Poppers
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Poppers (or popper) is a slang term referring to recreational drugs belonging to the
As poppers include a broad range of
The term poppers stems from the "popping" sound of glass vials containing the substance when crushed to release vapour for inhalation. Amyl nitrite, a chemical analogue of alkyl nitrite was originally prescribed in the late 1800s for the medical management of angina.[1] Many analogues exist, such as isoamyl nitrite, isopentyl nitrite, isopropyl nitrite, and isobutyl nitrite. These substances are subject to different regulations, for example, isobutyl nitrite is banned in the European Union.
Poppers act as muscle relaxants, causing involuntary smooth muscles relaxation in tissues such as the throat and anus.[4][5] Said physiological effects and other effects such as mild euphoria has led to use cases related to recreational drug use, in some cases, party and play (chemsex), to help facilitate anal intercourse.[6] It has been reported that poppers have been part of club culture beginning with the mid-1970s disco scene and surged in popularity in the 1980s and 1990s rave scene.[7][8]
History
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
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
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]
Chemistry
Poppers contain a class of chemicals called alkyl nitrites. To the extent that poppers products contain alkyl nitrites, the following applies.
The following table summarizes alkyl nitrite chemical and physical properties, including chemical structure:[21]
Alkyl nitrite | CAS | Formula | Molecular weight (g·mol−1) | Physical state | Boiling 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 |
Hexyl nitrite | 638-51-7 | CH3(CH2)5ONO | 131.17 | Clear liquid | 130 |
Administration and effects
Administration
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 significantly increase intraocular pressure and cause an acute attack of glaucoma.[31][24]
- 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]
With regular use, poppers can cause: [36][27][37][38][39]
- Attacks of bronchial asthma, obstructive bronchitis, which can lead to respiratory failure and death.
- Ulcer and perforation of the nasal septum, chronic rhinitis.
- Chronic dermatitis of the facial skin (nose, mouth).
Interactions
Alkyl nitrites
Toxicity
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]
Swallowing poppers (rather than inhaling the vapour) may cause
Isopropyl nitrite poppers may be a cause of
Foveal (center-of-gaze) damage has also been described, in six habitual users of isopropyl nitrite poppers.
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]
Treatment
Isobutyl nitrite toxicity
Isobutyl nitrite is known to cause methemoglobinemia.[59] Severe methemoglobinemia may be treated with methylene blue.[60]
Refuted link with HIV/AIDS
Early in the
Cyanide treatment
Amyl nitrites were part of some kits used to treat
Legal status
Australia
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
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]
Continental Europe
Since 2007, reformulated poppers containing isopropyl nitrite are sold in the EU; isobutyl nitrite is prohibited.[78]
In
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]
United Kingdom
Poppers are sold in
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
See also
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