSM versus 6 (18.8%) non-MSM clubbers had misused sildenafil in the last year (p < .001). Amongst the MSM clubbers, 232 (93.5%) had heard of sildenafil, 161 (64.9%) reported misuse of sildenafil in their lifetime and 133 (53.6%) had misused sildenafil in the last year. Conclusion: This study demonstrates a high prevalence of sildenafil misuse in a population who are heavy users of recreational drugs; it is not likely that this young population have underlying erectile dysfunction as a reason for legitimate sildenafil use. There is the potential for interaction with other recreational drugs used including cocaine and volatile nitrites. Further work is required in to determine the extent and reason for the misuse.
THE AUTHORS
Dr. Wui Ling Chan, MBBS, MRCS, MMed(EM), EMDM is a Consultant in the Emergency Department of Tan Tock Seng Hospital, Singapore. She is also one of the clinical toxicologists providing toxicological consultation services in the hospital and is a member of the national disaster site medical command team. Her clinical and research interests are in recreational drugs toxicity, prescription medicine misuse and disaster preparedness, and management of chemical incidents
Dr. David Michael Wood, BSc, MD, FRCP, FACMT, FBPhS is a Consultant Physician and Clinical Toxicologist and Clinical Lead for Medicine at Guy's and St Thomas’ NHS Foundation Trust and King's Health Partners in London. He is also an honorary senior lecturer at King's College London. In addition to interests in a variety aspects of clinical toxicology, his clinical, research and academic interests are in the epidemiology of use and acute harms associated with the use of classical recreational drugs and novel psychoactive substances (NPS). He has published over 100 peer-reviewed scientific papers and reviews in these areas, and is co-editor of a leading textbook in this area entitled ‘Novel Psychoactive Substances.’ He is a co-opted member for the UK Advisory Council for the Misuse of Drugs (ACMD) and an invited expert to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). He has co-authored and the risk assessments on behalf of the EMCDDA for several novel psychoactive substances, including mephedrone, 4-methylamphetamine, 1-benzylpiperazine, MDPV and methoxetamine. He also is joint holder of a European Commission grant for a longitudinal study entitled the ‘European Drug Emergencies Network (Euro-DEN),’ which is collecting data on presentations to Emergency Department in sentinel cities across Europe to further describe the acute toxicity of recreational drugs and NPS
Dr. Paul Ivor Dargan, MBBS, FRCPE, FACMT, FRCP, FAACT, FEAPCCT, FBPhS is a Consultant Physician and Clinical Toxicologist and Clinical Director at Guy's and St Thomas’ NHS Foundation Trust, London, UK. He is also a Reader in Toxicology at King's College London. He has an active research and teaching programme with a focus on recreational drug toxicity, self-poisoning and heavy metal toxicity. He has published over 200 peer-reviewed papers and numerous book chapters. He sits on the Advisory Council on the Misuse of Drugs (ACMD) and the Scientific Committee of the European Monitoring Centre for Drugs and Drugs Addiction (EMCDDA). He is an expert adviser to a number of other bodies including the US Food and Drug Administration (FDA) and the World Health Organisation (WHO)
