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Viagra's History
================

Who could have guessed that a former Senate Majority leader and
presidential candidate would end up pitching an impotence cure on
national television? Bob’s big boy wasn’t the only one that needed a
boost. Shortly after Viagra was introduced on March 27, 1998, doctors
were writing more than 100,000 prescriptions for it each week at a
cost of up to $10 per pill. By June, 2 million scrips had been issued
in the United States, while Asians and Europeans were paying hundreds
of dollars for questionable goods on the international black market.

According to the Journal of Urology, there may be 20 million men in
the United States -- and perhaps as many in Europe -- who have
significant “erectile dysfunction.” But a mounting body of evidence
suggests that membership in Viagra’s fan club includes healthy young
men who want to pump up their already able prowess, able-bodied guys
who use the stiffening agent as a party favor or simply to overcome
their dating jitters. However, there are Viagra alternatives that are
extremely effective.

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.

Jim Shaw

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