Poppers Drug of the Month: download
Transcript and Sources
And now it’s time for the Drug of the Month, where we take a closer look at the background, science, history, and recent trends in a different drug each month. For our last drug of the month, we talked about dextromethorphan (or DXM), which is a common cough medicine that is often used recreationally for its dissociative effects, also known as robotripping. This month, we’ll be examining a whole class of chemicals, particularly popular within the gay community, and known for their unique recreational use as preparation for anal sex. For December, our Drug of the Month is alkyl nitrites, also known as Poppers.
Different brands of Poppers may vary in their exact content, but various alkyl nitrites that may be included are amyl nitrite, which was the original compound used, isobutyl nitrite, butyl nitrite, isopropyl nitrite, or various combinations thereof. For example, isopropyl nitrite became popular as a primary compound in 2007 due to a ban on isobutyl nitrite in the European Union. Poppers are usually sold in small cap bottles and “huffed” or inhaled for recreational purposes.
Poppers do not exist in nature. Organic nitrites are prepared from alcohols and sodium nitrite in sulfuric acid solution. Then some chemistry happens, which Sam may or may not be interested in explaining to you next episode during the Science segment, and then we have Poppers.
It’s unclear how or why alkyl nitrites were originally discovered. However, amyl nitrites in particular were first synthesized by French chemist Antoine Jérôme Balard in 1844. Medically, amyl nitrites were traditionally used to treat angina pectoris, which is a chest pain due to insufficient blood flow to the heart muscle. Doctors would prescribe amyl nitrites to patients in capsules that were broken or “popped” in order to release the vapors. This would help to dilate the patients’ coronary arteries, thus improving blood flow to the heart muscle.
For chemically completely different reasons, amyl nitrite was also used medically as an antidote to cyanide poisoning.
However, because nitrites’ primary function is vasodilation, inhaling nitrites also relaxes smooth muscles throughout the body, including the sphincter muscles of the anus and the vagina. Hence their use in enhancing or easing anal sex. Other physiological effects include increased heart rate and blood flow throughout the body, which produces a sensation of heat and excitement, and an immediate decrease in blood pressure when the blood vessels dilate. A very common warning amongst users of Poppers is to not combine them with other sex drugs like Viagra, which is also a vasodilator and when combined may lead to dangerously low blood pressure, as well as fainting, a stroke, or a heart attack.
All alkyl nitrites are inhalants because they have very low vapor points and become airborne almost immediately at room temperature. The most common method of taking Poppers is to simply open the bottle, hold it under your nose, and inhale. Other methods of popper usage such as oral ingestion are extremely dangerous and can potentially result in a coma or death. Alkyl nitrites are also extremely flammable and, upon skin-to-skin contact, may cause chemical burns.
The effects of the drug are intense, but short-lived. They start after about 15 seconds and last for up to 3 minutes. Most alkyl nitrites lose their freshness within a few hours if the bottle is left open or not properly closed.
In one VICE article about the use of Poppers, hilariously titled “Hey Straight People, You’re Using Sex Drugs Wrong,” the author describes the effects of Poppers as follows:
Mostly they make you feel dizzy and weird and headrushy. They also make you feel really warm all over, particularly in the face. You might even blush a little. The other thing you’ll notice is, if you are using them in a sexual context, you will want every single one of your orifices stuffed at exactly that moment or to jam your various appendages into someone else’s holes. They don’t make you horny, necessarily; they make you want to fuck.
This particular article also notes that there are various brands of Poppers, sold in differently marketed bottles and packaging. This is much like having different brands of liquor or alcohol or different strains of marijuana, which are intended to have slightly different effects. The author of the VICE article notes that “Rush and Jungle Juice are probably the best known and both are pretty good,” but that “leather daddies prefer what they call “English,” which comes in a brown unmarked bottle,” The author notes that [QUOTE] “that shit is intense.”
Poppers containing alkyl nitrites other than amyl nitrite are readily available in the United States, though amyl nitrite may still be possessed with a doctor’s prescription. Poppers are typically sold in sex shops or head shops, and may be purchased legally if marketed for commercial purposes, rather than for human consumption. Thus, in retail formulations, Poppers are usually labeled as video-head cleaners, nail-polish removers, or room odorizers.
In the UK, Poppers gained vast media attention this past year when the Psychoactive Substances Act of 2016 was passed. Conservative gay MP Crispin Blunt came out strongly against the law specifically because it would affect the legality of poppers. Blunt testified publicly that he had used and currently uses Poppers. An amendment to specifically exclude alkyl nitrites from the ban was voted down in Parliament. However, 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.
So that’s all for our Introduction to Poppers. Next week, Sam will be back with the Science behind December’s Drug of the Month.
Now it’s time for the drug of the month, where we go over the background, science, history, and current events in a different drug each month. For December 2016, that drug, or rather, class of drugs, is alkyl nitrites, which are commonly known as “poppers.” For this, the second installment, I’ll be going over the science of poppers – methods of administration, what they do to your body, the recreational and medical uses for them, and their side effects.
As Rachelle explained last week, poppers are not one specific drug, but instead refer to a class of drugs called alkyl nitrites. What these compounds all have in common is their structure: they are always a nitrogen bonded to two oxygens, which are then connected to various configurations of carbon and hydrogen. For example, one common compound, amyl nitrite, has the formula C5H11NO2, while another, butyl nitrite, is C4H9NO2. All will have various numbers of carbon and hydrogen in various shapes, but then all will have that NO2 at the end.
Physically, poppers are all oily liquids, which are sold in small bottles. The only safe method of administration is to inhale the vapors, which occur at room temperature. Merely touching the liquid directly can cause chemical burns on your skin, and drinking it can lead to serious injury or death. If using poppers in their original packaging, it’s not uncommmon for people to accidentally touch their lip or nose to the edge of the bottle and get a small burn. To reduce this risk, some people will soak a cotton ball or piece of paper in the solution and then put it into its own, separate bottle, and then inhale the vapors from that. This minimizes the risk of contact with the liquid, and also has the added benefit of reducing the amount of poppers on hand so that it’s harder to use too much in one session. Other users will dip the end of a cigarette in poppers and then inhale from it without lighting the end, which has a similar effect. But it’s incredibly important to note that you should not light a cigarette dipped in poppers – alkyl nitrites are very flammable, so this could lead to serious injury.
Once inhaled, alkyl nitrites quickly enter the bloodstream through the membranes in your mouth, throat, and lungs. It takes effect within about 15 seconds, and then typically lasts for about 2 to 5 minutes.
Once in your body, poppers are actually not psychoactive. Rather, their main effect is to relax smooth muscle throughout your body. Biologically, smooth muscle is a specific type of muscle that controls involuntary movements, including your circulatory, digestive, and sexual organs. When your smooth muscles loosen up, this increases blood flow while reducing your blood pressure. This same phenomenon is responsible for many of its desired recreational and medical effects.
On the recreational side, this loosening of the heart muscles increases energy and excitement, and can increase the enjoyable sensations of dancing and music, which is why poppers are popular in club culture. It also loosens up the muscles around the vagina and anus, which many people find makes sex easier and more enjoyable. This assistance for anal sex has led it to become popular in the gay community, though in the last couple of decades it has become popular among straight people as well.
Medically, its loosening of the heart muscles has led alkyl nitrites to be used as a treatment for angina, which is characterized by chest pain and is caused by an inadequate blood supply to the heart. However, this is only at relatively small doses, and poppers can actually lead to cardiovascular problems in too high of doses.
This is because one of the other effects of poppers is that they turn hemoglobin, which is the good kind of red blood cells which are responsible for transporting oxygen throughout your body, into methemoglobin, which are another kind of red blood cell with a differently charged iron atom that makes them less able to transport oxygen. Your blood always has a small amount of methemoglobin, less than 1%, but increasing it beyond that leads to methemoglobinemia: a condition that in mild cases causes headaches and fatigue, and in severe cases can cause comas or death.
One interesting thing is that this creation of methemoglobin, while generally harmful, is also the reason that alkyl nitrites work as an antidote to cyanide poisoning. This is because methemoglobin readily bonds to cyanide in a way that normal hemoglobin does not. It’s not a cure by itself, but is rather the first of a regimen of various compounds: alkyl nitrites at first because they act quickly, followed by an injection of sodium nitrite and sodium thiosulfate, which are more effective but take longer to administer.
Aside from methemoglobinemia, there are a few other risks that come along with alkyl nitrites. When used casually, the most common side effects are headaches, sweating, and – potentially problematic for people using them in a sexual context – the inability to maintain an erection. They can also inhibit good judgment, so many harm reduction groups recommend preparing for safe sex with condoms or other methods BEFORE consuming poppers, rather than trying to remember after taking them. Studies have also shown that alkyl nitrites can lower your immune system for a few days after taking them, which could increase your risk of contracting an STI and makes safe sex even more important.
As Rachelle mentioned last week, people should not mix poppers with Viagra or other vasodilators, since this can lead to dangerously low blood pressure, strokes, and heart attacks. It’s also dangerous to combine them with stimulants such as cocaine. Taken in typical doses without mixing with other drugs, there aren’t huge risks associated with alkyl nitrites, and they are not thought to be physically addictive. Because of this, classifications by governments and chemical companies usually put them at the low end of the spectrum in terms of risk. And as I said earlier but is worth repeating, probably the most dangerous thing about poppers is the possibility of chemical burns on skin contact, so if someone spills them, or worse, is totally ignorant of their usage and tries to drink them, you should get medical attention immediately.
So that’s all for the science of alkyl nitrites, a class of compounds often referred to as “poppers.” Rachelle will be back next week with the history of alkyl nitrites, from their initial creation to their popularization.
Now it’s time for the Drug of the Month, where we take a closer look at the background, science, history, and recent news and trends in a different drug each month. For December, we’re examining a class of drugs called alkyl nitrites, which are more commonly known as Poppers, and for this episode, we’ll be going over the history of poppers, when people started using them, and how laws and societal attitudes about them have evolved over time.
As I mentioned in the first installment, amyl nitrites were first synthesized in 1844 by French chemist Antoine Jerome Balard. A decade later, in 1857, Sir Thomas Lauder Brunton discovered its medical use in treating angina pectoris, or chest pain. It’s unclear when its use as an antidote to cyanide poisoning was discovered, but according to one source, in 1959, medical professionals claimed “a century of amyl nitrite usage for medical purposes without fatality or casualty.” There is no indication that poppers were widely used for recreational purposes during that first century (though it’s impossible to say they weren’t used at all). And in 1960, the US Food and Drug Administration approved nitrites for over-the-counter sales without prescription. However, immediately the following year, allegedly based on reports of recreational usage, the FDA reinstated the prescription requirement for amyl nitrites. Other nitrites were banned for human consumption entirely under the Anti-Drug Abuse Act of 1988.
As I’ve also mentioned previously, the recreational use of poppers is very closely connected to its use in enhancing anal sex, especially within the gay community. A 1988 study found that 69% of men who had sex with other men in the Baltimore/DC area used poppers (Lange, 1988). Similarly, the ban on human consumption of nitrites in the 1980s closely followed years of gay panic and the unfounded, homophobic belief that poppers were the cause of AIDS.
As with so many illicit substances, it’s difficult to pinpoint the moment when poppers entered into recreational use, though most sources point to the late 1950s and early 1960s, particularly increasing in popularity with the rise of disco. One source claims that the first poppers sold commercially was in Los Angeles in 1969, containing isobutyl nitrite and the first brand name trademarked by “Locker Room,” which is still on the market today. In 1977, the Wall Street Journal and Time Magazine both published articles claiming that the market for poppers as a recreational drug had become as big as $50 million a year. One source reports that by 1979, 5 million Americans identified as regular users of poppers. Even in these early pieces, Time and the Wall Street Journal also reported that popper use began among homosexual men as a way to enhance sexual pleasure, but “quickly spread to avant-garde heterosexuals” as a result of aggressive marketing. In 1979, the first major study of the use and effects of alkyl nitrites as a recreational drug was published. In 1980, the Consumer Product Safety Commission began an investigation into the potential of abuse of popers.
The next few years saw a flurry of medical and academic interest in poppers, particularly to investigate the relationship between the use of poppers and AIDS. In 1982, Thomas Lowry published in the British Journal of Sexual Medicine, his seminal work on the subject of nitrite abuse. A year later, two studies were published suggesting a link between between poppers and the incidence of Karposi’s sarcoma, which is a type of tumor developed in AIDS victims. In 1984, the cover story of Time Magazine probed the association of alkyl nitrites abuse with AIDS.
That same year, the US Department of Health and Human Services determined that nitrite abuse does not lead to a medical emergency. Nevertheless, the following year, in 1985, the National Jewish Center for Immunology and Respiratory Diseases claimed to discover a link between the use of nitrites and the risk of contracting HIV. That same year, Dr. James Curran, who led the task force on HIV/AIDS at the Centers for Disease Control and Prevention, declared that there was insufficient evidence to support anti-poppers campaigns in combatting the spread of AIDS. Furthermore, the HIV virus was discovered in 1986 and medical evidence quickly mounted demonstrating that the virus, and not nitrites, was the cause of AIDS infections.
Nevertheless, certain segments of the medical community continued assisting on an association between the use of poppers and “gay cancer” as AIDS was still sometimes referred to.
In 1997, more than a decade after the connection between poppers and AIDS had been medically debunked, Stephen O’Brien, the director of the the Laboratory of Genomic Diversity at the National Cancer Institute was still compelled to issue a stern reprimand of the medical community in Newsline titled “The HIV-AIDS Debate Is Over: What to tell your patients when they ask if HIV causes AIDS.” In addition to summarizing the mountainous evidence that HIV does indeed cause AIDS to a medical degree of certainty, O’Brien denounces the crusade against poppers as a largely Puritan, homophobic campaign led by molecular virologist Peter Duesberg, who claimed that AIDS was caused not by HIV but by a combination of recreational drugs, hyperstimulation of the immune system, and possibly even antiretroviral drugs themselves.
“In the end, Duesberg’s alternative explanation for the AIDS epidemic was little more than an indictment of a certain kind of gay lifestyle, one that is popularly perceived as consecrated to casual sex and equally casual drug-taking (16). As such, his hypothesis was but a variant of the mean-spirited fundamentalist belief that people with AIDS are victims of their own vices.”
Despite its increasing popularity in the decades since, both among gay and straight users, particularly within the club and rave scene, the recreational use of poppers has never entirely escaped its associations with the gay community. In 2016, poppers re-entered mainstream political discussion when the British Parliament was debating the Psychoactive Substances Act of 2016. This bill banning the illicit recreational use of substances that would still be available for legitimate commercial purposes was considered by many to be aimed directly at the gay community. In particular, gay conservative Member of Parliament Crispin Blunt came out strongly against the law specifically because it would affect the legality of poppers. Blunt testified publicly that he had used and currently uses Poppers. An amendment to specifically exclude alkyl nitrites from the ban was voted down in Parliament. However, 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.
So that’s all for the history of December’s Drug of the Month. Tune in next week when Sam will wrap up with some recent news and trends about Poppers.
Now it’s time for the drug of the month, where we go over the background, science, history, and current events around a different drug each month of the year. For December 2016, that drug has been poppers, the slang term commonly used for a class of drugs called alkyl nitrites. For this, our final installment, I’ll be going into the current events of poppers: how many people use them today, recent changes in the law, and new scientific research published in the last few years.
To start off, just how common is the use of poppers? In the United States, the best numbers come from the national survey on drug use and health, which is conducted by SAMHSA, the Substance Abuse and Mental Health Services Administration. Unlike some other surveys that group all inhalants together, they actually break down inhalants into many categories, such as poppers, glue, nitrous oxide, or spraypaint. According to the 2015 results, 2.8% of Americans over 12 years old have tried poppers. This is less than the number who have tried mescaline, the psychoactive component in peyote, and only about ⅓ the number who have tried psilocybin mushrooms. However, it is the second-most-popular inhalant, just after nitrous oxide, which has been tried by 4.6% of US adults.
Among American youth, defined as 12 to 17 year olds, the number who have tried it was only 0.6%. So it’s quite a rare drug among children, and is only ⅓ the number who have tried huffing glue.
On the global level, we have some data from the Global Drugs Survey, which is the largest survey of its kind with over 100,000 respondents. However, responses are voluntary and self-selecting, so it’s likely that the amount of drug use reported in the survey is higher than the rate among the entire global population. In this survey, 5% of people said they had used poppers in the past year, placing it #8 in terms of most popular past-year drug. In comparison, cannabis was used by 55% of respondents, MDMA was used by 23%, and nitrous oxide came in just above poppers with 7%.
The laws surrounding poppers have changed a lot in the past ten years, with many countries all over the world engaged in a game of whack-a-mole to ban certain chemicals, only to see poppers manufacturers switch to a different formulation. Since it is a class of drugs, governments can ban a specific one, like amyl nitrite, which then just causes others to take its place. For example, the US technically banned them in the anti-drug abuse act of 1988, but provided an exemption for industrial products, which is why they are now marketed as room odorizers or cleaning products. Legally, this is similar to the treatment of bath salts, a class of chemicals only marketed as bath salts with a wink-wink label saying they’re not for human consumption.
France had also banned specific types of poppers in 1990, but then passed a law extending this ban to ALL alkyl nitrites in 2007. But just two years later, their courts overturned this law, saying that it was too broad and too harsh a response for a relatively small number of incidents, and now the products just are required to have warning labels.
Canada cracked down on poppers in 2013, going after many manufacturers in an effort to get them off of store shelves. And most notably, the United Kingdom had a very intense debate on poppers beginning in late 2015 and wrapping up this year, as they were on the verge of being banned entirely as part of the UK psychoactive substances act of 2016.
They were originally included in the law, but many members of parliament objected to poppers being swept up in this general push against new drugs, saying they have been around for a long time with minimal negative health effects, and that banning them would disproportionately criminalize the gay community. At least two MPs, Crispin Blunt and Michael Fabricant, came out as having used poppers themselves while arguing in favor of excluding them from the ban. Despite their efforts, on January 20 the House of Commons voted to keep them in the ban, with 309 wanting to ban them and 228 trying to keep them legal.
However, after this defeat, gay rights groups, drug policy reformers, and others kept up the pressure, leading the Home Office to announce on March 22 that after additional consideration, they would be excluding poppers from the law. They cited research from the Advisory Council on the Misuse of Drugs, which said that poppers were technically not psychoactive since they acted directly on the body, rather than having an impact on the brain – which as we explained in the science segment two weeks ago is actually true, as poppers act mainly as a muscle relaxant. This decision to keep poppers legal was hailed as a major victory, though it’s now becoming clearer that the UK government is going to have trouble enforcing that law anyway.
On the scientific front, there have been a few major developments in the past ten years. In 2007, Professor David Nutt published a paper in the Lancet that ranked 20 different drugs on various criteria of their harms, and poppers placed #19 on that list. In terms of physical harm, it was safer than cannabis and only slightly more dangerous than GHB and khat. It was deemed the safest drug in terms of dependence, and on social harms, it tied with methylphenidate, or Ritalin, as the second-least-harmful drug, behind khat once again. This study was used by many arguing against the ban on poppers, since they have relatively few harms when compared to other recreational drugs.
However, one recent study also published in the Lancet, this one in 2014, focused on how some poppers were causing permanent eye damage in even casual users. This loss of vision is referred to as “poppers maculopathy” and is blamed on the switch from isobutyl nitrite to isopropyl nitrite following a ban on the old formulation in 2006. Like the popularity of so-called synthetic cannabis like Spice or K2, which are far more dangerous than actual cannabis, this serves as a clear demonstration of how bans on certain drugs can lead to more dangerous substitutes being used.
That’s all for the current events of alkyl nitrites, also known as poppers, which also wraps up this month. Since we’re now on hiatus, we won’t have a drug of the month in January, and will be going back to news-only episodes, but we’ll be back with a new one in February. If you have a drug you’d like us to cover next, please send us an email or message us on Facebook or Twitter, and we’d love to check it out!