Poppers
Poppers are a class of recreational drugs that are used sexually for smooth muscle relaxation and a sensation of rapid onset euphoria. Typically "poppers" refers to one of several alkyl nitrites, though occasionally the term is used to describe ethyl chloride or "spray poppers". Specific drugs in this class include isoamyl nitrite, isopentyl nitrite, isopropyl nitrite, and isobutyl nitrite.
| Health risk | Mild |
|---|---|
| Addiction risk | Mild |
| Legal risk | Mild |
| External links | PsychonautWiki Erowid |
Background
Poppers, specifically amyl nitrite, gained popularity in the gay community during the 1960s and 1970s. At the time, they were often sold in small glass vials labeled as "room deodorizers" or "video head cleaner" to bypass legal restrictions on their sale. Gay bars and clubs became common places for people to use poppers, often in conjunction with dancing and socializing.
Appeal
The appeal of poppers in a sexual context can vary from person to person, but some common reasons people use them include:
- Increased Sensation: Poppers can enhance sexual pleasure by intensifying physical sensations and increasing sensitivity to touch. This can lead to heightened arousal and more intense orgasms.
- Reduced Inhibitions: Poppers are known for their ability to lower inhibitions and increase feelings of sexual openness and desire. This can lead to a more uninhibited and adventurous sexual experience.
- Enhanced Anal Sex: Poppers are particularly popular among individuals engaging in anal sex, as they can help relax the anal sphincter muscles, making penetration more comfortable and enjoyable.
Interactions
Poppers act synergistically with PDE5 inhibitors which are commonly used to treat erectile dysfunction. The combination of poppers and PDE5 inhibitors can cause dangerously low blood pressure and should be avoided. Examples of PDE5 inhibitors include:
Risks
In some individuals or in high doses, poppers can cause vomiting, methemoglobinemia, hypoxemia (reduced oxygen level in the blood), and unconsciousness[1] which can persist for an extended time even after popper use is stopped.[2] During methemoglobinemia, some oxygen-carrying hemoglobin in the blood is converted to methemoglobin, a form that cannot bind oxygen.
Poppers containing isopropyl nitrite can cause damage to the fovea and can cause significant visual disturbance[3]. There isn't an easy way to verify if a bottle contains isopropyl nitrite without a lab since product labels may be incorrect, misleading, or missing (e.g. unlabeled brown bottle).
Poppers can cause chemical burns if the liquid becomes exposed to skin or sinuses.
Risk mitigation
Cease poppers usage if blood oxygen levels become lowered. Pale or blue skin or lips, or a headache can be used to identify low blood oxygen levels. Seek medical attention if the subject does not recover.
Pulse oximeters should not be used to monitor oxygen level when poppers are used. Oximeters estimate oxygenation by measuring the absorbance of two wavelengths of light. Poppers generate methemoglobin which interferes with absorbance measurements, skewing the results towards a fixed number (in most cases, 85%) regardless of actual oxygenation[4].
Avoid poppers which are known to contain isopropyl nitrite. If any vision impairment is observed, stop using the poppers immediately, and consider avoiding that type of poppers again.
Secure containers by closing their lids and placing them on stable surfaces to prevent spills. Spilled poppers can cause exposure to higher concentrations than otherwise intended. To avoid spills, transfer a small amount of poppers onto a piece of absorbent cotton or paper in an empty poppers bottle, ensuring that the bottle contains no free liquid. The poppers will evaporate from the absorbent material and can be used as usual.
Known incidents
Medical case reports
- 23yr old male in the ER with hypoxemia, methemoglobinemia, and syncope (2023)[1]
- 39yr old male in the ER with hypoxemia and methemoglobinemia (2012)[5]
- 55yr old male in the ER with hypoxemia and methemoglobinemia for over a day (2016)[2]
- 44yr old male in the ER with hypoxemia, methemoglobinemia, unresponsive, stopped heart (1995)[6]
- 34yr old male in the ER with hypoxemia and methemoglobinemia for 4 days (2012)[7]
- 12 cases of impared vision presenting to an eye hospital (2017)[3]
External links
References
- ↑ 1.0 1.1 Barry, Katherine; McAteer, Kristina E. (2023-04-03). "Syncope and Methemoglobinemia Preceded by Amyl Nitrite 'Popper' Inhalation". Rhode Island Medical Journal (2013). 106 (3): 49–51. ISSN 2327-2228. PMID 36989098.
- ↑ 2.0 2.1 Olazagasti, Coral; Paralkar, Janvi; Vishnevetsky, Michael; Chakravarti, Aloke; Sulica, Roxana; Favila, Kristine (2016-10). "Poppers Not Only Make You High: A Rare Case of Amyl Nitrate-Induced Hypoxia". Chest. 150 (4): 1108A. doi:10.1016/j.chest.2016.08.1216. ISSN 0012-3692.
{{cite journal}}: Check date values in:|date=(help) - ↑ 3.0 3.1 Rewbury, Rebecca; Hughes, Edward; Purbrick, Robert; Prior, Stephen; Baron, Mark (2017-11-01). "Poppers: legal highs with questionable contents? A case series of poppers maculopathy". British Journal of Ophthalmology. 101 (11): 1530–1534. doi:10.1136/bjophthalmol-2016-310023. ISSN 0007-1161. PMID 28396339.
- ↑ academic.oup.com https://academic.oup.com/clinchem/article/51/2/434/5629640. Retrieved 2024-02-20.
{{cite web}}: Missing or empty|title=(help) - ↑ McCabe, Aileen; McCann, Brendan; Kelly, Paul (2012-11-21). "Pop goes the O2: a case of popper-induced methaemoglobinamia". BMJ Case Reports. 2012: bcr2012007176. doi:10.1136/bcr-2012-007176. ISSN 1757-790X. PMC 4543718. PMID 23175012.
- ↑ Edwards, R J; Ujma, J (1995-06). "Extreme methaemoglobinaemia secondary to recreational use of amyl nitrite". Journal of Accident & Emergency Medicine. 12 (2): 138–142. ISSN 1351-0622. PMC 1342554. PMID 7582412.
{{cite journal}}: Check date values in:|date=(help) - ↑ Wong, Anselm; Koutsogiannis, Zeff; Greene, Shaun; McIntyre, Shona (2013-03-01). "A case of hemolysis and methemoglobinemia following amyl nitrite use in an individual with G6PD deficiency". Journal of Acute Medicine. 3 (1): 23–25. doi:10.1016/j.jacme.2012.12.005. ISSN 2211-5587.
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