Overheard in an elevator, several years ago, at the CBC Broadcast Centre in Toronto: “I was at this party last night, and they had a bowl, kind of like a candy dish, of these diamond-shaped blue pills, so I took some.”

We’ve come a long way from the days when partygoers might not recognize a Viagra pill, but reports persist that young men are still using it for thrills.

Just who is taking Viagra as a recreational drug? A study in San Francisco by Dr. Jeffrey Klausner found that gay and bisexual men are four times more likely to use Viagra recreationally than heterosexual men. Klausner also found a significant number of thrill-seekers combined the little blue pills with ecstasy (43 per cent) or amphetamines (28 per cent).

Needless to say, such back alley combinations of drugs can lead to serious problems, such as a sudden drop in blood pressure.

Writing in the official journal of the International AIDS Society, Klausner also commented that “sildenafil (Viagra) . . . may be associated with unsafe drug use and sexual risk behaviour,” and that, “although Viagra is a drug that should only be taken under the direct supervision of a health-care provider, over half of the men (in his study of 844) received the drug from a friend.”

Straight boys are asking for those pills, too. The Harvard Medical School’s Dr. Abraham Morgantaler says teenage and 20-something guys are requesting erectile-dysfunction (ED) drugs - inventing a plumbing problem that doesn’t really exist.

Morgantaler is quoted in the Chicago Tribune saying that college students often ask him for a “six-pack” that’s not beer. (Viagra comes in packs of six.) He calls this “a stroke of (advertising) genius, evoking two great images of American maleness.”

In his book The Viagra Myth: The Surprising Impact on Love and Relationships (Jossey-Bass, 2003), Morgantaler blasts drug companies for using professional athletes and other macho figures to push their ED drugs.

And hey, this book came out in 2003, before we had the smirking Cialis couple arriving at the opera in time to hear the final notes and thunderous applause.

So what’s wrong with sneaking some Viagra? Let’s start with potentially lethal side-effects, such as the interaction between ED drugs and organic nitrates, commonly taken by people with heart problems. There are long lists of other contraindications, plus delightful side-effects like painful erections that won’t go down and can even injure you permanently.

Morgantaler also sees subtle emotional dangers. He writes about a couple that decided to separate after the man started taking Viagra.

The problem? “I thought that if I could have sex with her again, everything would work out fine. But it turns out our problems are bigger than the sex thing.”

Now to set the record straight, Viagra does not turn healthy guys into sexual supermen. But it certainly does something down there. To find out exactly what ED drugs do to healthy young guys, we turn to research coming out of Italy. Scientists at the University of Florence gave 60 healthy young men with no erection issues a pill that was either a 25-milligram tablet of sildenafil or a placebo. Talk about messing with people’s minds!

Anyway, the upshot was that “there were no differences between the two groups in the reported improvement of erection quality.”

However, the drug did cause “a significant reduction of the postejaculatory refractory time.” In other words, guys who got the real thing were ready for action a lot sooner than the others.

The Italians concluded that “sildenafil should not be given to young healthy men to improve their erections and patients should be advised against recreational abuse of the drug.” However, they did envision a place for ED drugs in treating premature ejaculation, and subsequent research has confirmed that.

That “20 minutes and ready for action again” goal is probably the driving force behind recreational use of Viagra, Cialis and other ED drugs. But the price of such sexual athleticism just might be eternal drug use. Suppose a healthy young stud takes Viagra at the beginning of a relationship. Will he have to keep taking it to meet his girlfriend’s expectations? Will she get angry if she finds out?

It’s been said that the brain is the most important sex organ, and that’s certainly true for guys. Since sexual performance has so much to do with confidence, some doctors are even prescribing ED drugs to younger men with the instructions “use it every other time.” This helps to restore their buoyancy, and eventually they may not need the drug at all.

With frisky couples prancing across our TVs, and Internet pharmacies trying to sell us their V1@GR@, it’s tempting to believe that a hard penis is the salvation of sexual relationships.

Yet, Morgantaler wrote that “the refill rate for Viagra prescriptions is less than 50 per cent.”

He concludes: “I came to see that our culture had taken Viagra and created a legend out of it that went far beyond its actual pharmacological properties.”

Sage advice from a thoughtful doctor who has written many, many prescriptions for those little blue pills.

Tom Keenan, I.S.P., is an award-winning science writer, professional speaker and professor at the University of Calgary.

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The Calgary Herald 2007