What are recreational drugs?
Recreational drugs are legal and illegal substances taken by individuals for pleasure rather than medical purposes 8 . They are mainly used by young adults for reasons such as curiosity on the drug’s effect on their wellbeing by making them feel happy or relaxed, or to help them to forget about their personal problems or circumstances 9 . One study reported that 9.5% of the population aged 16 to 59 (around 3.1 million people) and 17.6% of individuals aged 16 to 24 (about 1 million individuals) disclosed using drugs at some point in the year that ended in March 2023 15 .
There are many different types of recreational drugs, but the most common drug used in England is cannabis. Research shows,15.4% of those in the 16–24 age group and 7.6% of those in the 16–59 age group confirmed that they consumed the drug at some point in their life 15 . Some other examples of common recreational drugs include cocaine, codeine, ecstasy, alcohol, and nicotine.
What are the negative effects of recreational drugs?
Individuals consume recreational drugs because they like the after-effects they have on their bodies; however, they can also result in negative impacts such as addiction, crime predisposition, health, and social problems. Depending on the type of recreational drug, it can cause different effects such as high blood pressure, infections like HIV, anxiety, depression, psychosis, dizziness, and blackouts 9 .
The effects on recreational drugs on sperm
Many people are not aware that apart from the negative effects previously mentioned, recreational drugs can also influence men’s sperm by reducing its quality which could lead to fertility issues in the future. Recreational drugs have a negative impact on hormones such as testosterone, luteinizing hormone (LH), gonadotropin releasing hormone, and follicle stimulating hormone (FSH) which are necessary for the effective regulation of the male reproductive system, leading to changes in the spermatozoa and male fertility 12 .
Cannabis
Studies have demonstrated that the use of cannabis, which is also known as marijuana, is linked to the inhibition of LH, FSH and testosterone levels in the bloodstream 7 . Researchers observed that men who smoked cannabis more than once a week suffered from lower sperm concentrations, total sperm counts, motile sperm percentages, and morphologically average sperm percentages 6 . Regular use of cannabis, more than once per week was associated with a 28% decrease in sperm concentration and a 29% decrease in total sperm count, according to a Danish study 20 . However, research found that gradually stopping cannabis use can reduce these effects, so this is possibly reversible. Based on the study's findings, men who quit smoking cannabis for 77 days produced sperm that lacked most of the known alterations that were evident during their active cannabis usage 13 .
Cocaine
Frequent cocaine use has been associated with lower sperm mobility and concentration as well as a rise in the percentage of sperm with abnormal morphology 7 . Both short-term and long-term cocaine usage damages the ultrastructure of the testes and reduces spermatogenesis. Cocaine triggers cell death, vacuoles, and lipid droplets, which instantly interrupt spermatogenesis and tubule formation 7 . Men who had used cocaine for five years or longer were twice as likely to have poor sperm motility, according to research conducted on male patients at a Yale infertility clinic 4 . The limited information available on how cocaine affects spermatogenesis is obtained from research conducted on animals by Schifano et al. (2022) who discovered that rats given large doses of cocaine had reduced seminiferous tubule dimensions and a lower likelihood of pregnancy 18 .
Although some effects, primarily decreased motility, are still observed, research indicates that relatively low dosages of cocaine are unlikely to have an enormous effect on sperm quality 21 . Additionally, some evidence indicates that the alterations are temporary, restoring to normal sperm quality once the use of cocaine is stopped 21 .
Codeine
While codeine has been demonstrated to increase male libido and sexual activity, Ajayi and Akhigbe (2019) also found that it may significantly lower copulatory efficiency and reproductive indices 1 . Long-term codeine usage has been demonstrated to result in testicular degeneration, reduced sperm quality, and the development of oxidative sperm DNA damage and apoptosis 7 . It was discovered that at 4 mg/kg b.w., codeine caused a 25% and 30% reduction in sperm plasma membrane integrity in 30 and 60 minutes, compared at 10 mg/kg b.w., which caused a 35% and 42% decline in 30 and 60 minutes 2 . These findings indicated that the poor membrane integrity observed with codeine use was dose-dependent 2 .
Ecstasy
The effects of ecstasy were investigated in animal research, which revealed an increased incidence of tubular degeneration, damage to sperm DNA and interstitial oedema in the testes, although sperm motility and morphology were unaffected on all tested levels 4 .
Alcohol
Alcohol use has been associated with sexual dysfunction, which has been linked to male infertility. This includes issues with arousal and desire as well as erectile and ejaculatory impotence. It has been shown that persistent and excessive alcohol use decreases the levels of gonadotropin and testosterone in the blood, shrinks the testicles, reduces sperm production, and causes low sperm quality 7 . When compared to males who consumed 1-4 units per week, it was found that men who usually consumed more than 40 units per week had a 33% decline in sperm concentration 10 .
Research by Sansone et al. (2018) indicated that while there was no consistent dose-response pattern, alcohol consumption was linked to impairment of the majority of semen parameters 17 . Infertile patients in the "daily drinkers" group had poorer semen quality and hormonal characteristics in comparison to all other groups, according to the same study's results. Also, couples where the male drank over 20 units of alcohol a week had a noticeably longer time frame before getting pregnant 17 . Evidence suggests that alcohol abstinence can facilitate rapid changes in sperm quality, shown by the return of normal semen parameters within three months of the absence of alcohol 19 .
Nicotine
One of the most harmful components in cigarette smoke is nicotine. There have been concerns about its impact on the male reproductive system as it was found that nicotine reduced the number of spermatocytes and spermatids 3 . Because the testes are affected by cigarette smoke, continuous exposure to it changes the shape of spermatogenic cells and interferes with spermatogenesis and sperm production, all of which directly contribute to male infertility 3 . In addition, testosterone, pituitary gonadotropins, and the antioxidant status of the testicles are all altered by nicotine. Research revealed that the density of sperm in smokers was 13%–17% lower compared to nonsmokers 11 .
Testicular damage was also demonstrated in another study involving male rats, where the higher levels of reactive oxygen species (ROS) produced by nicotine targeted the polyunsaturated fatty acids (PUFA) in the testes membrane, eventually resulting in the impairment of testicular function and structure 3 . This means low sperm quality caused by nicotine-induced oxidative damage could be the cause of the structural damage to the testicles and an impairment of the testes' normal function.
Any male who stops smoking at least three months prior conception will have better sperm with a higher possibility of fertilising an egg. This means that quitting smoking can reverse its effects on sperm 22 .
How do recreational drugs and its effects on sperm relate to ethics?
Individuals who take recreational drugs often believe that there are no negative effects from regular use or that the effects do not have any major consequences 14 . Although it is known that there are limited studies on the effects of recreational drugs on sperm and fertility because of ethical concerns and insufficient reporting of the problem, there is still strong evidence that demonstrates that using recreational drugs can have a negative influence on sperm and the male reproductive system in general 18 .
From an ethical standpoint, recreational drugs have an impact on sperm quality which influences the chances of conceiving and giving birth to healthy children apart from causing issues in men’s reproductive health 18 . Equally, in terms of parental responsibility, future fathers should responsibly prevent unhealthy behaviours like recreational drugs that could cause their future children to face developmental or overall health issues due to the sperm quality 16 .
Recreational drug usage can cause problems in the future because the parent might not be able to give their child a safe and healthy environment. The reason behind this is that drug usage may eventually make it difficult for a parent to provide for their child's necessities and could cause doubt on their ability to keep their child safe 5 .
Everyone should be informed and aware about the risks and consequences of these and its impact on fertility and child health. This demonstrates that it is ethically necessary to inform the public about the harmful consequences of recreational drugs on the reproductive system by putting in place initiatives and raising awareness to reduce its incidence. This also leads to ethical issues concerning informed consent due to the lack of public health education as individuals cannot make the right decision due to not being appropriately informed about the risk of recreational drugs on their own health and the health of their unborn child 4 .
References
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2 Ajayi, A. F., & Akhigbe, R. E. (2020). Codeine-induced sperm DNA damage is mediated predominantly by oxidative stress rather than apoptosis. Redox Report , 25 (1), 33-40. https://doi.org/10.1080/13510002.2020.1752003
3 Budin, S. B., Kho, J. H., Lee, J. H., Ramalingam, A., Jubaidi, F. F., Latif, E. S., Zainalabidin, S., Taib, I. S., & Mohamed, J. (2017). Low-dose nicotine exposure induced the oxidative damage of reproductive organs and altered the sperm characteristics of adolescent male rats. The Malaysian journal of medical sciences , 24 (6), 50-57. https://doi.org/10.21315/mjms2017.24.6.6
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