Poppers

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Summary sheet: Poppers
A selection of poppers

Alkyl nitrites (also known as poppers) are a class of volatile liquid substances including amyl nitrite, butyl nitrite, cyclohexyl nitrite, ethyl nitrite, hexyl nitrite, isobutyl nitrite, isopropyl nitrite, and methyl nitrite (see this section for more details).

Alkyl nitrites are volatile whose fumes are inhaled for recreational purposes, particularly in preparation for sexual activities.[1]

They are known for producing intense but short-lived muscle relaxing effects that start after about 15 seconds and last for up to 3 minutes.

The most common method of administering poppers is to open the bottle, hold it under one's nostril, and inhale. Other methods of popper usage such as oral use are extremely dangerous and can potentially result in death or coma. It is worth noting that alkyl nitrites burn the skin on contact and are extremely flammable.

Alkyl nitrites

Alkyl nitrite: Boiling point (°C)[1]

  • Very volatile (perceived as "potent")
    • Methyl nitrite: -12.9±3.0 °C at 760 mmHg[2]
    • Ethyl nitrite: 20.0±3.0 °C at 760 mmH[3]
    • Isopropyl nitrite (2-propyl nitrite): 39.0±9.0 °C at 760 mmHg[4]
  • Moderately volatile
    • Isobutyl nitrite (2-methylpropyl nitrite): 70.5±9.0 °C at 760 mmHg[5]
    • Butyl nitrite (n-butyl nitrite): 78.8±3.0 °C at 760 mmHg[6]
  • Slowly volatile (perceived as "less potent")
    • Amyl nitrite (isoamyl nitrite, isopentyl nitrite): 99.1±9.0 °C at 760 mmHg[7]
    • Cyclohexyl nitrite: 138.7±7.0 °C at 760 mmHg[8]
    • Hexyl nitrite: 129.6±3.0 °C at 760 mmHg[9]

1: The lower the boiling point is, the more volatile.

Amyl nitrite is the most widely sold alkyl nitrite. Isopropyl nitrite became popular due to a ban on isobutyl nitrite in the European Union in 2007. Poppers were part of the disco club culture from the 1970s to the 1980s. Their usage was further popularized by the 1990s rave scene.[10] Today, they are mainly sold in sex shops in the form of small bottles, or as cap vials.

Chemistry

200px-Nitrite-ester-2D.png

Poppers are chemicals known as alkyl nitrites. These are chemical compounds of structure R–O-N=O. In more formal terms, they are alkyl esters of nitrous acid. Alkyl nitrites are inhalants, meaning they have very low vapor points and become airborne almost immediately at room temperature. Organic nitrites are prepared from alcohols and sodium nitrite in sulfuric acid solution. They decompose slowly on standing. The decomposition products are oxides of nitrogen, water and the alcohol as well as polymerization products of the aldehyde.

Pharmacology

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This pharmacology section is incomplete.

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The pharmacology of alkyl nitrites is not yet fully understood, but the primary mechanism by which they exert their effects is believed to be by reduction to nitric oxide which functions as a gasotransmitter (a gaseous neurotransmitter) in mammals which causes the relaxation of smooth muscle. Veins and arteries are mainly composed of vascular smooth muscle and by releasing nitric oxide, poppers cause dilation of veins and arteries, lowering blood pressure and allowing blood to be pumped around the body at a greater rate.[11] The relaxation of smooth muscle tissue in the vagina and anal sphincters is one reason for the use poppers during sexual activity with users aiming to facilitate easier penetration.

Subjective effects

Disclaimer: The effects listed below cite the Subjective Effect Index (SEI), an open research literature based on anecdotal user reports and the personal analyses of PsychonautWiki contributors. As a result, they should be viewed with a healthy degree of skepticism.

It is also worth noting that these effects will not necessarily occur in a predictable or reliable manner, although higher doses are more liable to induce the full spectrum of effects. Likewise, adverse effects become increasingly likely with higher doses and may include addiction, severe injury, or death ☠.

Physical effects
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Cognitive effects
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Experience reports

There are currently no anecdotal reports which describe the effects of this compound within our experience index. Additional experience reports can be found here:

Toxicity and harm potential

Radar plot showing relative physical harm, social harm, and dependence of alkyl nitrates[14]

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 including alcohol and tobacco.[15] The primary risk of popper usage is a chemical burn if spilled on one's skin.

All forms of alkyl nitrites are highly flammable and should not be used if one is smoking or has candles nearby.

Alkyl nitrites 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.[16] 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.[17] Another study described foveal (daylight vision) damage in six habitual poppers users.[18] 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.[19][20]

Isobutyl nitrite toxicity treatment

Isobutyl nitrite is known to cause methemoglobinemia.[21] Severe methemoglobinemia may be treated with methylene blue.[22]

Lethal dosage

The only consistently safe route of administration used with poppers is inhalation. Oral use of the liquid can prove fatal enough to result in a lethal dosage.[23][24] It is near impossible to overdose through the conventional use of poppers.

An overdose via oral ingestion (rather than inhalation) may result in cyanosis, unconsciousness, coma, and even death.[25][26][27][28][29] Accidental aspiration of amyl or butyl nitrites may cause lipoid pneumonia.[30] Methylene blue is a treatment for methemoglobinemia associated with popper use.[24][31][32][33] Accidental aspiration of amyl or butyl nitrites may lead to the development of lipoid pneumonia.[24]

It is strongly recommended that one use harm reduction practices when using this class of substances.

Tolerance and addiction potential

There is no real tolerance to be gained through popper use. They are considered to have little to not addictive potential.

Dangerous to administer orally

The consumption of alkyl nitrites can lead to methemoglobinemia, and the possibility of inhalation causing it has not been ruled out.[34]

Dangerous interactions

Alkyl nitrites are interactive with other vasodilators like sildenafil (Viagra, Revatio), vardenafil (Levitra), tadalafil (Cialis, Adcirca) and nitroglycerin to cause a serious decrease in blood pressure, which can lead to fainting.[35]

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.[36]
  • European Union: Since 2007, reformulated poppers containing isopropyl nitrite are sold in Europe; isobutyl nitrite is prohibited as it is considered carcinogenic.[37]
  • 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.[38] In 2007, the government extended this prohibition to all alkyl nitrites that were not authorized for sale as drugs.[39]
  • Germany: Poppers are not controlled under the BtMG (Narcotics Act) or the NpSG (New Psychoactive Substances Act).[40][41] They are legal, as long as they are not sold for human consumption, according to §2 AMG.[42]
  • 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.
  • United States: Poppers containing alkyl nitrites other than amyl nitrite are readily available in the United States. Sometimes they are sold as video head cleaners, polish removers, or room odorizers. They have not regained the popularity they had in the 1970s.

See also

External Links

References

  1. 1.0 1.1 Volatile Nitrites - Special Subjects 
  2. http://www.chemspider.com/Chemical-Structure.11730.html
  3. http://www.chemspider.com/Chemical-Structure.7735.html
  4. http://www.chemspider.com/Chemical-Structure.10466.html
  5. http://www.chemspider.com/Chemical-Structure.10493.html
  6. http://www.chemspider.com/Chemical-Structure.10530.html
  7. http://www.chemspider.com/Chemical-Structure.7762.html
  8. http://www.chemspider.com/Chemical-Structure.474493.html
  9. http://www.chemspider.com/Chemical-Structure.4895948.html
  10. Drugscope - Nitrites, 2007 
  11. Nossaman, V. E., Nossaman, B. D., Kadowitz, P. J. (2010). "Nitrates and Nitrites in the Treatment of Ischemic Cardiac Disease". Cardiology in review. 18 (4): 190–197. doi:10.1097/CRD.0b013e3181c8e14a. ISSN 1061-5377. 
  12. Poppers - TheSite.org, 2015 
  13. 13.0 13.1 13.2 Israelstam, Stephen; Lambert, Sylvia; Oki, Gustave (1978). "Poppers, A New Recreational Drug Craze*". Canadian Psychiatric Association Journal. 23 (7): 493–495. doi:10.1177/070674377802300711. ISSN 0008-4824. 
  14. Nutt, D., King, L. A., Saulsbury, W., Blakemore, C. (24 March 2007). "Development of a rational scale to assess the harm of drugs of potential misuse". The Lancet. 369 (9566): 1047–1053. doi:10.1016/S0140-6736(07)60464-4. ISSN 0140-6736. 
  15. Nutt, D., King, L. A., Saulsbury, W., Blakemore, C. (24 March 2007). "Development of a rational scale to assess the harm of drugs of potential misuse". Lancet (London, England). 369 (9566): 1047–1053. doi:10.1016/S0140-6736(07)60464-4. ISSN 1474-547X. 
  16. Davies, A. J., Kelly, S. P., Bhatt, P. R. (June 2012). "'Poppers maculopathy'—an emerging ophthalmic reaction to recreational substance abuse". Eye. 26 (6): 888–888. doi:10.1038/eye.2012.37. ISSN 1476-5454. 
  17. Dixon, D. S., Reisch, R. F., Santinga, P. H. (July 1981). "Fatal methemoglobinemia resulting from ingestion of isobutyl nitrite, a "room odorizer" widely used for recreational purposes". Journal of Forensic Sciences. 26 (3): 587–593. ISSN 0022-1198. 
  18. Audo, I., El Sanharawi, M., Vignal-Clermont, C., Villa, A., Morin, A., Conrath, J., Fompeydie, D., Sahel, J.-A., Gocho-Nakashima, K., Goureau, O., Paques, M. (June 2011). "Foveal damage in habitual poppers users". Archives of Ophthalmology (Chicago, Ill.: 1960). 129 (6): 703–708. doi:10.1001/archophthalmol.2011.6. ISSN 1538-3601. 
  19. More evidence 'poppers' may damage eyesight | http://in.reuters.com/article/2014/07/08/us-proppers-eyesight-idINKBN0FD1ZD20140708
  20. Gruener, A. M., Jeffries, M. A. R., Housseini, Z. E., Whitefield, L. (1 November 2014). "Poppers maculopathy". The Lancet. 384 (9954): 1606. doi:10.1016/S0140-6736(14)60887-4. ISSN 0140-6736. 
  21. Taylor, Gregory M; Avera, Robert S; Strachan, Christian C; Briggs, Christian M; Medler, Jason P; Pafford, Carl M; Gant, Timothy B (1 February 2021). "Severe methemoglobinemia secondary to isobutyl nitrite toxicity: the case of the 'Gold Rush'". Oxford Medical Case Reports. 2021 (2): omaa136. doi:10.1093/omcr/omaa136. 
  22. Modarai, B; Kapadia, YK; Kerins, M; Terris, J (May 2002). "Methylene blue: a treatment for severe methaemoglobinaemia secondary to misuse of amyl nitrite". Emergency medicine journal : EMJ. 19 (3): 270–1. doi:10.1136/emj.19.3.270. PMC 1725875Freely accessible. PMID 11971852. 
  23. Dixon, D. S., Reisch, R. F., Santinga, P. H. (July 1981). "Fatal methemoglobinemia resulting from ingestion of isobutyl nitrite, a "room odorizer" widely used for recreational purposes". Journal of Forensic Sciences. 26 (3): 587–593. ISSN 0022-1198. 
  24. 24.0 24.1 24.2 Hagan, I. G., Burney, K. (August 2007). "Radiology of recreational drug abuse". Radiographics: A Review Publication of the Radiological Society of North America, Inc. 27 (4): 919–940. doi:10.1148/rg.274065103. ISSN 1527-1323. 
  25. "Amyl Nitrite". Medsafe. New Zealand Medicines and Medical Devices Safety Authority. May 18, 2000. Archived from the original on November 11, 2006. Retrieved March 15, 2007. 
  26. Dixon DS, Reisch RF, Santinga PH (July 1981). "Fatal methemoglobinemia resulting from ingestion of isobutyl nitrite, a "room odorizer" widely used for recreational purposes". Journal of Forensic Sciences. 26 (3): 587–93. doi:10.1520/JFS11404J. PMID 7252472. 
  27. Pruijm MT, de Meijer PH (December 2002). "[Methemoglobinemia due to ingestion of isobutyl nitrite ('poppers')]". Nederlands Tijdschrift voor Geneeskunde. 146 (49): 2370–3. PMID 12510403. 
  28. Stalnikowicz R, Amitai Y, Bentur Y (2004). "Aphrodisiac drug-induced hemolysis". Journal of Toxicology. Clinical Toxicology. 42 (3): 313–6. doi:10.1081/clt-120037435. PMID 15362601.  Unknown parameter |s2cid= ignored (help)
  29. Emergency Medicine: Principles and Practice. Harper & Collins, 2nd edition. 2008. pp. 42–51.Template:Full citation needed
  30. Hagan IG, Burney K (July–August 2007). "Radiology of recreational drug abuse". Radiographics. 27 (4): 919–40. doi:10.1148/rg.274065103. PMID 17620459. 
  31. Pruijm, M. T. C., Meijer, P. H. E. M. de (7 December 2002). "[Methemoglobinemia due to ingestion of isobutyl nitrite ('poppers')]". Nederlands Tijdschrift Voor Geneeskunde. 146 (49): 2370–2373. ISSN 0028-2162. 
  32. Stalnikowicz, R., Amitai, Y., Bentur, Y. (2004). "Aphrodisiac drug-induced hemolysis". Journal of Toxicology. Clinical Toxicology. 42 (3): 313–316. doi:10.1081/clt-120037435. ISSN 0731-3810. 
  33. Emergency Medicine: Principles and Practice. Harper & Collins, 2nd edition. 2008. pp. 42–51.
  34. O'Toole JB, Robbins GB, Dixon DS (November 1987). "Ingestion of isobutyl nitrite, a recreational chemical of abuse, causing fatal methemoglobinemia". J. Forensic Sci. 32 (6): 1811–2. doi:10.1520/JFS11240J. PMID 3430141. 
  35. Romanelli, F., Smith, K. M. (June 2004). "Recreational use of sildenafil by HIV-positive and -negative homosexual/bisexual males". The Annals of Pharmacotherapy. 38 (6): 1024–1030. doi:10.1345/aph.1D571. ISSN 1060-0280. 
  36. Health Canada cracks down on poppers, Xtra Magazine 
  37. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/119139/acmdnps2011.pdf | Consideration of the Novel Psychoactive Substances (‘Legal Highs’)". Advisory Council on the Misuse of Drugs. pp. 52–54.
  38. http://www.legifrance.gouv.fr/affichTexte.do?dateTexte=20090901&cidTexte=JORFTEXT000000166136 | "Decree 90–274 of 26 March 1990" (in French). Legifrance.gouv.fr. 2009-05-15.
  39. http://www.legifrance.gouv.fr/affichTexte.do?dateTexte=20090901&cidTexte=JORFTEXT000000341445 | "Decree 2007-1636 of 20 November 2007" (in French). Legifrance.gouv.fr.
  40. BtMG | http://www.gesetze-im-internet.de/btmg_1981/BtMG.pdf
  41. NpSG | https://www.gesetze-im-internet.de/npsg/NpSG.pdf
  42. § 2 AMG - Einzelnorm