Poppers (or popper) is a slang term referring to recreational drugs belonging to the
alkyl nitrite family of
chemical compounds. When fumes from these substances are
inhaled, they act as potent
vasodilators, producing mild euphoria, warmth, and dizziness. Most effects have a rapid onset and are short-acting.[1] Its
recreational use is believed to be potentially dangerous for people with
heart problems,
anaemia and
glaucoma. Reported adverse effects include
fainting, retinal toxicity and vision loss.[2][3]
As poppers include a broad range of
chemical types, their legality differs across different jurisdictions. They are often packaged under the guise of room deodorizer, leather polish, nail polish remover, or
videotape head cleaner to evade
anti-drug laws.[1]
This section needs expansion with: a sourced paragraph on the transition from its use in medicine to its use as a recreational drug. You can help by
adding to it. (June 2016)
19th-century discovery
The French chemist
Antoine Jérôme Balard synthesized
amyl nitrite in 1844.[9]Sir Thomas Lauder Brunton, a Scottish physician born in the year of amyl nitrite's first synthesis, documented its clinical use to treat
angina pectoris in 1867 when patients experiencing chest pains would experience complete relief after inhalation.[10] Brunton was inspired by earlier work with the same agent, performed by
Arthur Gamgee and
Benjamin Ward Richardson.[10] Brunton reasoned that the angina sufferer's pain and discomfort could be reduced by administering amyl nitrite—to dilate the coronary arteries of patients, thus improving blood flow to the heart muscle.[10]
Amyl nitrites were originally enclosed in a glass mesh called "pearls". The usual administration of these pearls was done by crushing them between the fingers, followed by a popping sound. This administration process seems to be the origin of the
slang term "poppers". It was then administered via direct inhalation of the vapors or inhalation through silk that covered the capsule.
Brunton found that amyl nitrites had effects of dilating blood vessels and flushing of the face. Isobutyl nitrites were also documented around the late 1890s by Brunton and despite being found to have generally the same effects as amyl nitrites, they were never used as a clinical alternative to amyl nitrates. Brunton also found that propyl nitrites had the same effects as well.[11][12]
20th-century use
Although amyl nitrite is known for its practical therapeutic applications, the first documented case of recreational use was in 1964.[13][14] The poppers "craze" began in the early 1970s in the
gay male community in bars, discothèques and
bathhouses.[15][16] It was packaged and sold pharmaceutically in fragile glass ampoules wrapped in cloth sleeves which, when crushed or "popped" in the fingers, released the amyl nitrite for inhalation, hence the colloquialism poppers.[15] The term extended to the drug in any form as well as to other drugs with similar effects, e.g.
butyl nitrite which is packaged under a variety of trade names in small bottles.[15]
In the late 1970s Time magazine[17] and The Wall Street Journal[18] reported that popper use among
gay men began as a way to enhance sexual pleasure, but "quickly spread to
avant-gardeheterosexuals". A series of interviews conducted in the late 1970s revealed a wide spectrum of users.[17]
21st-century
Poppers were well established in the gay community, with more than a third of gay men having used poppers at least once.[19] Poppers were partial inspiration for songs such as
Troye Sivan's
Rush.[20]
Poppers come in liquid form, but this liquid is not directly consumed. When the bottle is opened, the vapors are inhaled, rather than the liquid. This is typically done through the nasal cavities, commonly directly from the bottle (avoiding touching the bottle to the skin) or with the help of small inhalers.
Physiological effect
Inhaling nitrites produces a fast-acting, short-lived and non-specific relaxation of
smooth muscles (along with the
sphincter muscles of the
anus and the
vagina).[22] Blood vessels are surrounded by smooth musculature, which directly influences blood pressure by increasing or decreasing its inward pressure on the blood vessels.
With relaxation of the smooth muscles, the 'inward' pressure on the blood vessels decreases and they
dilate, resulting in
a drop in blood pressure and an immediate (compensatory) increase in
heart rate (reflex tachycardia). Vasodilation may cause giddiness, dizziness, headache, nausea, vomiting and flushing, and may produce a sensation of heat and excitement. Maximum vasodilatory effect is usually reached within 30 seconds, with (secondary) physiological effects lasting for 5 to 10 minutes .[23][24][25][26]
Health harm and side effects
There are evidences that poppers can be harmful to health.[27]
With occasional use:
Studies have proven that the combination of poppers with
Viagra can cause
angina attacks and a serious decrease in blood pressure during sexual intercourse, which can lead to acute
myocardial infarction and sudden death.[28][24]
By some men with weakened erections poppers can cause temporary
erectile dysfunction with the inability to have sexual intercourse.[29][30]
Poppers can cause nitrate poisoning if the liquid is consumed and cause
methemoglobinemia, which causes headache, cyanosis, shortness of breath, fatigue, and altered consciousness (
coma) and can lead to death.[32][33][34]
If in contact with the skin, poppers can cause
chemical burns and contact
dermatitis of the skin around the mouth and nose.[29][35]
The Merck Manual of Diagnosis and Therapy reports insignificant hazard associated with inhalation of alkyl nitrites,[43] and British governmental guidance on the relative harmfulness of alkyl nitrites places them among the less harmful of recreational drugs.[44]
Isopropyl nitrite poppers may be a cause of
maculopathy (eye damage), as reported in France and the United Kingdom.[50] Some studies have concluded that there may be increased risk for at least temporary retinal damage with habitual popper use in certain users; in a letter to the New England Journal of Medicine,[51] an ophthalmologist described four cases in which recreational users of isopropyl nitrite poppers suffered temporary changes in vision.[52]
Foveal (center-of-gaze) damage has also been described, in six habitual users of isopropyl nitrite poppers.[53] Furthermore, in June 2014,
optometrists and
ophthalmologists reported having noticed an increase in vision loss in chronic popper users in the United Kingdom associated with isopropyl nitrite (substitute for isobutyl nitrite which was banned in 2007).[54][55]
In November 2014, it was observed
maculopathy is a rare complication of isopropyl nitrite abuse. A full recovery of visual acuity in longterm abuse could be demonstrated after drug abstinence.[56] Studies have shown that poppers users who have HIV and/or use Sildenafil in combination with poppers are at an increased risk of developing poppers‐associated maculopathy.[57]
A working group in 2019 from the
International Agency for Research on Cancer determined there to be "sufficient evidence" to suggest
carcionogenic properties of isobutyl nitrite on experimental animals, and because they could not find any sufficient studies regarding its carcinogenic effects on humans, they determined that isobutyl nitrite is "possibly carcinogenic to humans". The group primarily looked at 2 studies on animals, one on rats and one on mice. Both of these involved the administration of doses of isobutyl nitrite at seemingly low doses (0, 37.5, 75, or 150 ppm) 6 hours a day, 5 days a week, for a total of 103 weeks.[58] This is different from the relatively brief exposure to alkyl nitrites that inhaling poppers recreationally usually provides. Nonetheless, in the studies there was shown to be no increase in death rates for the animals exposed to isobutyl nitrite, but there was shown to be an increase in tumors in the lungs of the males and females of both species in the groups exposed, as well as in the thyroids of the male mice exposed.[58]
Early in the
AIDS crisis, widespread use of poppers among AIDS patients led to the later disproved hypothesis that poppers contributed to the development of
Kaposi's sarcoma, a rare form of cancer that occurs in AIDS patients.[61][62] Modest, short-term reductions in immune function were observed in animal studies, but not replicated in human studies.[63][64]
Poppers are legal in Australia, and from 2020, poppers can also be purchased as a schedule 3 substance from pharmacies, or a schedule 4 substance with a prescription.[69]
History of poppers legislation in Australia
In June 2018, the
Therapeutic Goods Administration (TGA) motioned to reschedule alkyl nitrites to be in the same category as heroin and cocaine (
Schedule 9).[70] This was met by criticism from the LGBTQI community for being discriminatory and further evidence was demanded and further consultation sought.[71]
In October 2018, the
Australian Federation of AIDS Organisations (AFAO) pointed out the lack of quality evidence provided by the TGA to justify the rescheduling[72] and that use of amyl nitrites has been stable over the past decade with very little evidence of harm and has been in use by a high proportion of gay men over a long period.
A final decision was pushed back from 29 November 2018 to late January or early February 2019 for further consultation with the public.[73]
As of March 2019, two public meetings have taken place in Sydney and Melbourne with
The Kirby Institute and the
Australian Research Centre in Sex, Health and Society (ARCSHS). Along with 70 written public proposals, there was significant opposition to alkyl nitrites rescheduling.[74] Banning alkyl nitrites was not considered acceptable as their use was said to help reduce harms such as anal injury and blood-borne disease transmission during anal sex.[75]
In June 2019, Australia decided not to ban poppers.[76]
However the new arrangements brought in from February 2020 onward, have brought some changes in local availability. As of February 2020, most poppers available in Australia are now based on the formula base of
Pentyl nitrite. Currently, the most common brand of poppers in Australia are being imported from the Canadian firm, Locker Room. These products include Jungle Juice Black, Jungle Juice Platinum, Jungle Juice Triple Distilled, Iron Horse, Amsterdam Special and Blue Boy. All these, if not before, are now fully
Pentyl nitrite based, confusing some consumers with their now relatively weak strength, as compared to before 2020.
In addition to the regular adult stores in Australia, a number of online platforms that are now selling poppers, for Australian only domestic supply. These platforms include a bigger variety and include poppers based on the stronger
amyl nitrite, based formula.
Canada
Since 2013,
Health Canada has banned all distribution and sales of poppers.[77]
In
France, the sale of products containing
butyl nitrite has been prohibited since 1990 on grounds of danger to consumers.[79] In 2007, the government extended this prohibition to all
alkyl nitrites that were not authorized for sale as
drugs.[80] After litigation by
sex shop owners, this extension was quashed by the
Council of State on the grounds that the government had failed to justify such a blanket prohibition: according to the court, the risks cited, concerning rare accidents often following abnormal usage, rather justified compulsory warnings on the packaging.[81]
The possession in
Germany,
Austria and
Switzerland is not subject to any regulations regarding
anesthetic drugs and is therefore legal; however, the purchase, sale or trade of
amyl nitrite without permission violates the drug laws of the corresponding countries. Occasionally, poppers were seized from sex shops, when sold there illegally.[82][83]
The
Psychoactive Substances Act 2016, scheduled to be enacted 1 April 2016, was initially claimed to impose a blanket ban on the production, import and distribution of all poppers.[85] On 20 January 2016 a motion to exempt poppers (alkyl nitrites) from this legislation was defeated.[86] This was opposed by Conservative MP
Ben Howlett. Howlett's fellow Conservative MP
Crispin Blunt declared that he has used and currently uses poppers. Manufacturers expressed concern over loss of business and potential unemployment.[87][88]
In March 2016, the Advisory Council on the Misuse of Drugs stated that, because alkyl nitrites do not directly stimulate or depress the
central nervous system, poppers do not fall within the scope of the Psychoactive Substances Act 2016.[89]
United States
Amyl nitrite was originally marketed as a
prescription drug in 1937. It remained so until 1960, when the
Food and Drug Administration removed the prescription requirement due to its safety record. This requirement was reinstated in 1969, after observing an increase in
recreational use. There was a huge increase in the number of brands for
butyl nitrites after the FDA put in the prescription requirement again in 1969.[10]
Butyl nitrites were outlawed in 1988 by the
Anti-Drug Abuse Act of 1988.[90] This prompted distributors to sell other
alkyl nitrites not yet banned, like
isopropyl nitrite. In 1990, isopropyl nitrites and other nitrites not yet banned were outlawed by the
Crime Control Act of 1990.[91] Both of these laws include an exception for commercial purpose, defined as any use other than for the production of consumer products containing volatile alkyl nitrites meant for inhaling or otherwise introducing volatile alkyl nitrites into the human body for euphoric or physical effects.[92]
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