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. Amyl nitrite has a centuries-long history of safe use in treating angina, as well as an antidote to cyanide poisoning. 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. Use is particularly prominent among urban gay men. These products have long been part of the club culture from the 1970s disco scene to the 1980s and 1990s rave scene.

Effects
Inhaling nitrites relaxes smooth muscles throughout the body, including the sphincter muscles of the anus and the vagina. 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.

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

While anecdotal evidence reveals that both men and women can find the experience of using poppers pleasurable, this experience is not universal. Some men report that poppers can cause short-term erectile problems.

History
Amyl nitrite has a long history of safe use in treating angina, as well as an antidote to cyanide poisoning.

Amyl nitrite leads to a non-specific relaxation of smooth muscle, resulting in coronary vasodilation and decreased systemic vascular resistance and left ventricular preload and afterload. Sir Thomas Lauder Brunton, (14 March 1844, 16 September 1916) a Scottish physician, is famously-associated with the use of amyl nitrite to treat angina pectoris. Brunton's clinical use of amyl nitrite to treat angina 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 open the coronary arteries of patients. Brunton was knighted in 1900.

Additionally, amyl nitrite causes the formation of methemoglobin wherein, as an effective antidote to cyanide poisoning, the methemoglobin combines with the cyanide to form nontoxic cyanmethemoglobin. First responders typically carry a cyanide poison kit containing amyl nitrite, such as the popular Taylor Pharmaceutical Cyanide Antidote Kit.

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 revealed a wide spectrum of users, including 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."), and frenetic disco dancers amid "flashing strobe lights and the pulsating beat of music in discos across the country".

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. 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.

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. 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. 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. 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. 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.

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. Today, generic-like street names include 'poppers', RUSH, Locker Room,  Snappers, and Liquid Gold. 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. 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.

Australia
In the state of Queensland poppers are no longer sold in adult shops. In New South Wales and Victoria they are still available in most adult shops, sold as room odourants or video head cleaners. They are available in other states and territories.

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.

Germany
Possession of poppers is legal in Germany since poppers are not mentioned in German Narcotics Law, although buying and selling of poppers is forbidden under German Narcotics Commerce Law. To avoid this, poppers are often traded as cleaning agents or room odourisers.

Ireland and Italy
Possession is legal, are available in most adult shops.

France
Possession is legal, but supply has been forbidden by a decree of Prime Minister François Fillon in November 2007. This decree was subsequently overturned by the courts.

Spain
The legal situation of poppers in the Spain is somewhat ambiguous. On the one hand, their components are legal, although no modern pharmaceutical laboratory fabricates it, as it is medically obsolete. Thus, they are frequently sold as solvents. The open sale of poppers as such is not allowed, although it is not difficult to buy them through the Internet and to import them from countries whose legislation is not so restrictive.

Switzerland
Possession of poppers is legal in Switzerland since poppers are not mentioned in Narcotics Law, although buying and selling of poppers is forbidden under Narcotics Commerce Law. To avoid this, poppers are often traded as cleaning agents or room odourisers.

United Kingdom
Amyl nitrite is controlled under the Medicines Act, and although possession is legal, supply may be an offence. 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. 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. Additionally, Isobutyl Nitrite has also been classified as a class 2 carcinogen making retail sale technically prohibited.

Prices are commonly in the range of £2–5 GBP per bottle.

United States of America
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.


 * 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 after observation of an increase in recreational use.


 * Other Alkyl nitrites were outlawed in the USA 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 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. The law came into effect in 1990. Visits to retail outlets selling these products reveal that some manufacturers have since reformulated their products to abide by the regulations, through the use of the legal cyclohexyl nitrite as the primary ingredient in their products, which are sold as video head cleaner, polish remover or room odorants. (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


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

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. Other risks include burns if spilt on skin, loss of consciousness, headaches, and red or itching rashes around the mouth and nose.

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. 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. 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. 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. 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.

Some health authorities now mandate point of sale warnings. Some health departments and AIDS prevention agencies have issued alerts about poppers use being associated with HIV transmission.In 2007 Seattle Health Department issued a poppers alert cautioning "be cautious about the information on the internet. Websites that sell poppers are not accurate sources of health information." However, reputable medical sites such as the online version of the Merck Manual of Diagnosis and Therapy continue to report that there is little evidence of significant hazard associated with inhalation of alkyl nitrites. Aside from the issue of HIV/AIDS, a 1983 U. S. Consumer Product Safety Commission investigation Briefing Package stated that "Available injury data did not indicate a significant risk of personal injury or illness from room odorizer abuse."

Chemistry
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.

Physical and Chemical Properties (Sutton, 1963):

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, 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 protagonist 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. In the Alex Cox film Repo Man, Duke (Dick Rude) asks Otto (Emilio Estevez), "Want some toot, dude?" and pulls out a small bottle, whose contents he then spills on the table. His companions, Debbi (Jennifer Balgobin) and Archie (Michael Sandoval), dive to the table to sniff it up rather than see it wasted. The bottle has a generic label (a recurring joke in the film) reading "Butyl Nitrate."

In the David Lynch film Blue Velvet, the character of Frank Booth, played by Dennis Hopper, inhales a gas before committing violent, sexual acts. Though the precise nature of the gas is never disclosed, Hopper states in interviews for the documentary making of the film, that he suggested it would be Amyl Nitrite. Initially Lynch had wanted the gas to be helium. In the film St. Trinian's a pupil offers poppers to an unconscious student in lieu of smelling salts.

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." Eminem references a brand of poppers, "RUSH," in his song "Just Don't Give a Fuck," from his 1999 album "The Slim Shady LP". He says, "Doin' too much RUSH had my face flushed like red blush."

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. In That Peter Kay Thing (a comedy series by Peter Kay) a character walks into a shop and asks for a twix and a bottle of poppers, to which the shop keeper remarks "try that pure gold".

In his March 22, 2008 article In Mexico, on the Lam With Ken Kesey, The New York Times editorial writer Lawrence Downes interviewed Bart Varelmann, who revealed in his self-published memoir, "Innkeeper", that “The interior of Ken’s bus was a grab-bag cornucopia of strange pills, exotic herbs, magic mushrooms, peyote buttons, LSD, uppers, downers, poppers and of course marijuana”.