View source for Poppers

{{Short description|Class of recreational drug}}
{{Other uses|Popper (disambiguation)}}
{{cs1 config|name-list-style=vanc|display-authors=6}}
{{more citations needed|date=March 2019}}
{{use dmy dates|cs1-dates=ly|date=March 2022}}
{{Infobox drug
| type = 
| image = HOpoppers.jpg
| width = 250px
| alt = A selection of over-the-counter poppers on display
| caption = A selection of over-the-counter poppers on display
| component1 = 
| class1 = 
| component2 = 
| class2 = 
| legal_AU = S4
| legal_AU_comment = in general; some exceptions<ref>''[https://www.legislation.gov.au/F2024L01228 Therapeutic Goods (Poisons Standard—October 2024) Instrument 2024]'' (Cth). Amyl nitrite also classified in Schedule 3 (Pharmacist only) in certain preparations. Isopropyl nitrite classified in Schedule 10 (Dangerous substance).</ref>
| legal_status = Elsewhere, usually available [[over-the-counter|OTC]]
| routes_of_administration = Inhalation
| bioavailability = When inhaled, 
* Amyl nitrite: unknown
* Isopropyl nitrite: 43%
* Isobutyl nitrite: unknown
| metabolism = Liver
| metabolites = * Amyl nitrite: [[pentanol]] (amyl alcohol)
* Isopropyl nitrite: [[isopropanol]]
* Isobutyl nitrite: [[isobutanol]]
| onset = 15 seconds
| elimination_half-life = Suspected to be minutes to less than an hour
| duration_of_action = 30 seconds to 5 minutes
| excretion = Primarily urine
| synonyms = popper, poppe, pops
| chemical_formula = 
| chemical_formula_comment = Depends on primary active ingredient
| molecular_weight_comment = Depends on primary active ingredient
| boiling_point = 
| boiling_notes = Depends on primary active ingredient
| class = [[Vasodilation|Vasodilator]]
}}

'''Poppers''' are recreational drugs belonging to the [[alkyl nitrite]] family of [[chemical class|chemical compounds]]. When fumes from these substances are [[inhalant|inhaled]], they act as potent [[Vasodilation|vasodilators]], producing mild euphoria, warmth, and dizziness. Most effects have a rapid onset and are short-acting.<ref name=":1">{{cite journal | vauthors = Romanelli F, Smith KM, Thornton AC, Pomeroy C | title = Poppers: epidemiology and clinical management of inhaled nitrite abuse | journal = Pharmacotherapy | volume = 24 | issue = 1 | pages = 69–78 | date = January 2004 | pmid = 14740789 | doi = 10.1592/phco.24.1.69.34801 | s2cid = 44991387 }}</ref> Its [[Recreational drug use|recreational use]] is believed to be potentially dangerous for people with [[Cardiovascular disease|heart problems]], [[Anemia|anaemia]], or [[glaucoma]]. Reported adverse effects include [[Syncope (medicine)|fainting]], retinal toxicity, and vision loss.<ref>{{cite journal | vauthors = Davies AJ, Kelly SP, Naylor SG, Bhatt PR, Mathews JP, Sahni J, Haslett R, McKibbin M | title = Adverse ophthalmic reaction in poppers users: case series of 'poppers maculopathy' | journal = Eye | volume = 26 | issue = 11 | pages = 1479–1486 | date = November 2012 | pmid = 23079752 | pmc = 3496104 | doi = 10.1038/eye.2012.191 }}</ref><ref>{{cite journal | vauthors = Vignal-Clermont C, Audo I, Sahel JA, Paques M | title = Poppers-associated retinal toxicity | journal = The New England Journal of Medicine | volume = 363 | issue = 16 | pages = 1583–1585 | date = October 2010 | pmid = 20942681 | doi = 10.1056/NEJMc1005118 }}</ref>

As poppers include a broad range of [[chemical class|chemical types]], their legality differs across different jurisdictions. They are often packaged under the guise of room deodorizer, leather polish, nail polish remover, or [[Videotape|videotape head cleaner]] to evade [[Drug prohibition|anti-drug laws]].<ref name=":1" />

The term ''poppers'' comes from the popping sound made when glass vials of the substance were crushed to release the vapors for inhalation. [[Amyl nitrite]] was originally prescribed in the late 1800s for the medical management of [[angina]].<ref name=":1" /> Many analogues exist, such as [[amyl nitrite|isoamyl nitrite, isopentyl nitrite]], [[isopropyl nitrite]], and [[isobutyl nitrite]]. These substances are subject to different regulations; for example, isobutyl nitrite is banned in the [[European Union]].

Poppers act as [[muscle relaxant]]s, causing the relaxation of [[smooth muscle|involuntary smooth muscles]] such as the [[throat]] and [[anus]].<ref>{{cite journal | vauthors = Zhao P, Tang S, Wang C, Zhang Y, Best J, Tangthanasup TM, Huang S, Yang B, Wei C, Tucker JD, Tang W | title = Recreational Drug Use among Chinese MSM and Transgender Individuals: Results from a National Online Cross-Sectional Study | journal = PLOS ONE | volume = 12 | issue = 1 | pages = e0170024 | date = 2017-01-20 | pmid = 28107391 | pmc = 5249205 | doi = 10.1371/journal.pone.0170024 | bibcode = 2017PLoSO..1270024Z | df = dmy-all | doi-access = free }}</ref><ref>{{cite journal | vauthors = Schmidt AJ, Bourne A, Weatherburn P, Reid D, Marcus U, Hickson F | title = Illicit drug use among gay and bisexual men in 44 cities: Findings from the European MSM Internet Survey (EMIS) | journal = The International Journal on Drug Policy | volume = 38 | pages = 4–12 | date = December 2016 | pmid = 27788450 | doi = 10.1016/j.drugpo.2016.09.007 }}</ref> Such physiological effects, along with others (such as mild euphoria), have resulted in poppers being used as [[recreational drug use|recreational drugs]], sometimes during [[party and play|sexual intercourse]], as the effects can heighten arousal and help facilitate acts such as [[anal sex|anal intercourse]].<ref>{{cite web |date=28 November 2017 |title=Sex and Poppers |url=https://sexinfo.soc.ucsb.edu/article/sex-and-poppers |url-status=dead |archive-url=https://web.archive.org/web/20191226172940/https://sexinfo.soc.ucsb.edu/article/sex-and-poppers |archive-date=2019-12-26 |access-date=2020-05-01 |website=SexInfo Online}}</ref> Poppers were a part of the club culture which began during the mid-1970s [[disco]] scene, and surged in popularity during the [[rave]] scene of the 1980s and 1990s.<ref name="Drugscope">{{cite web |title=Nitrites |url=http://www.drugscope.org.uk/druginfo/drugsearch/ds_results.asp?file=%5Cwip%5C11%5C1%5C1%5Cnitrites.html |url-status=dead |archive-url=https://web.archive.org/web/20070405132026/http://www.drugscope.org.uk/druginfo/drugsearch/ds_results.asp?file=%5Cwip%5C11%5C1%5C1%5Cnitrites.html |archive-date=2007-04-05 |access-date=2007-04-24 |work=Drugscope}}</ref><ref name="Nickerson, Mark">{{cite book | vauthors = Nickerson M |title=Isobutyl nitrite and related compounds |date=1979 |publisher=Pharmex |oclc=4790673}}{{page needed|date=May 2020}}</ref>

==Administration and effects==
[[File:Poppers.jpg|thumb|A selection of poppers]]

===Administration===
Poppers come in liquid form, but this liquid is not directly consumed. When the bottle is opened, the vapors are inhaled, rather than the liquid. This is typically done through the nasal cavities, commonly directly from the bottle (avoiding touching the bottle to the skin) or with the help of small inhalers.

=== Effects ===

==== Physiological effects ====
Inhaling nitrites produces a fast-acting, short-lived and non-specific relaxation of [[smooth muscle]]s (along with the [[sphincter]] muscles of the [[anus]] and the [[vagina]]).<ref name="Medsafe">{{cite web |title=Amyl Nitrite |work=Medsafe |publisher=New Zealand Medicines and Medical Devices Safety Authority |date=May 18, 2000 |url=http://www.medsafe.govt.nz/Profs/datasheet/a/Amylnitrateinh.htm |access-date=March 15, 2007 |archive-url=https://web.archive.org/web/20061111105814/http://www.medsafe.govt.nz/Profs/datasheet/a/Amylnitrateinh.htm |archive-date=November 11, 2006}}</ref> Blood vessels are surrounded by smooth musculature, which directly influences blood pressure by increasing or decreasing its inward pressure on the blood vessels.

With relaxation of the smooth muscles, the 'inward' pressure on the blood vessels decreases and they [[Vasodilation|dilate]], resulting in [[Hypotension|a drop in blood pressure]] and an immediate (compensatory) increase in [[Tachycardia|heart rate]] (reflex tachycardia). Vasodilation may cause giddiness, dizziness, headache, nausea, vomiting and flushing, and may produce a sensation of heat and excitement. Maximum vasodilatory effect is usually reached within 30 seconds, with (secondary) physiological effects lasting for 5 to 10 minutes.<ref>{{cite web |url=https://www.drugs.com/ppa/amyl-nitrite.html |title=Amyl Nitrite (Professional Patient Advice) |work=Drugs.com |access-date=June 29, 2016}}</ref><ref name=":2">{{cite news |url=https://adf.org.au/drug-facts/adf-drug-facts-amyl-nitrite/ |title = Drug Facts - Amyl Nitrite |work = Alcohol & Drug Foundation (ADF) |access-date=2018-10-25}}</ref><ref>{{cite web |url=https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/508179/Poppersadvice.pdf |title=ACMD review of alkyl nitrites ("poppers") | vauthors = Iversen L |date=March 16, 2016 |website=gov.uk |publisher=www.gov.uk |access-date=October 10, 2016}}</ref><ref>{{cite web |url=https://www.vergiftigingen.info/f?p=300:STOFMONOGRAFIE:9676941181930:::RP,1210,1040:: |title=Poppers | work = Dutch Poisons Information Center |date=November 25, 2022 | via = www.vergiftigingen.info |access-date=November 25, 2022}}</ref>

==== Psychological effects ====
Inhaling nitrites produces several psychological effects such as euphoria, increased sensual awareness, lowered inhibitions or increased confidence, and potential for impaired judgement and disorientation.<ref name=":2" />

== Interactions ==

=== Vasodilators ===
[[File:Rational harm assessment of drugs radar plot.svg|thumb|Addiction experts in psychiatry, chemistry, pharmacology, forensic science, epidemiology, and the police and legal services engaged in [[Delphi method|delphic analysis]] regarding 20 popular recreational drugs. Alkyl nitrites were ranked 20th in social and physical harm, and 18th in dependence.<ref>{{cite journal | vauthors = Nutt D, King LA, Saulsbury W, Blakemore C | title = Development of a rational scale to assess the harm of drugs of potential misuse | journal = [[The Lancet]] | volume = 369 | issue = 9566 | pages = 1047–1053 | date = March 2007 | pmid = 17382831 | doi = 10.1016/s0140-6736(07)60464-4 | s2cid = 5903121 }}</ref>]]
Alkyl nitrites [[Drug interaction|interact]] with other [[vasodilators]], such as [[sildenafil]] (Viagra), [[vardenafil]] (Levitra), and [[tadalafil]] (Cialis), to cause a serious [[hypotension|decrease in blood pressure]], which can cause strokes, and low blood pressure leading to people fainting.<ref>{{cite journal | vauthors = Harte CB, Meston CM | title = Recreational use of erectile dysfunction medications in undergraduate men in the United States: characteristics and associated risk factors | journal = Archives of Sexual Behavior | volume = 40 | issue = 3 | pages = 597–606 | date = June 2011 | pmid = 20358273 | pmc = 2909482 | doi = 10.1007/s10508-010-9619-y }}</ref> Side effects of popper abuse include [[tachycardia]], [[headaches]], [[migraine]]s, [[dizziness]] and [[Syncope (medicine)|fainting]].<ref>{{cite journal | vauthors = Wood RW | title = The acute toxicity of nitrite inhalants | journal = NIDA Research Monograph | volume = 83 | pages = 28–38 | year = 1989 | pmid = 3140020 | publisher = National Institute on Drug Abuse | hdl = 1802/1150 }}</ref>

===Toxicity===
The ''[[Merck Manual of Diagnosis and Therapy]]'' reports insignificant hazard associated with inhalation of alkyl nitrites,<ref name="Merck">{{cite encyclopedia |url=http://www.msdmanuals.com/en-gb/professional/special-subjects/recreational-drugs-and-intoxicants/volatile-nitrites |title=Volatile Nitrites |access-date=2017-09-16 |date=January 2016 |encyclopedia=[[The Merck Manual Online]] | publisher=[[Merck & Co.]] | veditors = Porter RS, etal | vauthors = O'Malley GF, O'Malley R }}</ref> and British governmental guidance on the relative harmfulness of alkyl nitrites places them among the less harmful of recreational drugs.<ref name="Nutt-2007">{{cite journal | vauthors = Nutt D, King LA, Saulsbury W, Blakemore C | title = Development of a rational scale to assess the harm of drugs of potential misuse | journal = Lancet | volume = 369 | issue = 9566 | pages = 1047–1053 | date = March 2007 | pmid = 17382831 | doi = 10.1016/S0140-6736(07)60464-4 | s2cid = 5903121 }}</ref>

If in contact with the skin, butyl nitrite poppers can cause [[chemical burn]]s and contact [[dermatitis]] of the skin around the mouth and nose.<ref>{{cite journal | vauthors = Wood RW | title = The acute toxicity of nitrite inhalants | journal = NIDA Research Monograph | volume = 83 | pages = 28–38 | date = 19 April 1988 | pmid = 3140020 | url = https://urresearch.rochester.edu/institutionalPublicationPublicView.action?institutionalItemId=967&versionNumber=1 }}</ref>

Swallowing poppers (rather than inhaling the vapour) may cause [[cyanosis]], [[methemoglobinemia]], unconsciousness, coma, and complications leading to death.<ref name="Medsafe" /><ref name="Dixon-1981">{{cite journal | vauthors = Dixon DS, Reisch RF, Santinga PH | title = Fatal methemoglobinemia resulting from ingestion of isobutyl nitrite, a "room odorizer" widely used for recreational purposes | journal = Journal of Forensic Sciences | volume = 26 | issue = 3 | pages = 587–593 | date = July 1981 | pmid = 7252472 | doi = 10.1520/JFS11404J }}</ref><ref name="Pruijm-2002">{{cite journal | vauthors = Pruijm MT, de Meijer PH | title = [Methemoglobinemia due to ingestion of isobutyl nitrite ('poppers')] | journal = Nederlands Tijdschrift voor Geneeskunde | volume = 146 | issue = 49 | pages = 2370–2373 | date = December 2002 | pmid = 12510403 }}</ref><ref>{{cite journal | vauthors = Stalnikowicz R, Amitai Y, Bentur Y | title = Aphrodisiac drug-induced hemolysis | journal = Journal of Toxicology. Clinical Toxicology | volume = 42 | issue = 3 | pages = 313–316 | year = 2004 | pmid = 15362601 | doi = 10.1081/clt-120037435 | s2cid = 9389458 }}</ref><ref>{{cite book | title = Emergency Medicine: Principles and Practice. | publisher = Harper & Collins | edition = 2nd | date = 2008 | pages = 42–51 |isbn=978-0-86433-073-4}}</ref> Accidental aspiration of amyl or butyl nitrites may cause [[lipoid pneumonia]].<ref name="Hagan-">{{cite journal | vauthors = Hagan IG, Burney K | title = Radiology of recreational drug abuse | journal = Radiographics | volume = 27 | issue = 4 | pages = 919–940 | date = July–August 2007 | pmid = 17620459 | doi = 10.1148/rg.274065103 }}</ref>

==== Isopropyl nitrite ====
Isopropyl nitrite poppers may be a cause of [[maculopathy]] (eye damage), as reported in France and the United Kingdom.<ref>{{cite journal | vauthors = Davies AJ, Kelly SP, Bhatt PR | title = 'Poppers maculopathy'--an emerging ophthalmic reaction to recreational substance abuse | journal = Eye | volume = 26 | issue = 6 | pages = 888 | date = June 2012 | pmid = 22402700 | pmc = 3376285 | doi = 10.1038/eye.2012.37 | df = dmy-all | type = correspondence }}</ref> 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]]'',<ref>{{cite journal | vauthors = Vignal-Clermont C, Audo I, Sahel JA, Paques M | title = Poppers-associated retinal toxicity | journal = The New England Journal of Medicine | volume = 363 | issue = 16 | pages = 1583–1585 | date = October 2010 | pmid = 20942681 | doi = 10.1056/NEJMc1005118 | doi-access = free }}</ref> an ophthalmologist described four cases in which recreational users of isopropyl nitrite poppers suffered temporary changes in vision.<ref>{{Cite news | vauthors = Rabin RC |date=2010-10-18 |title=Vision: A Quick High for Sex May Damage Vision |language=en-US |work=The New York Times |url=https://www.nytimes.com/2010/10/19/health/research/19vision.html |access-date=2022-10-15 |issn=0362-4331}}</ref> In November 2014, it was observed [[maculopathy]] is a rare complication of isopropyl nitrite abuse. A full recovery of visual acuity in longterm abuse could be demonstrated after drug abstinence.<ref>{{cite journal | vauthors = Pahlitzsch M, Mai C, Joussen AM, Bergholz R | title = Poppers Maculopathy: Complete Restitution of Macular Changes in OCT after Drug Abstinence | journal = Seminars in Ophthalmology | volume = 31 | issue = 5 | pages = 479–484 | date = 2016 | pmid = 25398125 | doi = 10.3109/08820538.2014.962175 | s2cid = 7780239 }}</ref> Studies have shown that poppers users who have HIV and/or use Sildenafil in combination with poppers are at an increased risk of developing poppers‐associated maculopathy.<ref>{{cite journal | vauthors = Bral NO, Marinkovic M, Leroy BP, Hoornaert K, van Lint M, ten Tusscher MP | title = Do not turn a blind eye to alkyl nitrite (poppers)! | journal = Acta Ophthalmologica | volume = 94 | issue = 1 | pages = e82–e83 | date = February 2016 | pmid = 25975842 | doi = 10.1111/aos.12753 | s2cid = 39061955 | doi-access =  }}</ref>

Foveal (center-of-gaze) damage has also been described, in six habitual users of isopropyl nitrite poppers.<ref>{{cite journal | vauthors = Audo I, El Sanharawi M, Vignal-Clermont C, Villa A, Morin A, Conrath J, Fompeydie D, Sahel JA, Gocho-Nakashima K, Goureau O, Paques M | title = Foveal damage in habitual poppers users | journal = Archives of Ophthalmology | volume = 129 | issue = 6 | pages = 703–708 | date = June 2011 | pmid = 21320953 | doi = 10.1001/archophthalmol.2011.6 | doi-access =  }}</ref> Furthermore, in June 2014, [[optometrists]] and [[ophthalmologists]] reported having noticed an increase in vision loss in chronic popper users in the United Kingdom associated with isopropyl nitrite (substitute for isobutyl nitrite which was banned in 2007).<ref>{{cite news |url=http://in.reuters.com/article/us-proppers-eyesight-idINKBN0FD1ZD20140708 |title=More evidence 'poppers' may damage eyesight | vauthors = Storr K |publisher=Reuters Health |date=2014-07-08 |access-date=2021-07-06  |archive-date=2020-08-08  |archive-url=https://web.archive.org/web/20200808085652/https://in.reuters.com/article/us-proppers-eyesight-idINKBN0FD1ZD20140708 |url-status=dead }}</ref><ref>{{cite journal | vauthors = Gruener AM, Jeffries MA, El Housseini Z, Whitefield L | title = Poppers maculopathy | journal = Lancet | volume = 384 | issue = 9954 | pages = 1606 | date = November 2014 | pmid = 24954683 | doi = 10.1016/S0140-6736(14)60887-4 | s2cid = 8083375 }}</ref>

==== Isobutyl nitrite ====
A working group in 2019 from the [[International Agency for Research on Cancer]] determined there to be "sufficient evidence" to suggest [[Carcinogen|carcinogenic]] properties of isobutyl nitrite on experimental animals, and because they could not find any sufficient studies regarding its carcinogenic effects on humans, they determined that isobutyl nitrite is "possibly carcinogenic to humans". The group primarily looked at 2 studies on animals, one on rats and one on mice. Both of these involved the administration of doses of isobutyl nitrite at seemingly low doses (0, 37.5, 75, or 150 ppm) 6 hours a day, 5 days a week, for a total of 103 weeks.<ref name=":0">{{Cite book |last=IARC Working Group on the Evaluation of Carcinogenic Risks to Humans |url=http://www.ncbi.nlm.nih.gov/books/NBK558045/ |title=Isobutyl Nitrite, β-Picoline, and Some Acrylates |date=2019 |publisher=International Agency for Research on Cancer |isbn=978-92-832-0160-1 |series=IARC Monographs on the Evaluation of Carcinogenic Risks to Humans |location=Lyon (FR) |pages=33–60 |pmid=32520473}}</ref> This is different from the relatively brief exposure to isobutyl nitrite that inhaling poppers recreationally usually provides. Nonetheless, in the studies there was shown to be no increase in death rates for the animals exposed to isobutyl nitrite, but there was shown to be an increase in tumors in the lungs of the males and females of both species in the groups exposed, as well as in the thyroids of the male mice exposed.<ref name=":0" /> Isobutyl Nitrite is no longer sold as 'Poppers' having been banned in the EU since 2007 and banned in the US since 1990.<ref>{{Cite web | vauthors = Brazil R | date = 16 September 2021 |url=https://www.chemistryworld.com/news/explainer-the-science-of-alkyl-nitrites-aka-poppers/4014395.article|title=The Science of Alkyl Nitrites|website=chemistryworld.com }}</ref>

===Refuted link with HIV/AIDS===
Early in the [[AIDS]] crisis, widespread use of poppers among AIDS patients led to the later disproved hypothesis that poppers contributed to the development of [[Kaposi's sarcoma]], a rare form of cancer that occurs in AIDS patients.<ref>{{cite journal | vauthors = Duesberg P, Koehnlein C, Rasnick D | title = The chemical bases of the various AIDS epidemics: recreational drugs, anti-viral chemotherapy and malnutrition | journal = Journal of Biosciences | volume = 28 | issue = 4 | pages = 383–412 | date = June 2003 | pmid = 12799487 | doi = 10.1007/BF02705115 | s2cid = 56553 }}</ref><ref>{{cite journal | vauthors = Schechter MT, Craib KJ, Gelmon KA, Montaner JS, Le TN, O'Shaughnessy MV | title = HIV-1 and the aetiology of AIDS | journal = Lancet | volume = 341 | issue = 8846 | pages = 658–659 | date = March 1993 | pmid = 8095571 | doi = 10.1016/0140-6736(93)90421-c | s2cid = 23141531 }}</ref> Modest, short-term reductions in immune function were observed in animal studies, but not replicated in human studies.<ref name="Romanelli">{{cite journal | vauthors = Romanelli F, Smith KM, Thornton AC, Pomeroy C | title = Poppers: epidemiology and clinical management of inhaled nitrite abuse | journal = Pharmacotherapy | volume = 24 | issue = 1 | pages = 69–78 | date = January 2004 | pmid = 14740789 | doi = 10.1592/phco.24.1.69.34801 | s2cid = 44991387 }}</ref><ref>{{cite journal | vauthors = James JS | title = Poppers: large cancer increase and immune suppression in animal tests | journal = AIDS Treatment News | issue = 317 | pages = 1–2 | date = April 1999 | pmid = 11366993 }}</ref>

=== Cyanide treatment ===
Amyl nitrites were part of some kits used to treat [[cyanide poisoning]], containing amyl nitrite, [[Sodium nitrite (medical use)|sodium nitrite]], and [[Sodium thiosulfate (medical use)|sodium thiosulfate]]. The nitrites were administered to produce [[methemoglobin]] and induce [[vasodilation]].<ref>{{cite journal | vauthors = Johnson WS, Hall AH, Rumack BH | title = Cyanide poisoning successfully treated without 'therapeutic methemoglobin levels' | journal = The American Journal of Emergency Medicine | volume = 7 | issue = 4 | pages = 437–440 | date = July 1989 | pmid = 2567600 | doi = 10.1016/0735-6757(89)90057-0 }}</ref><ref>{{cite journal | vauthors = Marraffa JM, Cohen V, Howland MA | title = Antidotes for toxicological emergencies: a practical review | journal = American Journal of Health-System Pharmacy | volume = 69 | issue = 3 | pages = 199–212 | date = February 2012 | pmid = 22261941 | doi = 10.2146/ajhp110014 }}</ref> Amyl nitrites were discontinued in 2012 in standard cyanide kits.<ref>{{Cite web|url=https://reference.medscape.com/drug/cyanide-antidote-kit-sodium-thiosulfate-sodium-nitrite-amyl-nitrite-343737|title=cyanide antidote kit (sodium thiosulfate, sodium nitrite, & amyl nitrite) dosing, indications, interactions, adverse effects, and more|website=reference.medscape.com|access-date=2019-12-02|archive-url=https://web.archive.org/web/20191226172850/https://reference.medscape.com/drug/cyanide-antidote-kit-sodium-thiosulfate-sodium-nitrite-amyl-nitrite-343737|archive-date=2019-12-26|url-status=dead}}</ref> Cyanide kits now use [[hydroxocobalamin]].<ref>{{Cite web | work = Center for Drug Evaluation and Research | publisher = U.S. Food and Drug Administration |date=2019-08-14|title=Products Approved for Chemical Emergencies |url = https://www.fda.gov/drugs/bioterrorism-and-drug-preparedness/products-approved-chemical-emergencies }}{{dead link|date=May 2025|bot=medic}}{{cbignore|bot=medic}}</ref>

==Chemistry==
{{Main|Alkyl nitrites}}

Poppers contain a class of chemicals called alkyl nitrites. To the extent that poppers products contain alkyl nitrites, the following applies.

The following table summarizes alkyl nitrite chemical and physical properties, including chemical structure:<ref>{{Cite journal |vauthors=Sutton WL |date=1963 |title=Aliphatic nitro compounds, nitrates, nitrites, alkyl nitrites. |journal=Industrial Hygiene and Toxicology |volume=2 |pages=414–438}}</ref>
{| class="wikitable"
|-
! Alkyl nitrite!!CAS!!Formula!!Molecular weight ({{nobr|g·mol}}<sup>&minus;1</sup>)!!Physical state
!Color!!Boiling point
|-
||[[Amyl nitrite]] (isoamyl nitrite, isopentyl nitrite)
||110-46-3
||{{nobr|(CH<sub>3</sub>)<sub>2</sub>CH(CH<sub>2</sub>)<sub>2</sub>ONO}}
||117.15
||liquid
|yellow<ref>{{cite web |title=Isoamyl nitrite, 97%, stabilized, Thermo Scientific Chemicals |url=https://www.fishersci.com/shop/products/isoamyl-nitrite-97-stabilized-thermo-scientific/AC165701000 |access-date=August 15, 2024}}</ref>
||{{convert|97-99|C}}
|-
||[[Pentyl nitrite]] (''n''-pentyl nitrite)
||463-04-7
||CH<sub>3</sub>(CH<sub>2</sub>)<sub>4</sub>ONO
||117.15
||liquid
|yellow
||{{convert|104|C}}
|-
||[[Butyl nitrite]] (''n''-butyl nitrite)
||544-16-1
||CH<sub>3</sub>(CH<sub>2</sub>)<sub>3</sub>ONO
||103.12
||liquid
|yellow
||{{convert|78|C}}
|-

||[[Isobutyl nitrite]] (2-methylpropyl nitrite)
||542-56-3
||(CH<sub>3</sub>)<sub>2</sub>CHCH<sub>2</sub>ONO
||103.12
||liquid
|colorless (transparent)
||{{convert|67|C}}
|-
||[[Isopropyl nitrite]] (2-propyl nitrite)
||541-42-4
||(CH<sub>3</sub>)<sub>2</sub>CHONO
||89.09
||liquid
|yellow
||{{convert|39|C}}
|-
||[[Hexyl nitrite]]
||638-51-7
||CH<sub>3</sub>(CH<sub>2</sub>)<sub>5</sub>ONO
||131.17
||liquid
|colorless (transparent)
||{{convert|130|C}}
|}

==History==
{{expand section|a sourced paragraph on the transition from its use in medicine to its use as a recreational drug|small=no|date=June 2016}}

=== 19th-century discovery ===
The French chemist [[Antoine Jérôme Balard]] synthesized [[amyl nitrite]] in 1844.<ref>{{cite book |url=https://books.google.com/books?id=FjKfqkaKkAAC&pg=PAXXX |title=Analogue-based Drug Discovery |vauthors=Fischer J, Ganellin CR |publisher=John Wiley & Sons |year=2006 |isbn=978-3-527-60749-5 |location=United States |pages=247, 248 |chapter=Chapter 10: Development of Organic Nitrates for Coronary Heart Disease |chapter-url=https://books.google.com/books?id=FjKfqkaKkAAC&pg=PA247}}</ref> [[Sir Thomas Lauder Brunton]], a Scottish physician born in the year of amyl nitrite's first synthesis, documented its clinical use to treat [[angina pectoris]] in 1867 when patients experiencing chest pains would experience complete relief after inhalation.<ref name="pmid3524895">{{cite journal |vauthors=Fye WB |date=August 1986 |title=T. Lauder Brunton and amyl nitrite: a Victorian vasodilator |journal=Circulation |volume=74 |issue=2 |pages=222–229 |doi=10.1161/01.cir.74.2.222 |pmid=3524895 |doi-access=free}}</ref>  Brunton was inspired by earlier work with the same agent, performed by [[Arthur Gamgee]] and [[Benjamin Ward Richardson]].<ref name="pmid3524895" /> Brunton reasoned that the angina sufferer's pain and discomfort could be reduced by administering amyl nitrite—to dilate the coronary arteries of patients, thus improving blood flow to the heart muscle.<ref name="pmid3524895" />
  
Amyl nitrites were originally enclosed in a glass mesh called "pearls". The usual administration of these pearls was done by crushing them between the fingers, followed by a popping sound. This administration process seems to be the origin of the [[Slang|slang term]] "poppers". It was then administered via direct inhalation of the vapors or inhalation through silk that covered the capsule.

Brunton found that amyl nitrites had effects of dilating blood vessels and flushing of the face. Isobutyl nitrites were also documented around the late 1890s by Brunton and despite being found to have generally the same effects as amyl nitrites, they were never used as a clinical alternative to amyl nitrates. Brunton also found that propyl nitrites had the same effects as well.<ref name="Newell et al 1988">{{cite journal |vauthors=Newell GR, Spitz MR, Wilson MB |date=1988 |title=Nitrite inhalants: historical perspective |journal=NIDA Research Monograph |volume=83 |pages=1–14 |pmid=3140018}} Also published as: {{cite book |title=Health Hazards of Nitrite Inhalants |vauthors=Newell GR, Spitz MR, Wilson MB |date=1988 |publisher=U.S. Department of Health and Human Services, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, National Institute on Drug Abuse |veditors=Haverkos HW, Dougherty JA |pages=1–14 |chapter=Nitrite Inhalants: Historical Perspective |citeseerx=10.1.1.152.4015 |oclc=18456297 |chapter-url={{Google books|NQmWSoooPaYC|page=1|plainurl=yes}}}}</ref><ref>{{Cite book |url=https://archive.org/details/lecturesonactio00brungoog |title=Lectures on the Action of Medicines: Being the Course of Lectures on Pharmacology and Therapeutics Delivered at St. Bartholomew's Hospital During the Summer Session of 1896 |vauthors=Brunton TL |date=1898 |publisher=Macmillan |pages=[https://archive.org/details/lecturesonactio00brungoog/page/n354 332]–339 |quote=Brunton, T.L Lectures on the actions of medicines.}}</ref>

=== 20th century ===
Although amyl nitrite is known for its practical therapeutic applications, the first documented case of recreational use was in 1964.<ref>Lubell, I. Correspondence with Burroughs Wellcome Co., 1964, U.S. Food and Drug Administration, 1967.</ref><ref>{{cite web |date=2016-01-22 |title=How gay culture bottled a formula that has broken down boundaries |url=http://www.independent.co.uk/life-style/poppers-how-gay-culture-bottled-a-formula-that-has-broken-down-boundaries-a6828466.html |access-date=2019-05-21 |website=The Independent}}</ref> The poppers "craze" began in the early 1970s in the [[gay men|gay male]] community in [[Gay bar|bars]], [[Nightclub|discothèques]] and [[Gay bathhouse|bathhouses]].<ref name="Craze">{{cite journal |vauthors=Israelstam S, Lambert S, Oki G |date=November 1978 |title=Poppers, a new recreational drug craze |journal=Canadian Psychiatric Association Journal |volume=23 |issue=7 |pages=493–495 |doi=10.1177/070674377802300711 |pmid=709498 |s2cid=9696049 |doi-access=free}}</ref><ref name="French 57–76">{{cite journal |vauthors=French R, Power R |date=1998-01-01 |title=A Qualitative Study of the Social Contextual Use of Alkyl Nitrites (Poppers) among Targeted Groups |journal=Journal of Drug Issues |volume=28 |issue=1 |pages=57–76 |doi=10.1177/002204269802800104 |issn=0022-0426 |s2cid=58853221}}</ref> It was packaged and sold pharmaceutically in fragile glass ampoules wrapped in cloth sleeves which, when crushed or "popped" in the fingers, released the amyl nitrite for inhalation, hence the colloquialism ''poppers''.<ref name="Craze" /> The term extended to the drug in any form as well as to other drugs with similar effects, e.g. [[butyl nitrite]] which is packaged under a variety of trade names in small bottles.<ref name="Craze" />

In the late 1970s, ''[[Time (magazine)|Time]]'' magazine<ref name="Time">{{cite magazine |date=1978-07-17 |title=Rushing to a new high |url=http://content.time.com/time/magazine/article/0,9171,916269,00.html |access-date=2020-09-08 |magazine=Time}}</ref> and ''[[The Wall Street Journal]]''<ref>{{cite news |date=October 10, 1977 |title=wall street journal - A new way to glow and giggle, and get a headache. "Poppers, legally sniffable, becoming a big business; The FDA isn't interested |url=http://virusmythpoppersmyth.org/wall-street-journal/ |access-date=October 10, 2016 |work=Wall Street Journal October 10, 1977 Stephen J. Sansweet |via=virusmythpoppersmyth.org |vauthors=Sansweet SJ}}{{Dead link|date=May 2020|bot=InternetArchiveBot|fix-attempted=yes}}</ref> reported that popper use among [[gay men]] began as a way to enhance sexual pleasure, but "quickly spread to [[avant-garde]] [[heterosexuals]]". A series of interviews conducted in the late 1970s revealed a wide spectrum of users.<ref name="Time" />{{failedverification|reason=article only references interviewing two people, one of whom is not a regular user|date=May 2024}}

=== 21st century ===
Poppers were well established in the gay community, with more than a third of gay men in the United States having used poppers at least once.<ref>{{cite journal |vauthors=Le A, Yockey A, Palamar JJ |date=2020 |title=Use of "Poppers" among Adults in the United States, 2015-2017 |journal=Journal of Psychoactive Drugs |volume=52 |issue=5 |pages=433–439 |doi=10.1080/02791072.2020.1791373 |pmc=7704544 |pmid=32669067}}</ref> Poppers were partial inspiration for songs such as [[Troye Sivan]]'s 2023 song "[[Rush (Troye Sivan song)|Rush]]".<ref>{{cite web |date=2023-07-13 |title=Troye Sivan's Rush music video is a sweaty, queer party and fans are in love |url=https://www.thepinknews.com/2023/07/13/troye-sivan-rush-music-video-something-to-give-each-other-fan-reactions/ |access-date=2024-02-02 |website=PinkNews |vauthors=Wratten M}}</ref>

==Legal status==
===Australia===
Poppers are legal in Australia, and from 2020, poppers can also be purchased as a schedule 3 substance from pharmacies, or a schedule 4 substance with a prescription.<ref>{{cite news | vauthors = Butler G |title=You'll Soon Be Allowed to Buy Amyl in Australian Pharmacies—But There's A Catch |url=https://www.vice.com/en/article/youll-soon-be-allowed-to-buy-amyl-in-australian-pharmaciesbut-theres-a-catch/ |work=Vice |date=7 June 2019 }}</ref>

====History of poppers legislation in Australia====

In June 2018, the [[Therapeutic Goods Administration]] (TGA) motioned to reschedule alkyl nitrites to be in the same category as heroin and cocaine ([[Standard for the Uniform Scheduling of Medicines and Poisons#Schedule 9: prohibited substance|Schedule 9]]).<ref name="tga.gov.au">{{cite web|url=https://www.tga.gov.au/consultation-invitation/consultation-proposed-amendments-poisons-standard-being-referred-june-2018-meetings-accs-acms-and-joint-accsacms|title=Consultation: Proposed amendments to the Poisons Standard being referred to the June 2018 meetings of the ACCS, ACMS and Joint ACCS/ACMS| publisher = Australian Government |date=7 June 2018| work = Therapeutic Goods Administration (TGA)|access-date=31 January 2019}}</ref> This was met by criticism from the LGBTQI community for being discriminatory and further evidence was demanded and further consultation sought.<ref name="qnews.com.au">{{cite web|url=https://www.qnews.com.au/lgbtiq-health-experts-slam-proposed-government-ban-on-poppers/|title=LGBTIQ Health Experts Slam Proposed Government Ban On Poppers|date=18 October 2018|website=QNews|access-date=31 January 2019}}</ref>

In October 2018, the [[Australian Federation of AIDS Organisations]] (AFAO) pointed out the lack of quality evidence provided by the TGA to justify the rescheduling<ref>{{cite web|url= https://assets.healthequitymatters.org.au/wp-content/uploads/2018/10/16052145/Alkyl-Nitrite-Submission-AFAO-and-Alliance-10-October.pdf|title=Submission to the Publication of interim decision proposing to amend, or not amend, the current Poisons Standard, September 2018|date=11 October 2018|website=Australian Federation of AIDS Organisations}}</ref> and that use of amyl nitrites has been stable over the past decade with very little evidence of harm and has been in use by a high proportion of gay men over a long period.

A final decision was pushed back from 29 November 2018 to late January or early February 2019 for further consultation with the public.<ref name="tga.gov.au-intrim">{{cite web|url=https://www.tga.gov.au/media-release/further-public-consultation-appropriate-access-and-safety-controls-poisons-standard-schedule-alkyl-nitrites|title=Further public consultation on appropriate access and safety controls (Poisons Standard schedule) for alkyl nitrites| publisher  = Australian Government |date=22 November 2018| work = Therapeutic Goods Administration (TGA)|access-date=31 January 2019}}</ref>

As of March 2019, two public meetings have taken place in Sydney and Melbourne with [[Kirby Institute|The Kirby Institute]] and the [[La Trobe University|Australian Research Centre in Sex, Health and Society]] (ARCSHS). Along with 70 written public proposals, there was significant opposition to alkyl nitrites rescheduling.<ref>{{cite news | vauthors = Butler G |title=It Looks Like the Australian Government Probably Won't Ban Amyl |url=https://www.vice.com/en/article/looks-like-australian-government-probably-wont-ban-amyl-poppers-illegal/ |work=Vice |date=25 April 2019 }}</ref> Banning alkyl nitrites was not considered acceptable as their use was said to help reduce harms such as anal injury and blood-borne disease transmission during anal sex.<ref>{{cite web|url=https://www.tga.gov.au/public-meeting-communique-regulatory-options-appropriate-access-and-safety-controls-alkyl-nitrites|title=Public meeting communique: Regulatory options for appropriate access and safety controls for alkyl nitrites | publisher = Australian Government |date=2019-03-07| work = Therapeutic Goods Administration (TGA) |access-date=2019-05-23}}</ref>

In June 2019, Australia decided not to ban poppers.<ref>{{cite news | vauthors = Badge J |title=Australia's decision not to ban poppers is a win for sensible drug policy, but the stigma remains |url=https://www.theguardian.com/commentisfree/2019/jun/10/australias-decision-not-to-ban-poppers-is-a-win-for-sensible-drug-policy-but-the-stigma-remains |work=The Guardian |date=10 June 2019 }}</ref>

===Canada===
Since 2013, [[Health Canada]] has banned all distribution and sales of poppers.<ref>{{cite web|url=http://www.healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2013/34343a-eng.php|title=Poppers sold across Canada pose serious risks|website=www.healthycanadians.gc.ca|access-date=2019-05-23}}</ref>

===Continental Europe===
Since 2007, reformulated poppers containing [[isopropyl nitrite]] are sold in the EU; [[isobutyl nitrite]] is prohibited.<ref name="eur-lex.europa.eu">{{cite web |url=http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ%3AL%3A2006%3A033%3A0028%3A0081%3Aen%3APDF |title=Directive 2005/90/EC of the European Parliament and of the Council |publisher=Official Journal of the European Union |date=January 18, 2006}}</ref>

In [[France]], the sale of products containing [[butyl nitrite]] has been prohibited since 1990 on grounds of danger to consumers.<ref>{{cite web |url=http://www.legifrance.gouv.fr/affichTexte.do?dateTexte=20090901&cidTexte=JORFTEXT000000166136 |title=Decree 90–274 of 26 March 1990 |language=fr |publisher=Legifrance.gouv.fr |date=May 15, 2009 |access-date=July 26, 2012}}</ref> In 2007, the government extended this prohibition to all [[alkyl nitrites]] that were not authorized for sale as [[drug]]s.<ref>{{cite web |url=http://www.legifrance.gouv.fr/affichTexte.do?dateTexte=20090901&cidTexte=JORFTEXT000000341445 |title=Decree 2007-1636 of 20 November 2007 |language=fr |publisher=Legifrance.gouv.fr |access-date=July 26, 2012}}</ref> After litigation by [[sex shop]] owners, this extension was quashed by the [[Conseil d'État (France)|Council of State]] on the grounds that the government had failed to justify such a blanket prohibition: according to the court, the risks cited, concerning rare accidents often following abnormal usage, rather justified compulsory warnings on the packaging.<ref>{{cite web |url=http://www.legifrance.gouv.fr/affichJuriAdmin.do?oldAction=rechJuriAdmin&idTexte=CETATEXT000020868995 |title=Conseil d'État, 10ème et 9ème sous-sections réunies, 15/05/2009, 312449, Publié au recueil Lebon |language=fr |website=Legifrance.gouv.fr |date=May 15, 2009 |access-date=January 11, 2016}}</ref>

The possession in [[Germany]], [[Austria]] and [[Switzerland]] is not subject to any regulations regarding [[anesthetic]] drugs and is therefore legal; however, the purchase, sale or trade of [[amyl nitrite]] without permission violates the drug laws of the corresponding countries. Occasionally, poppers were seized from sex shops, when sold there illegally.<ref>{{cite news |url=http://www.news.de/reisen-und-leben/855244035/zur-ekstase-geschnueffelt/1/ |title=Sexdroge Poppers: Zur Ekstase geschnüffelt |website=news.de |language=de}}</ref><ref>{{cite news |url=https://www.welt.de/print-welt/article182967/Poppers-sichergestellt.html |title="Poppers" sichergestellt. Polizei entdeckt 400 Flaschen des Schnüffelstoffs in Sex-Shop |newspaper=[[Die Welt]] |language=de |date=2005-12-08}}</ref>

===United Kingdom===
Poppers are sold in [[nightclub]]s, [[Bar (establishment)|bar]]s, sex shops, [[drug paraphernalia]] [[head shop]]s, over the [[Internet]] and in markets. It is illegal under [[Medicines Act 1968]] to sell them advertised for human consumption. The [[Advisory Council on the Misuse of Drugs]] noted in 2011 that poppers, rather than being a psychoactive substance or a [[designer drug|legal high]], "appear to fall within the scope of [[The Intoxicating Substances (Supply) Act 1985]]".<ref name=acmd>{{cite web |url=https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/119139/acmdnps2011.pdf |title=Consideration of the Novel Psychoactive Substances ('Legal Highs') |publisher=Advisory Council on the Misuse of Drugs |pages=52–54}}</ref>

The [[Psychoactive Substances Act 2016]], scheduled to be enacted 1 April 2016, was initially claimed to impose a blanket ban on the production, import and distribution of all poppers.<ref>{{cite web|url=https://publications.parliament.uk/pa/bills/lbill/2015-2016/0002/16002.pdf|title=publications.parliament.uk|access-date=31 January 2019}}</ref> On 20 January 2016 a motion to exempt poppers (alkyl nitrites) from this legislation was defeated.<ref>{{cite web |url=https://publications.parliament.uk/pa/cm201516/cmhansrd/cm160120/debtext/160120-0003.htm#16012033005245 |title=House of Commons Hansard Debates for 20 January 2016 (pt 0003) |work=parliament.uk |access-date=June 29, 2016}}</ref> This was opposed by Conservative MP [[Ben Howlett (politician)|Ben Howlett]]. Howlett's fellow Conservative MP [[Crispin Blunt]] declared that he has used and currently uses poppers. Manufacturers expressed concern over loss of business and potential unemployment.<ref>{{cite news | vauthors = Sutcliffe R |title=UK's biggest poppers manufacturer vows to fight legal high ban on product he's made for 35 years |url=https://www.mirror.co.uk/news/uk-news/uks-biggest-poppers-manufacturer-vows-7373648 |publisher=Mirror}}</ref><ref>{{cite web | vauthors = Tayag Y |title=The UK is at war with synthetic drugs and brain boosters are in the crossfire |date=11 February 2016 |url=https://www.inverse.com/article/11351-england-s-psychoactive-substances-act-puts-nootropic-poppers-on-notice}}</ref>

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.<ref>{{cite web |url=https://www.independent.co.uk/news/uk/politics/poppers-are-so-harmless-they-dont-even-fall-under-the-governments-legal-highs-ban-acmd-says-a6934096.html |title=The Government thought it had banned Poppers but actually accidentally didn't |website=The Independent |access-date=March 16, 2016|date=2016-03-16 }}</ref>

===United States===
[[Amyl nitrite]] was originally marketed as a [[prescription drug]] in 1937. It remained so until 1960, when the [[Food and Drug Administration]] removed the prescription requirement due to its safety record. This requirement was reinstated in 1969, after observing an increase in [[Recreational drug use|recreational use]]. There was a huge increase in the number of brands for [[butyl nitrite]]s after the FDA put in the prescription requirement again in 1969.<ref name=pmid3524895/>

Butyl nitrites were outlawed in 1988 by the [[Anti-Drug Abuse Act of 1988]].<ref>{{Cite web|url=https://www.law.cornell.edu/uscode/text/15/2057a|title=15 U.S. Code § 2057a - Banning of butyl nitrite|website=LII / Legal Information Institute|access-date=2019-12-02}}</ref> This prompted distributors to sell other [[alkyl nitrites]] not yet banned, like [[isopropyl nitrite]]. In 1990, isopropyl nitrites and other nitrites not yet banned were outlawed by the [[Crime Control Act of 1990]].<ref>{{Cite web|url=https://www.law.cornell.edu/uscode/text/15/2057b|title=15 U.S. Code § 2057b - Banning of isopropal nitrite and other nitrites|website=LII / Legal Information Institute|access-date=2019-12-02}}</ref> Both of these laws include an exception for ''commercial purpose'', defined as any use 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.<ref>Anti-Drug Abuse Act of 1988 (Public Law 100-690, section 2404) (15 U.S.C. 2d57a(e)(2)).</ref>

== See also ==
* [[Alcohol and sex]]
* [[Sex and drugs]]

== References ==
{{Reflist}}

{{Euphoriants}}

{{Use Oxford spelling|date=July 2018}}

[[Category:Alkyl nitrites]]
[[Category:Antianginals]]
[[Category:Antidotes]]
[[Category:Dissociative drugs]]
[[Category:Drug culture]]
[[Category:Eli Lilly and Company]]
[[Category:Euphoriants]]
[[Category:Inhalants]]
[[Category:LGBTQ terminology]]
[[Category:Muscle relaxants]]
[[Category:Vasodilators]]
[[Category:AIDS origin hypotheses]]
[[Category:Sex and drugs]]