Poppers

Poppers is the street term for various alkyl nitrites taken for recreational purposes through direct inhalation, particularly amyl nitrite, butyl nitrite and isobutyl nitrite.^[1][2] Amyl nitrite has a centuries-long history of use in treating angina,^[3] as well as an antidote to cyanide poisoning.^[4][5] Amyl nitrite and several other alkyl nitrites which are used in over-the-counter products, such as air fresheners and video head cleaners, may be inhaled to enhance sexual pleasure.^[6] Use is particularly prominent among gay urban men.^[6] These products have long been part of the club culture from the 1970s disco scene to the 1980s and 1990s rave scene.^[7]

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Effects

Inhaling nitrites relaxes smooth muscles throughout the body, including the sphincter muscles of the anus and the vagina.^[5] This causes the blood vessels to dilate (which causes a sudden drop in blood pressure), increases heart rate, and produces a sensation of heat and excitement that usually lasts for a couple of minutes.^[8]

Alkyl nitrites are often used as a club drug or to enhance a sexual experience.^[6] The head rush, euphoria, and other sensations that result from the blood pressure drop are often felt to increase sexual arousal and desire.^[6] At the same time, the relaxation of the sphincters of the anus and vagina can make penetration easier. ^[9] It is widely reported that poppers can enhance and prolong orgasms.^[1]

While anecdotal evidence reveals that both men and women can find the experience of using poppers pleasurable, this experience is not universal.^[10] Some men report that poppers can cause erectile problems.^[1]

History

Amyl nitrite has a long history of use in treating angina,^[3] as well as an antidote to cyanide poisoning.^[5]

Users

TIME Magazine and The Wall Street Journal reported that the popper fad began among homosexual men as a way to enhance sexual pleasure, but "quickly spread to avant-garde heterosexuals" as a result of aggressive marketing. A series of interviews conducted in the late 1970s with construction workers, a "trendy East Side NYC couple" at a "chic NYC nightclub", a Los Angeles businesswoman "in the middle of a particularly hectic public-relations job" (who confided to the reporter that "I could really use a popper now."), along with the observation of frenetic disco dancers amid "flashing strobe lights and the pulsating beat of music in discos across the country", demonstrated a wide spectrum of users.^[11][12]

User surveys are hard to come by but a 1988 study found that 69% of men who had sex with men in the Baltimore/Washington DC area reported they had ever used poppers, with 21% having done so in the prior year. The survey also found that 11% of recreational drug users in the area reported using poppers, increasing to 22% among "heavy abusers", with an average age of first use of 25.6 years old. Both survey groups used poppers to "get high", but the men who had sex with men were more likely to use them during sex. It was reported that this group reduced usage following the AIDS epidemic, while the drug-users had not.^[13] A 1987 study commissioned by the US Senate and conducted by the Department of Health and Human Services found that less than 3% of the overall population had ever used poppers.^[14]

Use by minors is historically minimal due, in part, to the ban on sales to minors by major manufacturers for public relations reasons and because some jurisdictions regulate sales to minors by statute.^[15]A paper published in 2005 examined use of poppers self-reported by adolescents aged 12-17 in the (American) 2000 and 2001 National Household Surveys on Drug Abuse. 1.5% reported having used poppers; 1.8% of those over 14. Living in nonmetropolitan areas, having used mental health services in the past year (for purposes unconnected with substance use treatment), the presence of delinquent behaviours, past year alcohol and drug abuse and dependence, and multi-drug use were all associated with reporting the use of poppers.^[16] In contrast to these low rates, a survey in the North West of England found a rate of 20% self-reported use of poppers among 16 year olds.^[7]

Street names

  Amyl Nitrite, manufactured by Burroughs Wellcome (Now GlaxoSmithKline) and Eli Lilly and Company, was originally sold in small glass ampules that were crushed to release their vapors, and received the name "poppers" as a result of the popping sound made by crushing the ampule.^[17] Today, generic-like street names include 'poppers', RUSH®,^[2][6][18] Locker Room®,^[2][6] Snappers,^[2][19] and Liquid Gold®.^[1][2] Many brand names exist and are in use in different localities.

Availability and legality

Poppers are not listed by the International Narcotics Control Board as substances under international control.^[20] However, the sale of poppers is legally controlled in some countries of which examples appear below. Amyl nitrite's status as a medication means that it can be subject to separate legislation from that which affects other Alkyl nitrites. As discussed below, various techniques have been developed by suppliers to circumvent the laws that apply locally.

Denmark

In 2006, amyl nitrite and associated compounds were added to List D under the "Law on Euphoric Substances" which controls psychoactive substances in Denmark.

France

Possession is legal, but supply has been forbidden by a decree of Prime Minister François Fillon in November 2007.

United Kingdom

Amyl nitrite is controlled under the Medicines Act, and although possession is legal, supply may be an offence.^[1][2] Other nitrites are readily available in consumer products such as room odorants and leather cleaner, and numerous shops, particularly sex shops, clubs, and shops selling drug paraphernalia, sell them as "room aromas" or similar.^[1][2] However, a recent European Union directive, as well as a decision made by the Medicines and Healthcare products Regulatory Agency means that any product on sale with a psychoactive effect could be classed as a medicine regardless of how it is marketed, and so controlled under the Medicines Act.^[7] Additionally, Isobutyl Nitrite has also been classified as a class 2 carcinogen making retail sale technically prohibited. ^[21]

Prices are commonly in the range of £2–5 GBP per bottle.^[1]

United States

It is illegal to sell or distribute alkyl nitrites for use as poppers in the United States. Federal law charges the Consumer Products Safety Commission with enforcing the law. Individual possession and use are not banned.^[3][22]

• 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. This requirement was reinstated in 1969^[3] after observation of an increase in recreational use.

• Other Alkyl nitrites were outlawed in the USA by Congress in 1989. The law includes an exception for commercial purposes. The term commercial purpose is defined to mean any commercial purpose 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.^[23] The law came into effect in 1990.^[24] Manufacturers reformulated their products to abide by the law, and today nitrite based products are sold as video head cleaner, polish remover or room odorants.^[3]

• Cyclohexyl nitrite is technically not a member of the class of alkyl nitrites encompassed by the law, but as a result of the Federal Analog Act, its status remains in question.

Health Issues

There is little evidence of significant hazard associated with inhalation of alkyl nitrites.^[6][25]

High doses of nitrites may cause the rare methemoglobinemia, especially in individuals predisposed towards such a condition.^[5][26] It is suggested that taking Viagra with nitrites could cause a serious decrease in blood pressure, leading to fainting, stroke, or even heart attack.^[27][28] As poppers increase pressure within the eyeball, users with glaucoma take additional risks when using poppers.^[26][29]

There has also been a suggestion that poppers may weaken the immune system, however any damage is undone within a few days of halting use.^[30] Other risks include rashes around the mouth and nose, burns if spilt on skin, loss of consciousness, and headaches.^[1][31]

Suggestions of a link between poppers and either AIDS, HIV-infection or an AIDS-related cancer called Kaposi's Sarcoma have been made and are a subject of on-going debate. Several researchers have demonstrated a statistical correlation between popper use and HHV-8-infection and development of Kaposi's Sarcoma. However the most recently published peer-reviewed English-language overview of research on the health risks of poppers notes a lack of controlled trials. The correlation might therefore be accounted for by a bias among some popper users towards high-risk sexual behaviours.^[32] A 1992 article in The Lancet draws exactly that conclusion in a finding that the practice of insertive rimming explained excess rates of Kaposi's sarcoma.^[33] In a 1986-1988 series of study reviews and technical workshops with leading authorities, mandated by the US Congress, it was concluded that nitrites are not a causal factor in AIDS infection or Kaposi's sarcoma.^[34] A study that followed 715 gay men for eight and a half years published in the Lancet in 1993 rejected any causal relationship between AIDS and poppers, but noted a correlation between HIV infection and poppers. Anal sex was also correlated.^[35] However, a meta review of 30 research articles examining HIV infection risk and club drug use showed some evidence for poppers being a risk factor for HIV infection but considered further research was necessary.^[36] Some health authorities now mandate point of sale warnings.^[37]

Chemistry

Main article: Alkyl nitrites

Poppers are a class of chemicals called alkyl nitrites. These are chemical compounds of structure R-ONO. More formally, they are alkyl esters of nitrous acid.

The first few members of the series are volatile liquids; methyl nitrite and ethyl nitrite are gaseous at room temperature and pressure.

Organic nitrites are prepared from alcohols and sodium nitrite in sulfuric acid solution. They decompose slowly on standing, the decomposition products being oxides of nitrogen, water, the alcohol, and polymerization products of the aldehyde.

In popular culture

Poppers have been depicted or referred to in a number of films and songs since the 1970s, often in connection with sexual activities. In the 1970s, Hunter S. Thompson's Fear and Loathing in Las Vegas and in Radley Metzger's 1972 cult classic film Score depicted poppers. In the latter film, a bisexual woman glides an ampoule of amyl nitrite under the nose of a heterosexual woman in an attempt to seduce her. In the Sundance Channel documentary called Gay Sex in the '70s, there is a full-screen, slow pan along a bottle of Hardware® poppers.

In the John Waters film Pink Flamingos, Divine sniffs amyl nitrite during the party scene. Amyl nitrite is also mentioned in Hannibal, the sequel to The Silence Of The Lambs, and by Chloe in Fight Club.

In JFK (film), David Ferrie (Joe Pesci) uses poppers while engaging in a gay sex orgy with Clay Shaw (Tommy Lee Jones) and Willie O'Keefe (Kevin Bacon). During a scene in the 1993 movie Modern Day Houdini, the protaganist holds up a bottle of Hardware® poppers. During the rape scene in the 2002 film Irréversible the rapist (Le Tenia, played by Jo Prestia) is shown using poppers as he rapes Alex, played by Monica Bellucci.

The title of the song "Animal Nitrate" by Suede is a reference to amyl nitrite. The song "Pharmacist's Daughter" by punk band NOFX, is about a person who can get almost any drug from his girlfriend, who is the daughter of a pharmacist; the song mentions many drugs, including amyl nitrite. In the Hold Steady song "Killer Parties", they refer to the drug with the line "Pensacola parties hard with poppers, pills, and Pepsi."

In the popular US television series Queer As Folk amyl nitrite is referred to on a number of occasions. During a scene in the 42nd episode of The Sopranos, Ralphie Cifaretto holds a small brown bottle containing an unknown liquid while engaging in sex acts with Janice Soprano. In series three, episode five of The Mighty Boosh, Tony Harrison states that he has ordered "three crates of poppers" for the upcoming party at the Nabootique.

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