Poppers

A selection of poppers

Poppers is a slang term given broadly to the chemical class called alkyl nitrites, that are inhaled for recreational drug purposes, typically for the "high" or "rush" that the drug can create. Poppers have also been historically used for sexual encounters among the youth, including in the gay community.[1]

If you trace the bottle of amyl (a type of alkyl nitrite) through late 20th-century history, you trace the legacies of gay culture on popular culture in the 20th century. We wouldn't have had rave, disco or club culture as we know it today without the gay community.[1]

Poppers were part of club culture from the mid 1970s disco scene to the 1980s, and the 1990s rave scene made their use popular again.[2]

Popper use has a relaxation effect on involuntary smooth muscles, such as those in the throat and anus.[3][4] Most widely sold products include the original amyl nitrite (isoamyl nitrite, isopentyl nitrite), but also variants such as isobutyl nitrite, isopropyl nitrite (2-propyl nitrite, increasingly, after EU ban of the isobutyl form). In some countries, to evade anti-drug laws, poppers are labelled or packaged as room deodorizers, leather polish or tape head cleaner.

History

The French chemist Antoine Jérôme Balard synthesized amyl nitrite in 1844. Sir Thomas Lauder Brunton, a Scottish physician born in the year of amyl nitrite's first synthesis, famously pioneered its use to treat angina pectoris. Brunton was inspired by earlier work with the same agent, performed by Arthur Gamgee and Benjamin Ward Richardson. 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.

Although amyl nitrite is known to have been used recreationally as early as the 1960s, the poppers "craze" began around 1975.[5] It was sold in fragile glass ampoules which are crushed or "popped" in the fingers and then inhaled: hence the colloquialism poppers.[5] The term extended to the drug in any form as well as the commercial variant of the drug, butyl nitrite, which is packaged under a variety of trade names in small bottles.[5]

In the late 1970s Time[6] and the Wall Street Journal[7] reported that popper use among homosexual men began as a way to enhance sexual pleasure, but "quickly spread to avant-garde heterosexuals". A series of interviews conducted in the late 1970s revealed a wide spectrum of users.[6]

Pharmacology and physiology

Inhaling nitrites relaxes smooth muscles throughout the body, including the sphincter muscles of the anus and the vagina.[8] Smooth muscle surrounds the body's blood vessels and when relaxed causes these vessels to dilate resulting in an immediate increase in heart rate and blood flow throughout the body, producing a sensation of heat and excitement that usually lasts for a couple of minutes.[9] When these vessels dilate, a further result is an immediate decrease in blood pressure.[10]

Chemistry

Composition

Poppers contain a class of chemicals called alkyl nitrites.

To the extent that poppers products contain alkyl nitrites, the following applies.

Alkyl nitrite properties

The following table summarizes alkyl nitrite chemical and physical properties, including chemical structure:[11]

Alkyl nitriteCASFormulaMolecular weight (g·mol−1)Physical stateBoiling point (°C)
Amyl nitrite (isoamyl nitrite, isopentyl nitrite) 110-46-3 (CH3)2CH(CH2)2ONO 117.15 Transparent liquid 97–99
Pentyl nitrite (n-pentyl nitrite) 463-04-7 CH3(CH2)4ONO 117.15 Yellow liquid 104
Butyl nitrite (n-butyl nitrite) 544-16-1 CH3(CH2)3ONO 103.12 Oily liquid 78.2
Isobutyl nitrite (2-methylpropyl nitrite) 542-56-3 (CH3)2CHCH2ONO 103.12 Colourless liquid 67
Isopropyl nitrite (2-propyl nitrite) 541-42-4 (CH3)2CHONO 89.09 Clear pale yellow oil 39

Use

Administration

Poppers are inhaled.

Popularity

A selection of poppers

Through the 1970s, use by minors has been described as minimal, due to the ban on sales to minors by major manufacturers (for public relations reasons), and because some jurisdictions regulate sales to minors by statute.[12] A 1987 study commissioned by the United States Senate and conducted by the Department of Health and Human Services found that less than three per cent of the overall population had ever used poppers.[13]

Interactions

Alkyl nitrites interact with other vasodilators, such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis), to cause a serious decrease in blood pressure, which can cause fainting, stroke, and low blood pressure leading to potential heart attack.[14]

Side effects

Common side effects of popper use include headaches.[15]

Toxicity

The Merck Manual of Diagnosis and Therapy reports insignificant hazard associated with inhalation of alkyl nitrites,[16] and British governmental guidance on the relative harmfulness of alkyl nitrites places them among the less harmful of recreational drugs.[17]

Swallowing poppers (rather than inhaling the vapour) may cause cyanosis, unconsciousness, coma, and complications leading to death. Methemoglobinemia can occur if poppers have been swallowed.[8][18][19][20][21] Accidental aspiration of amyl or butyl nitrites may cause lipoid pneumonia.[22]

Isopropyl nitrite poppers may be a cause of maculopathy (eye damage), as reported in France and the United Kingdom.[23] 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, an ophthalmologist described four cases in which recreational users of poppers suffered temporary changes in vision.[24] Foveal (center-of-gaze) damage has also been described, in six habitual users of poppers.[25] In 2014, optometrists and ophthalmologists reported having noticed an increase in vision loss in chronic popper users in the United Kingdom, associated with the substitution of isopropyl nitrite.[26][27]

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, which occurs in AIDS patients.[28][29] Modest, short-term reductions in immune function were observed in animal studies,[30][31] but direct support for a role of nitrites in development of AIDS-associated diseases has not found broad agreement.[32] A study examining men who have sex with men, and who also take recreational drugs, suggested poppers, when used in a pattern of recreational drug taking could be associated with increase in sexual risk-taking.[33]

Australia

It is illegal to sell poppers as inhalants in Australia, although some, including amyl nitrite, are often sold in sex shops misleadingly labeled as DVD or leather cleaner.[34]

European Union

Since 2007, reformulated poppers containing isopropyl nitrite are sold in Europe; isobutyl nitrite is prohibited.[35]

France

In France, the sale of products containing butyl nitrite has been prohibited since 1990 on grounds of danger to consumers.[36] In 2007, the government extended this prohibition to all alkyl nitrites that were not authorized for sale as drugs.[37] 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.[38]

Germany, Austria, Switzerland

The possession in the German speaking countries 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.[39][40]

United Kingdom

In the United Kingdom, poppers are sold in nightclubs, bars, sex shops, drug paraphernalia head shops, over the Internet, and in markets. It is illegal under Medicines Act 1968 to sell them advertised for human consumption. The Advisory Council on the Misuse of Drugs noted in 2011 that poppers, rather than being psychoactive substance or 'legal high', "appear to fall within the scope of The Intoxicating Substances (Supply) Act 1985".[41] The Psychoactive Substances Act 2016, scheduled to be enacted April 1, 2016, was initially claimed to impose a blanket ban on the production, import and distribution of all poppers.[42] On January 20, 2016 a motion to exempt poppers (alkyl nitrites) from this legislation was defeated.[43] 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.[44][45] 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.[46]

United States

In the US, amyl nitrite was originally marketed as a prescription drug in 1937 and remained so until 1960, when the Food and Drug Administration removed the prescription requirement due to its good safety record. This requirement was reinstated in 1969, after observation of an increase in recreational use.

Other alkyl nitrites were outlawed in the US by Congress through the Anti-Drug Abuse Act of 1988. The law includes 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.[47] The law came into effect in 1990.

Substances containing alkyl nitrites other than amyl nitrite are available at many retailers—typically sex shops and stores that sell recreational-drug paraphernalia—and may be purchased legally.

See also

References

  1. 1 2 "How gay culture bottled a formula that has broken down boundaries". The Independent. 2016-01-22. Retrieved 2017-01-23.
  2. ↑ "Nitrites". Drugscope. Archived from the original on 2007-04-05. Retrieved 2007-04-24.
  3. ↑ Zhao, Peizhen; Tang, Songyuan; Wang, Cheng; Zhang, Ye; Best, John; Tangthanasup, Thitikarn May; Huang, Shujie; Yang, Bin; Wei, Chongyi (2017-01-20). "Recreational Drug Use among Chinese MSM and Transgender Individuals: Results from a National Online Cross-Sectional Study". PLoS ONE. 12 (1): e0170024. Bibcode:2017PLoSO..1270024Z. doi:10.1371/journal.pone.0170024. ISSN 1932-6203. PMC 5249205. PMID 28107391.
  4. ↑ Schmidt, Axel J.; Bourne, Adam; Weatherburn, Peter; Reid, David; Marcus, Ulrich; Hickson, Ford (2016). "Illicit drug use among gay and bisexual men in 44 cities: Findings from the European MSM Internet Survey (EMIS)". International Journal of Drug Policy. 38: 4–12. doi:10.1016/j.drugpo.2016.09.007. PMID 27788450.
  5. 1 2 3 Israelstam, Stephen; Lambert, Sylvia; Oki, Gustave (26 April 2017). "Poppers, A New Recreational Drug Craze". Canadian Psychiatric Association Journal. 23 (7): 493–495. doi:10.1177/070674377802300711. Retrieved 25 November 2017.
  6. 1 2 "Rushing to a New High". Time. 1978-07-17. Retrieved 2007-04-29.
  7. ↑ Sansweet, Stephen J. (October 10, 1977). "wall street journal - A new way to glow and giggle, and get a headache. "Poppers, legally sniffable, becoming a big business; The FDA isn't interested". Wall Street Journal October 10, 1977 Stephen J. Sansweet. Retrieved October 10, 2016 – via http://virusmythpoppersmyth.org/.
  8. 1 2 "Amyl Nitrite". Medsafe. New Zealand Medicines and Medical Devices Safety Authority. May 18, 2000. Archived from the original on November 11, 2006. Retrieved March 15, 2007.
  9. ↑ "Amyl Nitrite (Professional Patient Advice) - Drugs.com". drugs.com. Retrieved June 29, 2016.
  10. ↑ Iversen, Les (March 16, 2016). "ACMD review of alkyl nitrites ("poppers")" (PDF). gov.uk. www.gov.uk. Retrieved October 10, 2016.
  11. ↑ Sutton (1963)
  12. ↑ Nickerson, Mark, John Parker, Thomas Lowry, and Edward Swenson. Isobutyl Nitrite and Related Compounds; chapter on "Sociology and Behavioral Effects" . 1st ed. San Francisco: Pharmex, Ltd, 1979.
  13. ↑ Kennedy, Edward, US Senate, Chair Committee on Labor and Human Resources. "Report of the Committee on Labor and Human Resources."Comprehensive Alcohol Abuse, Drug Abuse, and Mental Health Amendments of 1988. Section 4015. 1988.
  14. ↑ Romanelli, F.; Smith, KM. (Jun 2004). "Recreational use of sildenafil by HIV-positive and -negative homosexual/bisexual males". Ann Pharmacother. 38 (6): 1024–30. doi:10.1345/aph.1D571. PMID 15113986.
  15. ↑ Wood, Ronald W. (1989). The Acute Toxicity of Nitrite Inhalants (PDF). National Institute on Drug Abuse. pp. 28–29. Retrieved 2007-03-15.
  16. ↑ O’Malley, Gerald F.; O’Malley, Rika (January 2016). "Volatile Nitrites". In Porter, Robert S.; et al. The Merck Manual Online. Merck & Co. Retrieved 2017-09-16.
  17. ↑ Nutt, D.; King, LA.; Saulsbury, W.; Blakemore, C. (March 2007). "Development of a rational scale to assess the harm of drugs of potential misuse". Lancet. 369 (9566): 1047–53. doi:10.1016/S0140-6736(07)60464-4. PMID 17382831.
  18. ↑ Dixon, DS.; Reisch, RF.; Santinga, PH. (July 1981). "Fatal methemoglobinemia resulting from ingestion of isobutyl nitrite, a "room odorizer" widely used for recreational purposes". J Forensic Sci. 26 (3): 587–93. PMID 7252472.
  19. ↑ Pruijm, MT.; de Meijer, PH. (December 2002). "[Methemoglobinemia due to ingestion of isobutyl nitrite ('poppers')]". Ned Tijdschr Geneeskd. 146 (49): 2370–3. PMID 12510403.
  20. ↑ Stalnikowicz, R.; Amitai, Y.; Bentur, Y. (2004). "Aphrodisiac drug-induced hemolysis". J Toxicol Clin Toxicol. 42 (3): 313–6. doi:10.1081/clt-120037435. PMID 15362601.
  21. ↑ Emergency Medicine: Principles and Practice. Harper & Collins, 2nd edition. 2008. pp. 42–51.
  22. ↑ Hagan, IG.; Burney, K. (July–August 2007). "Radiology of recreational drug abuse". Radiographics. 27 (4): 919–40. doi:10.1148/rg.274065103. PMID 17620459.
  23. ↑ Davies, A. J.; Kelly, S. P.; Bhatt, P. R. (2012-03-09). "'Poppers maculopathy'—an emerging ophthalmic reaction to recreational substance abuse". Eye (correspondence). 26 (888): 1479–86. doi:10.1038/eye.2012.37. PMC 3376285. Retrieved 2016-01-11.
  24. ↑ The New York Times: "Vision: A Quick High for Sex May Damage Vision"
  25. ↑ Audo, I; El Sanharawi, M; Vignal-Clermont, C; Villa, A; Morin, A; Conrath, J; Fompeydie, D; Sahel, JA; Gocho-Nakashima, K; Goureau, O; Paques, M (2015-09-28). "Foveal damage in habitual poppers users". Arch Ophthalmol. 129: 703–8. doi:10.1001/archophthalmol.2011.6. PMID 21320953.
  26. ↑ Krystnell Storr (2014-07-08). "More evidence 'poppers' may damage eyesight". Reuters Health.
  27. ↑ Gruener, A. M.; Jeffries, M. A.; El Housseini, Z; Whitefield, L (2014). "Poppers maculopathy". Lancet. 384: 1606. doi:10.1016/S0140-6736(14)60887-4. PMID 24954683.
  28. ↑ Duesberg, P (2003). "The chemical bases of the various AIDS epidemics: recreational drugs, anti-viral chemotherapy and malnutrition". J Biosci. 28 (4): 383–412.
  29. ↑ Schechter, MT (1993). "HIV-1 and the aetiology of AIDS". Lancet. 341: 658–659. doi:10.1016/0140-6736(93)90421-c.
  30. ↑ "Poppers: Epidemiology and Clinical Management of Inhaled Nitrite Abuse". Pharmacotherapy. 24: 69–78. doi:10.1592/phco.24.1.69.34801.
  31. ↑ James, JS. "Poppers: large cancer increase and immune suppression in animal tests". AIDS Treat News (317): 1–2. PMID 11366993.
  32. ↑ NAM [National AIDS Manual], "Poppers", http://www.aidsmap.com/Poppers/page/1322957/. Retrieved October 29, 2014.
  33. ↑ Herbst, Jeffrey H.; Raiford, Jerris L.; Carry, Monique G.; Wilkes, Aisha L.; Ellington, Renata D.; Whittier, David K. (2016). "Adaptation and National Dissemination of a Brief, Evidence-Based, HIV Prevention Intervention for High-Risk Men Who Have Sex with Men". Morbidity and Mortality Weekly Reports (Supplements). Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health & Human Services. 65 (1, February 12): 42–50. Retrieved June 29, 2016. National survey data suggest that many MSM consume alcohol and other drugs that can impair judgment and increase risky behavior ... Among MSM populations, methamphetamine, amyl nitrate (poppers), cocaine, and heavy alcohol use (i.e., binge drinking) are the substances most consistently associated with risky sexual behavior ... and increased HIV risk ...
  34. ↑ http://www.abc.net.au/triplej/programs/hack/man-dead-rainbow-serpent-drunk-amyl-nitrate-poppers-sources-say/8227740
  35. ↑ "DIRECTIVE 2005/90/EC OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL". Official Journal of the Europe. January 18, 2006.
  36. ↑ "Decree 90–274 of 26 March 1990" (in French). Legifrance.gouv.fr. May 15, 2009. Retrieved July 26, 2012.
  37. ↑ "Decree 2007-1636 of 20 November 2007" (in French). Legifrance.gouv.fr. Retrieved July 26, 2012.
  38. ↑ "Conseil d'État, 10ème et 9ème sous-sections réunies, 15/05/2009, 312449, Publié au recueil Lebon". Legifrance.gouv.fr (in French). May 15, 2009. Retrieved January 11, 2016.
  39. ↑ Sexdroge Poppers: Zur Ekstase geschnüffelt. news.de
  40. ↑ „Poppers“ sichergestellt. Polizei entdeckt 400 Flaschen des Schnüffelstoffs in Sex-Shop. In: Die Welt. 8. Dezember 2005.
  41. ↑ "Consideration of the Novel Psychoactive Substances ('Legal Highs')" (PDF). Advisory Council on the Misuse of Drugs. pp. 52–54.
  42. ↑ publications.parliament.uk
  43. ↑ "House of Commons Hansard Debates for 20 January 2016 (pt 0003)". parliament.uk. Retrieved June 29, 2016.
  44. ↑ Sutcliffe, Robert. "UK's biggest poppers manufacturer vows to fight legal high ban on product he's made for 35 years". Mirror.
  45. ↑ Tayag, Yasmin. "The UK is at war with synthetic drugs and brain boosters are in the crossfire".
  46. ↑ "The Government thought it had banned Poppers but actually accidentally didn't". The Independent. Retrieved March 16, 2016.
  47. ↑ Anti-Drug Abuse Act of 1988 (Public Law 1QO-690, section 2404) (15 U.S.C. 2d57a(e)(2)).

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