Viagra, poppers & crystal

Trying Viagra for crystal dick? Have poppers become your "pick-me-up" during weekend sex-fests? Some men are using crystal, poppers, and Viagra together. Using these drugs at the same time can cause serious problems. To keep your party from ending in the emergency room or worse, here are some things to know about mixing these drugs into your sex play.

CRYSTAL
Crystal is a stimulant that sends your body into overdrive. To handle this, crystal shrinks your veins, speeds up your heart rate, and increases blood pressure. It also floods your brain with chemicals that give you lots of energy. You may feel euphoric, confident or even paranoid. Crystal can boost sex drive, delay orgasm and heighten your sense of pleasure.

The downsides are not so pretty. The chemicals in crystal are highly toxic. Even after a few uses, crystal can cause depression, sexual dysfunction, heart problems, psychosis, and long-term brain damage. It can also be very addictive. Some men get hooked quickly and soon need crystal to have sex or just get through a normal day. Some signs of addiction may include:

• Feeling "out of control"
• Health, money or relationship problems
• Getting high even when you don't want to
• Feeling like it "isn't fun anymore"
  

If you use crystal . . .

• Eat, drink plenty of water, and get some sleep. That's the first rule of safer speed use.
• Take frequent breaks from using. Don't get high every weekend or stay up past one or two days.
• If you inject, never share needles or any of your works. Always use new, clean equipment.
• Watch for signs of addiction or problem use. Don't wait to get help (check out our resource list).

VIAGRA
Viagra (sildenafil) is used to treat impotence (the inability to get or keep a hard-on). Viagra opens your blood vessels to let more blood flow into your penis. As a result, your blood pressure drops and your heart speeds up. This can cause dizziness, headaches, facial flushing or blue tinted vision. Take too much Viagra and you might feel breathless, have chest pains, or black out. You might also get an erection that won't go down. This can be painful and cause long-term damage to penile tissue.

Never use Viagra with poppers. Together, these drugs can have a fatal effect on blood pressure and heart rate. Several deaths related to the overuse of Viagra have already occurred.

Viagra is not believed to increase sex drive or make people horny. Viagra needs some sexual stimulation to really work, so you won't get an instant hard-on. Getting turned-on is up to you and your partner. If you get aroused and hard on your own, then Viagra isn't worth the extra risk.

Viagra doesn't work the same for all men. Your results will depend on how much you take, what other drugs are in your system, your current health status and even where you take it. If you pop a Viagra at the bathhouse, you just might get an erection. But is that due to Viagra or the naked buffet in front of you?

If you use Viagra . . .

• Get a prescription from your doctor. Limit your dose to what your doctor recommends. This will help you avoid risky side effects.
• Give it time to work. Viagra takes about an hour to reach full effect.
• Absolutely avoid poppers. This combination is very dangerous and can be fatal. Don't use Viagra and poppers together or within 24 hours of each other.

"I've used crystal for a year and can't get hard anymore. Why?"
"Crystal dick" is common among crystal users. It's most likely the result of vein damage and changes in brain chemicals that cause an erection. Sometimes, these changes are permanent. Will Viagra help? Reports from crystal users vary. Sometimes taking a break from crystal does the trick. Over time, many men see their erections improve once they stop crystal for a while. Before you start popping little blue wonder pills, talk to your doctor first!

POPPERS
Poppers are a liquid form of amyl or butyl nitrite. Some guys inhale the fumes during sex to enhance orgasm, prolong sex, or relax their butt muscles for easier penetration or fisting. After a quick rush, you may feel light headed, nauseous, or flushed. Expect a slamming headache in the morning! Poppers are not physically addictive, but you can develop a tolerance. After frequent use, some guys can't have or enjoy sex without them.

Poppers open your blood vessels and can dramatically lower your blood pressure. If you use too much, your blood pressure can drop too low. You could feel faint or pass out. Poppers also put extra strain on your heart. Going overboard on poppers can increase your chance of heart attack. The chances are even higher when you add dancing, crystal, cocaine, Viagra, or intense sex.

If you use poppers . . .

• Leave some time between whiffs. Let yourself recover before taking another hit.
• Don't let the liquid touch your nose, mouth, or skin and don't swallow it. Poppers are harsh chemicals that burn!
• Don't confuse a bottle of poppers with GHB. GHB comes in little bottles like poppers but should not have a smell.
  

"Compared to crystal, poppers seem like candy. So what's the big deal?"
Poppers may seem mild compared to other "harder" drugs, but they are not harmless. Poppers can cause skin disorders, rashes, and tissue damage in your nose. Poppers can block your blood's ability to carry oxygen which can lead to death. Poppers can also cause brain damage, but how much isn't clear. And the more you use, the worse the damage can get. Research has shown that poppers weaken parts of your immune system and may actually promote the growth of Kaposi's Sarcoma tumors.

AVOIDING THE EMERGENCY ROOM
Mixing crystal, Viagra or poppers at the same time can have very serious health risks. The danger lies in how these drugs affect your heart rate and blood pressure. Using two drugs together that both lower your blood pressure can cause fainting, unconsciousness, coma, or even death. Using two drugs that speed up your heart can send your blood pressure zooming towards heart attack or stroke. Strenuous all-night dancing, intense sex, dehydration, and lack of sleep could make the problem worse. So can alcohol, ecstasy, GHB, or Special K.

"But I love all three!! I don't want to quit any of them! What can I do?"
You don't have to quit any of them - just don't use them together! That's your safest choice. If you do choose to mix, then at least cut back on one drug. This isn't the best option, but it might lessen your risks.

Cutting back can mean using less of a drug or using it less often. One may be easier for you than the other. So, how do you decide?

In general, you have the most control over the drug you do first. Your judgment is usually better at the beginning. Once you start adding drugs or getting surprise offers of drugs, your choices may not be the best. Use less of your first drug.

But what if your first drug is the one you love the most and can't cut down? Then ask, Which drug can I say "no" to most easily? For example, if you can't resist crystal, then skip or do less poppers.

HIV POSITIVE? THERE'S MORE!
Some men with HIV turn to crystal, Viagra and poppers to spice up sex lives sometimes dampened by low testosterone levels, medications, depression, infections and simply getting older. But many of these problems can be helped by a good doctor. For example, if your testosterone is low, testosterone is the solution - not Viagra. If you're depressed, maybe you need an antidepressant, not more crystal.

Crystal, poppers, and some HIV meds get broken down in the same liver pathway. Since only one drug can enter at a time, the other drugs get backed up. The HIV meds reach this pathway first, so crystal and Viagra can build up, sometimes to dangerous levels. Your heart may not be able to handle the extra stress of so much Viagra or crystal in your system.

The following HIV medications increase the levels of both crystal and Viagra:

• protease inhibitors (especially ritonavir)
• delaviridine
• itraconazole, ketaconazole (anti-fungals)
• erythromycin, clarithromycin, azithromycin (antibiotics)

As far as we know, neither Viagra nor crystal seems to affect the way anti-retroviral meds work. However, forgetting to take your meds while you're high can have an impact on drug resistance and viral load. Here are some tips on handling drug use and HIV meds:

• Always take your HIV meds as prescribed. Taking frequent "drug holidays" to get high could impact your viral load. Over time, your cocktails could lose their effect.
• Be alert to any changes in your high after you start a new HIV medication. Do you feel "higher," stay up longer, have more paranoia or a harder crash? These could signal drug interactions. Tell your doctor.
• Use less crystal. Try one-third or even one-half your normal amount. If you just can't stop at one hit or say "no" to that extra bump, talk to your doctor about options.
• Take less Viagra. If you take protease inhibitors, the makers of Viagra suggest using only 25mg (half the standard 50mg dose) within 48 hours. Start low and see what results you get.
• Don't follow advice from well-meaning friends. Their experience and their HIV are not yours. Talk with your doctor.
  

"My doctor always lectures me about my crystal use, so I don't talk about it anymore. I'd rather avoid the subject than listen to that every time."
A lot of men who use drugs feel judged and intimidated by their doctors. But your doctor does need to know about your drug use: both medical and recreational. Otherwise, he or she could prescribe a medication or dose that doesn't mix well with crystal. If your doctor won't talk respectfully and openly about your drug use, tell him or her how you feel. If talking it through doesn't work - get a new doctor!

GETTING HIGH AND GETTING HIV
Can crystal or poppers make it easier to get HIV? In many ways, the answer is yes. Here's why:

• When you're high you may lose good judgment. You may intend to be safe, but in the heat of the moment, condoms might never cross your mind.
• Poppers open blood vessels, sending more blood to areas like your dick and ass. This makes it easier for HIV and other STD's to get into your bloodstream.
• Crystal, alcohol, or all-night dancing and sex can dehydrate you and dry up the natural lubricant in your butt. A dry, cracked butt is a welcome mat for viruses and germs.
• Poppers and crystal can each reduce the pain of anal sex. But long, hard butt sex beyond your normal limits can create small tears and more openings for HIV.
• Guys who use crystal or poppers tend to have more sex with more partners.

And it's not just about HIV. There are plenty of other sexually transmitted diseases like syphilis, gonorrhea, herpes, and hepatitis B that are just waiting to find you. Having another STD can make it easier to get or pass on HIV.

So what's a crystal user to do?
Prepare for safety BEFORE you get high or get into sex. Before any dick goes into any butt, get the condoms out. Talk about what is OK and not OK. Also, be more consistent with your safety plan when you're NOT high. For many guys, the safer they are straight edge, the safer they are high. It just becomes a natural part of their sexual practice.
Here are some other tips for safer drug and sex play:

1. Don't buy into "the drugs made me do it" excuse. Plenty of guys use speed and other sex drugs and still use condoms or negotiate safety. You can too.
2. Plan ahead BEFORE you get high! If you think you might have sex later, take condoms and lube. Keep them with your drugs, wallet, or keys.
3. Lube, lube, more lube - and always water-based lube!
4. Condoms and lube may wear out before you do. Check them often during sex, when you change position, or withdraw.

Still have questions about safer crystal or other drug use? Project NEON provides reliable, peer-based information and services to gay and bisexual crystal users. Our staff and peer educators can answer questions about crystal, party drugs, and safer sex or needle use. If you need help with life problems, managing your use or feel you want to quit, our speed-savvy counselors at Stonewall Recovery Services can also help. And it's FREE. You don't have to quit or even want to quit to get help. You'll find our numbers in the Resource List.

You can also stop by the Needle Exchange Medical Clinic, 1511 Second Ave, M-F 1:30-4:30. Walk-ins welcome.