The Scenario: Driven by an urge to be the best he can be, a friend who does not have erectile dysfunction is pre-gaming for sex by taking Viagra recreationally. He maintains that the erections he sports while taking it are fuller, harder, and more long lasting than the ones he produces naturally and help overcome a slew of obstacles that can bedevil his boner including too much booze, cocaine, performance anxiety, and the fact that he's long past the days when a stiff breeze would be enough to provoke a thumping erection. He's also been known to take it when he's not necessarily in the mood for sex but doesn't want to disappoint a horny partner.

The Reality: Viagra is a brand name for sildenafil, a prescription drug developed by Pfizer scientists looking for ways to treat cardiovascular disease. It's been on the market since 1998 and works by increasing blood flow to the penis so that people with erectile dysfunction—an inability to achieve and/or maintain an erection—can be hard enough for sex.

In 2015, a meta-analysis of 150 trials determined that while Viagra is the most effective of the various ED drugs on the market, it also has the highest incidence of side effects—things like headache, upset stomach, vision loss or becoming blue-tinged, nasal congestion, back pain, muscle pain, nausea, and dizziness. Another rarer side effect can be having a rock hard erection that doesn't abate—the medical name for this perma-stiffy is called priapism. While priapism might sound appealing to a guy who has been thumbing-in softies for years, it's important to know that an erection that won't go away can cause permanent damage. But we'll get into that in a moment.

Given that most of the more common side-effects are relatively minor and its intended effect has been a diamond hard erection when he needed one the most, this friend wouldn't dream of leaving the house without a pill or a portion of a pill in his pocket. Not least because he says that Viagra also stops him from ejaculating too soon.

Worst Case Scenario: When Viagra is prescribed by a doctor for a genuine medical problem, the dose will be clearly specified. Taken recreationally, however, the only counsel you receive may be from a buddy recounting the tale of his indomitable boner during an epic sex session. That might lead some to jump to the conclusion that more Viagra means more good times—people like Daniel Medforth—a Brit who in 2015 choked down 35 pills at the end of a boozy two-day bender "for a laugh."

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This led to nausea, dizziness, hallucinations, and a five-day throbber that could have cost him his life. But you needn't take handfuls of the stuff for bad things to happen. In 2007, the wife of a 50-year-old Italian construction worker spiked her husband's wine with just two Viagra which resulted in him suffering a near-fatal heart attack. There are many other reports of people dying from a heart attack as a result of taking Viagra, but one gentleman nearly suffered a fate worse than death after trying to impress his wife by super-dosing. Gentil Ramírez Polanía, a Colombian farmer in his mid-60s scarfed a bunch of the stuff and impressed his woman with a multi-day hard on before checking himself into a hospital with an inflamed, fractured and gangrenous penis. Only emergency surgery managed to save Polanía's life and his penis although, sadly, it was not quite the same as it once was.

The Probable Outcome: Unless you exceed the medically recommended dose, you will probably be spared injury and death in your quest to have a cock like a crowbar for an evening. In fact, our friend is throwing his money away by using Viagra recreationally, according to Arthur Burnett, a urologist at Johns Hopkins. "If erections are really intact, it does not make a better erection," he says. Burnett does add, however, that what the recreational Viagra user is more likely to experience is a shorter refractory period—the time between ejaculating and being able to have sex again.

Psychotherapist, sex counsellor, and author Ian Kerner takes into account some of the psychological issues that can cause erections to wilt and suggests that Viagra can help in these instances. "I do find a higher percentage of men are dealing with sexual anxiety and sexual problems related to erectile quality and so there are more men dealing with situational ED and taking Viagra," he says. "The effect often for these men is a firmer, more consistent and dependable erection."

Early scientific research also backs up another of the friend's observations: that taking Viagra can delay his ejaculation.

What to Tell Your Friend: If our friend's penis was immune to the effects of booze, drugs, performance anxiety, fatigue, or simply not being in the mood for sex, the first thing to do would be to recommend that he go into porn because that's quite a skill set. Then we'd tell him to not waste the money he and his stunt cock earn by spending it on Viagra because he doesn't need it.

However, our friend is not in fact some sort of unthinking, unfeeling sex bot and as such is going to have his resolve softened by a number of external factors such as the ones mentioned above. As Kerner says, Viagra can help with the non-physical hurdles in between him and a prize winning hard-on, and it's probably not going to do him any serious or permanent damage.