Indigestion

Rum and Poke

"Poke," as Viagra is casually known, has replaced Ecstasy and cocaine as the drug of choice for many on the club circuit, reports The Web of Abuse, an Internet magazine. Users frequently combine poke with alcohol or other drugs, saying it enhances sexual desire and lovemaking and gives them "feelings of warmth." It also gives them feelings of complacency. "These kids know that there's no real price to pay," acknowledges Hubert, a Miami club deejay. "If you get caught with a gram of coke, you're looking at jail time. If you're busted with poke, you're not going to take much heat." Despite anecdotal evidence, Viagra's manufacturer is hesitant to admit that its sales champ has any secondary use. "These stories about Viagra as a party drug really can't be substantiated," says Pfizer Inc. spokeswoman Mariann Caprino, "and I don't tend to believe them." Based on the company's data, the vast majority of Viagra users are men over 50 -- hardly the folks you'd expect to find traversing high-decibel, high-energy nightclubs. But Caprino somewhat grudgingly admits that there may be a trickle-down effect from Viagra's target market. "There's a certain chic to having Viagra, and right now it's very easy to get," says Steven Lamm, M.D., author of The Virility Solution: Everything You Need to Know About Viagra. "Some Internet sites even accept faxed prescriptions. But that's to be expected; it isn't exactly a controlled substance or a narcotic. You can't get arrested for having Viagra, and [doctors] can't question whether someone needs the drug or plans to sell it for profit. I mean, if a patient comes to us and says he can't get it up, we're not going to make him prove it." Pfizer has launched its own campaign against overly accommodating doctors, especially those with commercial Web sites offering viagra on line. "Pfizer is adamantly opposed to the Internet availability of Viagra, and we've contacted a number of state medical boards that have taken action against physicians who have engaged in this practice," Caprino says. "We don't believe that buying any drug on the Net without [appropriate medical supervision] is a good way to be diagnosed or treated for a serious medical condition. Erectile dysfunction is associated with other medical conditions, like prostate cancer, and by not seeing a physician, you're missing a potential diagnosis of a serious underlying condition." Viagra's big bang actually started with a humble whimper. The little blue pill, also known as sildenafil citrate, was first tried -- unsuccessfully -- as a treatment for angina. Although it didn't eliminate chest pain, its users were reluctant to stop taking it. Doctors quickly discovered why: The drug enhances the effects of chemicals that the body normally releases during sexual arousal, thereby allowing an increase of blood flow into the penis; it also blocks the natural enzyme that counteracts those chemicals. During clinical trials, Viagra had a success rate of 70 to 90 percent, compared to 10 to 30 percent for a placebo. Reported side effects included headaches, flushing, indigestion and a visual impairment where everything seems tinted a murky pale blue. Not surprisingly, only 2.5 percent of the trial subjects found these reactions objectionable enough to discontinue treatment. More serious reactions have come to light since then, but for some men, Viagra's benefit is apparently worth any risk.

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