title: Significant Misuse of Sildenafil in London Nightclubs.
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).
  
  
  OBJECTIVE
  To evaluate the prevalence of sildenafil misuse in a UK population that has previously been shown to have high recreational drug use.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: a Emergency Department, Tan Tock Seng Hospital , Singapore.
authors.forename: Wui Ling
authors.initials: WL
authors.lastname: Chan
authors.affiliation: b Guy's and St Thomas' NHS Foundation Trust, Clinical Toxicology, St Thomas' Hospital , London , United Kingdom.
authors.forename: David Michael
authors.initials: DM
authors.lastname: Wood
authors.affiliation: b Guy's and St Thomas' NHS Foundation Trust, Clinical Toxicology, St Thomas' Hospital , London , United Kingdom.
authors.forename: Paul Ivor
authors.initials: PI
authors.lastname: Dargan
mesh_terms: D000293:Adolescent; D000328:Adult; D003042:Cocaine; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D013287:Illicit Drugs; D008131:London; D008297:Male; D008694:Methamphetamine / Q000031:analogs & derivatives; D008875:Middle Aged; D018817:N-Methyl-3,4-methylenedioxyamphetamine; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D015995:Prevalence; D000068677:Sildenafil Citrate; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
chemical_list: D013287:Illicit Drugs; D008694:Methamphetamine; C548233:mephedrone; D000068677:Sildenafil Citrate; D003042:Cocaine; D018817:N-Methyl-3,4-methylenedioxyamphetamine
keywords: club drug medicine; misuse; recreational drugs; recreational use; sildenafil