Poppers

For other uses, see Popper (disambiguation).
A selection of poppers

Poppers is a slang term given to the chemical class called alkyl nitrites that are inhaled for recreational purposes, especially in preparation for sex.[1] Today, poppers are mainly sold in cap vials.

Most widely sold concentrated products include the original compound amyl nitrite (isoamyl nitrite, isopentyl nitrite), cyclohexyl nitrite, isobutyl nitrite (2-methylpropyl nitrite), and isopropyl nitrite (2-propyl nitrite). Isopropyl nitrite became popular due to a ban on isobutyl nitrite in the EU in 2007. More rarely sold is the compound butyl nitrite.

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

History

In 1844, the French chemist Antoine Jérôme Balard synthesized amyl nitrite. Scottish physician Sir Thomas Lauder Brunton (1844–1916) famously pioneered the use of amyl nitrite to treat angina pectoris (now treated with nitroglycerin). He was inspired by earlier work with the same reagent by Arthur Gamgee and Benjamin Ward Richardson. Brunton reasoned that the pain and discomfort of angina could be reduced by administering amyl nitrite to dilate the coronary arteries of patients, thus improving blood flow to the heart muscle.

Time and the Wall Street Journal reported that popper use among homosexual men began 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 revealed a wide spectrum of users.[3]

Chemistry

Main article: Alkyl nitrites

Poppers are a class of chemicals called alkyl nitrites. These are chemical compounds of structure R–ONO. In more formal terms, 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.

Physical and chemical properties

(Sutton, 1963 for amyl nitrite, butyl nitrite, isobutyl nitrite):

Alkyl nitriteCASFormulaMolecular weight (g·mol−1)Physical stateBoiling point (°C)Specific gravity
Amyl nitrite (isoamyl nitrite, isopentyl nitrite) 110-46-3 (CH3)2CHCH2CH2ONO 117.15 Transparent liquid 97–99 0.872
Butyl nitrite 544-16-1 CH3(CH2)2CH2ONO 103.12 Oily liquid 78.2 0.9144 (0/4 °C)
Cyclohexyl nitrite 5156-40-1 C6H11ONO
Isobutyl nitrite (2-methylpropyl nitrite) 542-56-3 (CH3)2CHCH2ONO 103.12 Colorless liquid 67 0.8702 (20/20 °C)
Isopropyl nitrite (2-propyl nitrite) 541-42-4 (CH3)2CHONO 89.09 Clear pale yellow oil 39 °C at 760 mmHg
Pentyl nitrite 463-04-7 C5H11NO2

Usage

Dosage

The dose administered can easily be determined by subtracting the weight of a small vial after inhalation from its weight before inhalation. Two-cm vial openings, now being more common, are broad enough to cover the nostrils; smaller vial necks distribute lower doses.

Sexual use

Inhaling nitrites relaxes smooth muscles throughout the body.[4] Smooth muscle surrounds the body's blood vessels and, when relaxed, causes these vessels to dilate, resulting in an immediate decrease in blood pressure.

Alkyl nitrites are often used as a club drug or to enhance a sexual experience.[1] They facilitate anal intercourse by relaxing the internal and external anal sphincter muscles.

Popularity

A selection of poppers

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.[5]

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.[6] A 2005 paper examined use of poppers self-reported by adolescents aged 12–17 in the (American) 2000 and 2001 National Household Surveys on Drug Abuse. In all, 1.5% of the respondents in this age group reported having used poppers. This figure rose to 1.8% in those over 14.

Health issues

The 2005 Merck Manual of Diagnosis and Therapy reported that there is little evidence of significant hazard associated with inhalation of alkyl nitrites.[1] A study and ranking of drugs for harmfulness devised by British-government advisers and based upon health professionals' opinions of harm to both individuals and society placed alkyl nitrites among the less harmful substances when compared to other recreational drugs.[7]

Putative link with AIDS

In the early days of the AIDS crisis, widespread use of poppers among the earliest AIDS cases drove speculation that poppers contributed to the development of Kaposi's sarcoma, a rare form of cancer that occurs in AIDS patients.[8][9] Some modest, short-term reductions in immune cells have been seen in animal studies. Overall, however, evidence that poppers cause any significant degree of immune suppression is sparse and, by about 2009, very little research on the subject was recent.[10]

Administration

The only route of administration used with poppers is insufflation – swallowing or aspirating the liquid can prove fatal.[11][12]

An overdose via ingestion (rather than inhalation) may result in cyanosis, unconsciousness, coma, and even death. Methylene blue is a treatment for methemoglobinemia associated with popper use.[4][11][13][14][15] Accidental aspiration of amyl or butyl nitrites may lead to the development of lipoid pneumonia.[12]

Interactions

Alkyl nitrites interact with other vasodilators such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) to cause a serious decrease in blood pressure, leading to fainting, stroke, or heart attack.[16]

Habitual use and temporary symptoms

Poppers are a possible and rare cause of concern in a small number of cases of maculopathy (eye damage) in recent case reports from UK and France.[17] 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 experienced temporary changes in vision.[18] Another study described foveal (center-of-gaze) damage in six habitual poppers users.[19] In 2014, optometrists and ophthalmologists reported having noticed an increase in vision loss in chronic poppers users in the UK associated with isopropyl nitrite being substituted for isobutyl nitrite in 2006.[20][21][22]

Side effects

Common side effects of popper use include headaches[23] and temporary erectile problems. Other risks include burns if spilled on skin.

Legal status

Canada

The sale of poppers in any formulation has been banned in Canada. Although not considered a narcotic and not illegal to possess or use, they are considered a drug. Sales that are not authorized can now be punished with fines and prison.[24]

European Union

Since 2007, reformulated poppers containing isopropyl nitrite are sold in Europe; isobutyl nitrite is prohibited.[25]

France

In France, the sale of products containing butyl nitrite, pentyl nitrite, or isomers thereof, has been prohibited since 1990 on grounds of danger to consumers.[26] In 2007, the government extended this prohibition to all alkyl nitrites that were not authorized for sale as drugs.[27] 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.[28]

United Kingdom

In the United Kingdom, poppers are sold in gay clubs/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, and in order to bypass this, they are usually sold as odorizers. Those containing amyl nitrite are "very unlikely" to be sold as that compound is regulated as a medicine. 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".[29] The Psychoactive Substance Bill 2015-16, scheduled to be enacted 1 April 2016, would see a blanket ban on the production, import and distribution of all poppers.[30] On the 20th January 2016 a motion to exempt poppers (Alkyl nitrates) from this legislation was defeated.[31]

United States

In the U.S., 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 safety record. This requirement was reinstated in 1969, after observation of an increase in recreational use. Other alkyl nitrites were outlawed in the U.S. by Congress through the Anti-Drug Abuse Act of 1988. The law includes an exception for commercial purposes. The term commercial purpose is defined to mean 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.[32] The law came into effect in 1990.

Poppers containing alkyl nitrites other than amyl nitrite are readily available in some parts of the United States. Sometimes they are sold as video head cleaners, polish removers, or room odorizers.

See also

Further reading

References

  1. 1 2 3 Porter, Robert S.; et al., eds. (November 2005). "Volatile Nitrites". The Merck Manual Online. Merck & Co. Retrieved 2007-03-16.
  2. ↑ "Nitrites". Drugscope. Archived from the original on 2007-04-05. Retrieved 2007-04-24.
  3. ↑ "Rushing to a New High". Time. 1978-07-17. Retrieved 2007-04-29.
  4. 1 2 "Amyl Nitrite". Medsafe. New Zealand Medicines and Medical Devices Safety Authority. 2000-05-18. Archived from the original on 2006-11-11. Retrieved 2007-03-15.
  5. ↑ Kennedy, Edward, U.S. 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.
  6. ↑ 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.
  7. ↑ Nutt, D.; King, LA.; Saulsbury, W.; Blakemore, C. (Mar 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.
  8. ↑ Duesberg P et al., "The chemical bases of the various AIDS epidemics: recreational drugs, anti-viral chemotherapy and malnutrition", J Biosci 28(4):383-412, 2003.
  9. ↑ Schechter MT et al., "HIV-1 and the aetiology of AIDS", Lancet 341:658-659, 1993.
  10. ↑ NAM [National AIDS Manual], "Poppers", http://www.aidsmap.com/Poppers/page/1322957/, retrieved 29 October 2014.
  11. 1 2 Dixon, DS.; Reisch, RF.; Santinga, PH. (Jul 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.
  12. 1 2 Hagan, IG.; Burney, K. (Jul–Aug 2007). "Radiology of recreational drug abuse.". Radiographics 27 (4): 919–40. doi:10.1148/rg.274065103. PMID 17620459.
  13. ↑ Pruijm, MT.; de Meijer, PH. (Dec 2002). "[Methemoglobinemia due to ingestion of isobutyl nitrite ('poppers')]". Ned Tijdschr Geneeskd 146 (49): 2370–3. PMID 12510403.
  14. ↑ 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.
  15. ↑ Emergency Medicine: Principles and Practice. Harper & Collins, 2nd edition. 2008. pp. 42–51.
  16. ↑ 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.
  17. ↑ 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). doi:10.1038/eye.2012.37. Retrieved 2016-01-11.
  18. ↑ The New York Times: "Vision: A Quick High for Sex May Damage Vision"
  19. ↑ "Foveal damage in habitual poppers users. - PubMed - NCBI". Ncbi.nlm.nih.gov. 2015-09-28. Retrieved 2016-01-11.
  20. ↑ Krystnell Storr (2014-07-08). "More evidence 'poppers' may damage eyesight". Reuters Health.
  21. ↑ 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.
  22. ↑ Davies, S. J.; Kelly, S. P.; Naylor, S. G.; et al. (November 2012). "Adverse ophthalmic reaction in poppers users: case series of 'poppers maculopathy'". Eye 26: 1479–86. doi:10.1038/eye.2012.191.
  23. ↑ Wood, Ronald W. (1989). The Acute Toxicity of Nitrite Inhalants (PDF). National Institute on Drug Abuse. pp. 28–29. Retrieved 2007-03-15.
  24. ↑ Rob Salerno (Jun 25, 2013). "Health Canada cracks down on poppers". Canada: Pink Triangle Press.
  25. ↑ "DIRECTIVE 2005/90/EC OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL". Official Journal of the Europe. 18 January 2006.
  26. ↑ "Decree 90–274 of 26 March 1990" (in French). Legifrance.gouv.fr. 2009-05-15. Retrieved 2012-07-26.
  27. ↑ "Decree 2007-1636 of 20 November 2007" (in French). Legifrance.gouv.fr. Retrieved 2012-07-26.
  28. ↑ "Conseil d'État, 10ème et 9ème sous-sections réunies, 15/05/2009, 312449, Publié au recueil Lebon". Legifrance.gouv.fr (in French). 2009-05-15. Retrieved 2016-01-11.
  29. ↑ "Consideration of the Novel Psychoactive Substances (‘Legal Highs’)" (PDF). Advisory Council on the Misuse of Drugs. pp. 52–54.
  30. ↑ http://www.publications.parliament.uk/pa/bills/lbill/2015-2016/0002/16002.pdf
  31. ↑ http://www.publications.parliament.uk/pa/cm201516/cmhansrd/cm160120/debtext/160120-0003.htm#16012033005245
  32. ↑ Anti-Drug Abuse Act of 1988 (Public Law 1QO-690,section 2404) (15 U.S.C. 2d57a(e)(2)).
  33. ↑ "Diseased Pariah News #8". Diseasedpariahnews.com. Retrieved 2016-01-11.
  34. ↑ "Poppers Ahoy - Magazine Feature - October 2004". Archive.guidemag.com. Retrieved 2016-01-11.
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