Poppers

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Summary sheet: Poppers
A selection of poppers

Alkyl nitrites (commonly known as Poppers) are a class of volatile liquid substances whose fumes are inhaled for recreational purposes, particularly in preparation for sexual activities.[1] They are known for producing intense but short-lived effects that start after about 15 seconds and last for up to 3 minutes.

The 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 European Union in 2007. The compound butyl nitrite is more rarely sold.[citation needed]

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.

Poppers were part of the disco club culture from the 1970s to the 1980s. Their usage was further popularized by the 1990s rave scene.[2] Today, they are mainly sold in sex shops in the form of small bottles, or as cap vials.

Chemistry

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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.

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 are oxides of nitrogen, water and the alcohol as well as polymerization products of the aldehyde.

The decomposition of alkyl nitrites is different with each one; the original nitrite, amyl nitrite, has a relatively high rate of decomposition and isopropyl nitrite, the nitrite most commonly used today, has a slow decomposition.

Pharmacology

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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.[3] 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

The effects listed below are based upon the subjective effects index and personal experiences of PsychonautWiki contributors. These effects should be taken with a grain of salt and will rarely (if ever) occur all at once, but heavier doses will increase the chances of inducing a full range of effects. Likewise, adverse effects become much more likely on higher doses and may include serious 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[6]

The 2005 Merck Manual of Diagnosis and Therapy reported that there is little evidence of significant hazard associated with inhalation of alkyl nitrites.[7] 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.[8] 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.[9] 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.[10] Another study described foveal (daylight vision) damage in six habitual poppers users.[11] 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.[12][13]

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.[14][15] 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. Methylene blue is a treatment for methemoglobinemia associated with popper use.[16][17][18][19] Accidental aspiration of amyl or butyl nitrites may lead to the development of lipoid pneumonia.[20]

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 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.[21]

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.[22]
  • European Union: Since 2007, reformulated poppers containing isopropyl nitrite are sold in Europe; isobutyl nitrite is prohibited as it is considered carcinogenic.[23]
  • 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.[24] In 2007, the government extended this prohibition to all alkyl nitrites that were not authorized for sale as drugs.[25]
  • 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. Volatile Nitrites | http://www.merckmanuals.com/professional/special_subjects/drug_use_and_dependence/volatile_nitrites.html?qt=&sc=&alt=
  2. Nitrates | http://web.archive.org/web/20070405132026/http://www.drugscope.org.uk/druginfo/drugsearch/ds_results.asp?file=%5cwip%5c11%5c1%5c1%5cnitrites.html
  3. Nossaman VE, Nossaman BD, Kadowitz PJ. Nitrates and Nitrites in the Treatment of Ischemic Cardiac Disease. Cardiology in review. 2010;18(4):190-197. doi:10.1097/CRD.0b013e3181c8e14a. | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2885014/
  4. http://www.thesite.org/drink-and-drugs/legal-highs/poppers-9999.html
  5. 5.0 5.1 5.2 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. 
  6. Development of a rational scale to assess the harm of drugs of potential misuse (ScienceDirect) | http://www.sciencedirect.com/science/article/pii/S0140673607604644
  7. Volatile Nitrites | http://www.merckmanuals.com/professional/special_subjects/drug_use_and_dependence/volatile_nitrites.html?qt=&sc=&alt=
  8. Development of a rational scale to assess the harm of drugs of potential misuse (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/17382831
  9. http://www.nature.com/eye/journal/v26/n6/full/eye201237a.html
  10. Fatal methemoglobinemia resulting from ingestion of isobutyl nitrite, a "room odorizer" widely used for recreational purposes (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/7252472
  11. Foveal damage in habitual poppers users (PubMed.gov / NCBI) | https://www.ncbi.nlm.nih.gov/pubmed/21320953
  12. More evidence 'poppers' may damage eyesight | http://in.reuters.com/article/2014/07/08/us-proppers-eyesight-idINKBN0FD1ZD20140708
  13. Poppers maculopathy | http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60887-4/abstract
  14. Fatal methemoglobinemia resulting from ingestion of isobutyl nitrite, a "room odorizer" widely used for recreational purposes (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/7252472
  15. Radiology of recreational drug abuse (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/17620459
  16. Radiology of recreational drug abuse (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/17620459
  17. Methemoglobinemia due to ingestion of isobutyl nitrite ('poppers') (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/12510403
  18. Aphrodisiac drug-induced hemolysis (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/15362601
  19. Emergency Medicine: Principles and Practice. Harper & Collins, 2nd edition. 2008. pp. 42–51.
  20. Radiology of recreational drug abuse (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/17620459
  21. Recreational use of sildenafil by HIV-positive and -negative homosexual/bisexual males (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/15113986
  22. http://dailyxtra.com/canada/news/health-canada-cracks-poppers?market=209 | Rob Salerno (Jun 25, 2013). "Health Canada cracks down on poppers". Canada: Pink Triangle Press.
  23. 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.
  24. 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.
  25. http://www.legifrance.gouv.fr/affichTexte.do?dateTexte=20090901&cidTexte=JORFTEXT000000341445 | "Decree 2007-1636 of 20 November 2007" (in French). Legifrance.gouv.fr.