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[[File:HOpoppers.jpg|300px|thumbnail|A selection of poppers]]
[[File:HOpoppers.jpg|300px|thumbnail|A selection of poppers]]
Alkyl nitrites, most commonly known as poppers, is a class of chemicals that are inhaled for recreational purposes (especially in preparation for sexual activities).<ref>Volatile Nitrites | http://www.merckmanuals.com/professional/special_subjects/drug_use_and_dependence/volatile_nitrites.html?qt=&sc=&alt=</ref> Today, they are mainly sold in cap vials.
'''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 [[#Alkyl nitrites|this section]] for more details).
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.
Alkyl nitrites are volatile whose fumes are inhaled for recreational purposes, particularly in preparation for sexual activities.<ref name="MerckManuals">{{Citation | title=Volatile Nitrites - Special Subjects | url=https://www.merckmanuals.com/professional/special-subjects/recreational-drugs-and-intoxicants/volatile-nitrites?ruleredirectid=249&qt=&sc=&alt=}}</ref>
They were part of the club culture from the 1970s disco scene to the 1980s. The 1990s rave scene made their use popular.<ref>Nitrates | http://web.archive.org/web/20070405132026/http://www.drugscope.org.uk/druginfo/drugsearch/ds_results.asp?file=%5cwip%5c11%5c1%5c1%5cnitrites.html</ref>
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.
==Usage==
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 [[Routes_of_Administration#Oral|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 are inhalants; they have very low vapor points and become airborne almost immediately at room temperature. The most common method of taking them is to simply open the bottle, hold it under one's nose, and inhale. Other methods of popper usage such as [[Routes_of_Administration#Oral|oral]] use are extremely dangerous and can potentially result in death or coma. It is also worth noting that alkyl nitrites burn the skin on contact and are extremely flammable.
The effects of the drug are intense, but short-lived. They start after about 15 seconds and last for up to 3 minutes.
==Alkyl nitrites==
Alkyl nitrite: Boiling point (°C)[1]
* Very volatile (perceived as "potent")
** Methyl nitrite: -12.9±3.0 °C at 760 mmHg<ref>http://www.chemspider.com/Chemical-Structure.11730.html</ref>
** Ethyl nitrite: 20.0±3.0 °C at 760 mmH<ref>http://www.chemspider.com/Chemical-Structure.7735.html</ref>
** Isopropyl nitrite (2-propyl nitrite): 39.0±9.0 °C at 760 mmHg<ref>http://www.chemspider.com/Chemical-Structure.10466.html</ref>
* Moderately volatile
** Isobutyl nitrite (2-methylpropyl nitrite): 70.5±9.0 °C at 760 mmHg<ref>http://www.chemspider.com/Chemical-Structure.10493.html</ref>
** Butyl nitrite (n-butyl nitrite): 78.8±3.0 °C at 760 mmHg<ref>http://www.chemspider.com/Chemical-Structure.10530.html</ref>
* Slowly volatile (perceived as "less potent")
** Amyl nitrite (isoamyl nitrite, isopentyl nitrite): 99.1±9.0 °C at 760 mmHg<ref>http://www.chemspider.com/Chemical-Structure.7762.html</ref>
** Cyclohexyl nitrite: 138.7±7.0 °C at 760 mmHg<ref>http://www.chemspider.com/Chemical-Structure.474493.html</ref>
** Hexyl nitrite: 129.6±3.0 °C at 760 mmHg<ref>http://www.chemspider.com/Chemical-Structure.4895948.html</ref>
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.<ref>{{Citation | year=2007 | title=Drugscope - Nitrites | url=http://web.archive.org/web/20070405132026/http://www.drugscope.org.uk/druginfo/drugsearch/ds_results.asp?file=%5cwip%5c11%5c1%5c1%5cnitrites.html}}</ref> Today, they are mainly sold in sex shops in the form of small bottles, or as cap vials.
Most alkyl nitrites lose their freshness within a few hours if the bottle is left open or not properly closed. If they are stored correctly in the refrigerator they will remain fresh for a couple of weeks.
As explained earlier, poppers are chemicals known as alkyl nitrites. These are chemical compounds of structure R–ONO. In more formal terms, 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 are oxides of nitrogen, water and the alcohol as well as polymerization products of the aldehyde.
Poppers are chemicals known as [[chemical class::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.
The decomposition of alkyl nitrites is different with each one; the original nitrite, amyl nitrite, being a example for a nitrite with a relatively high rate of decomposition and isopropyl nitrite, the nitrite most commonly used today, being one nitrite with slow decomposition.
==Pharmacology==
==Pharmacology==
{{Pharmacology}}
{{Pharmacology}}
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.<ref>{{cite journal | vauthors=((Nossaman, V. E.)), ((Nossaman, B. D.)), ((Kadowitz, P. J.)) | journal=Cardiology in review | title=Nitrates and Nitrites in the Treatment of Ischemic Cardiac Disease | volume=18 | issue=4 | pages=190–197 | date= 2010 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2885014/ | issn=1061-5377 | doi=10.1097/CRD.0b013e3181c8e14a}}</ref> 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==
==Subjective effects==
The effects listed below are based upon the [[subjective effects index]] and personal experiences of [[PsychonautWiki]] [[Special:TopUsers|contributors]]. The listed effects will rarely (if ever) occur all at once, but heavier dosages will increase the chances and are more likely to induce a full range of effects.
{{Preamble/SubjectiveEffects}}
{{effects/base
|{{effects/physical|
*'''[[Effect::Headaches]]''' - Users are sometimes left with a headache due to the expansion of blood vessels in the brain.<ref>{{Citation | year=2015 | title=Poppers - TheSite.org | url=https://web.archive.org/web/20150704070750/http://www.thesite.org/drink-and-drugs/legal-highs/poppers-9999.html}}</ref>
*'''[[Effect::Changes in gravity]]''' - Many users report feelings that they are falling or that the room is spinning.
*'''[[Effect::Changes in gravity]]''' - Many users report feelings that they are falling or that the room is spinning.
*'''[[Effect::Decreased blood pressure]]''' - Since nitrites are vasodilating, they often substantially decrease blood pressure.<ref name="IsraelstamLambert2017">{{cite journal|last1=Israelstam|first1=Stephen|last2=Lambert|first2=Sylvia|last3=Oki|first3=Gustave|title=Poppers, A New Recreational Drug Craze*|journal=Canadian Psychiatric Association Journal|volume=23|issue=7|year=1978|pages=493–495|issn=0008-4824|doi=10.1177/070674377802300711}}</ref>
*'''[[Effect::Increased heart rate]]'''
*'''[[Effect::Muscle relaxation]]''' - Inhaling nitrites relaxes smooth muscles throughout the body, and are particularly effective at relaxing the sphincter muscles in the anus. They are popularly used in the LGBT community for this purpose.<ref name="IsraelstamLambert2017"/>
*'''[[Effect::Physical euphoria]]'''
*'''[[Effect::Vasodilation]]''' - The vasodilation of poppers is intense and sudden. It results in feelings of blood rushing to the brain accompanied by a sensation of heat throughout one's body (but particularly in the face/head region).<ref name="IsraelstamLambert2017"/>
*'''[[Effect::Tactile enhancement]]'''
}}
|{{effects/cognitive|
*'''[[Effect::Disinhibition]]'''
*'''[[Effect::Disinhibition]]'''
*'''[[Effect::Headaches]]''' - Users are sometimes left with a headache due to the blood vessel expansion in the brain.<ref>http://www.thesite.org/drink-and-drugs/legal-highs/poppers-9999.html</ref>
*'''[[Effect::Increased libido]]'''
*'''[[Effect::Increased libido]]'''
*'''[[Effect::Increased music appreciation]]'''
*'''[[Effect::Laughter]]'''
*'''[[Effect::Laughter]]'''
*'''[[Effect::Muscle relaxation]]''' - Inhaling nitrites relaxes smooth muscles throughout the body.<ref>http://web.archive.org/web/20061111105814/http://www.medsafe.govt.nz/Profs/datasheet/a/Amylnitrateinh.htm</ref> This effect facilitates anal intercourse by relaxing the sphincter muscles and poppers are famously used within the LGBT community for this purpose.
*'''[[Effect::Thought loops]]'''
*'''[[Effect::Physical euphoria]]'''
*'''[[Effect::Time distortion]]''' - Some users may experience the impression of time slowing down.
*'''[[Effect::Tactile enhancement]]'''
}}
*'''[[Effect::Time distortion]]''' - Some users may experience the impression of time slowing down.
*'''[[Effect::Vasodilation]]''' - The vasodilation of poppers is intense and sudden. It results in feelings of blood rushing to the brain accompanied by a sensation of heat throughout one's body (but particularly in the face/head region).
}}
===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:
[[File:harmchart.png|thumb|right|300px|Radar plot showing relative physical harm, social harm, and dependence of akyl nitrates<ref>Development of a rational scale to assess the harm of drugs of potential misuse (ScienceDirect) | http://www.sciencedirect.com/science/article/pii/S0140673607604644</ref>]]
[[File:harmchart.png|thumb|right|300px|Radar plot showing relative physical harm, social harm, and dependence of alkyl nitrates<ref>{{cite journal | vauthors=((Nutt, D.)), ((King, L. A.)), ((Saulsbury, W.)), ((Blakemore, C.)) | journal=The Lancet | title=Development of a rational scale to assess the harm of drugs of potential misuse | volume=369 | issue=9566 | pages=1047–1053 | date=24 March 2007 | url=https://www.sciencedirect.com/science/article/pii/S0140673607604644 | issn=0140-6736 | doi=10.1016/S0140-6736(07)60464-4}}</ref>]]
The 2005 Merck Manual of Diagnosis and Therapy reported that there is little evidence of significant hazard associated with inhalation of alkyl nitrites.<ref>Volatile Nitrites | http://www.merckmanuals.com/professional/special_subjects/drug_use_and_dependence/volatile_nitrites.html?qt=&sc=&alt=</ref> 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]].<ref>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</ref> The primary risk of popper usage is a chemical burn if spilled on one's skin.
The 2005 Merck Manual of Diagnosis and Therapy reported that there is little evidence of significant hazard associated with inhalation of alkyl nitrites.<ref name="MerckManuals"/> 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]].<ref>{{cite journal | vauthors=((Nutt, D.)), ((King, L. A.)), ((Saulsbury, W.)), ((Blakemore, C.)) | journal=Lancet (London, England) | title=Development of a rational scale to assess the harm of drugs of potential misuse | volume=369 | issue=9566 | pages=1047–1053 | date=24 March 2007 | issn=1474-547X | doi=10.1016/S0140-6736(07)60464-4}}</ref> 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.
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.<ref>http://www.nature.com/eye/journal/v26/n6/full/eye201237a.html</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, an ophthalmologist described four cases in which recreational users of poppers experienced temporary changes in vision.<ref>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</ref> Another study described foveal (daylight vision) damage in six habitual poppers users.<ref>Foveal damage in habitual poppers users (PubMed.gov / NCBI) | https://www.ncbi.nlm.nih.gov/pubmed/21320953</ref> 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.<ref>More evidence 'poppers' may damage eyesight | http://in.reuters.com/article/2014/07/08/us-proppers-eyesight-idINKBN0FD1ZD20140708</ref><ref>Poppers maculopathy | http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60887-4/abstract</ref>
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.<ref>{{cite journal | vauthors=((Davies, A. J.)), ((Kelly, S. P.)), ((Bhatt, P. R.)) | journal=Eye | title=‘Poppers maculopathy’—an emerging ophthalmic reaction to recreational substance abuse | volume=26 | issue=6 | pages=888–888 | date= June 2012 | url=https://www.nature.com/articles/eye201237 | issn=1476-5454 | doi=10.1038/eye.2012.37}}</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, an ophthalmologist described four cases in which recreational users of poppers experienced temporary changes in vision.<ref>{{cite journal | vauthors=((Dixon, D. S.)), ((Reisch, R. F.)), ((Santinga, P. H.)) | journal=Journal of Forensic Sciences | title=Fatal methemoglobinemia resulting from ingestion of isobutyl nitrite, a “room odorizer” widely used for recreational purposes | volume=26 | issue=3 | pages=587–593 | date= July 1981 | issn=0022-1198}}</ref> Another study described foveal (daylight vision) damage in six habitual poppers users.<ref>{{cite journal | vauthors=((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.)) | journal=Archives of Ophthalmology (Chicago, Ill.: 1960) | title=Foveal damage in habitual poppers users | volume=129 | issue=6 | pages=703–708 | date= June 2011 | issn=1538-3601 | doi=10.1001/archophthalmol.2011.6}}</ref> 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.<ref>More evidence 'poppers' may damage eyesight | http://in.reuters.com/article/2014/07/08/us-proppers-eyesight-idINKBN0FD1ZD20140708</ref><ref>{{cite journal | vauthors=((Gruener, A. M.)), ((Jeffries, M. A. R.)), ((Housseini, Z. E.)), ((Whitefield, L.)) | journal=The Lancet | title=Poppers maculopathy | volume=384 | issue=9954 | pages=1606 | date=1 November 2014 | url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60887-4/fulltext | issn=0140-6736 | doi=10.1016/S0140-6736(14)60887-4}}</ref>
=====Isobutyl nitrite toxicity treatment=====
Isobutyl nitrite is known to cause methemoglobinemia.<ref>{{cite journal |last1=Taylor |first1=Gregory M |last2=Avera |first2=Robert S |last3=Strachan |first3=Christian C |last4=Briggs |first4=Christian M |last5=Medler |first5=Jason P |last6=Pafford |first6=Carl M |last7=Gant |first7=Timothy B |title=Severe methemoglobinemia secondary to isobutyl nitrite toxicity: the case of the ‘Gold Rush’ |journal=Oxford Medical Case Reports |date=1 February 2021 |volume=2021 |issue=2 |pages=omaa136 |doi=10.1093/omcr/omaa136}}</ref> Severe methemoglobinemia may be treated with [[methylene blue]].<ref>{{cite journal |last1=Modarai |first1=B |last2=Kapadia |first2=YK |last3=Kerins |first3=M |last4=Terris |first4=J |title=Methylene blue: a treatment for severe methaemoglobinaemia secondary to misuse of amyl nitrite. |journal=Emergency medicine journal : EMJ |date=May 2002 |volume=19 |issue=3 |pages=270-1 |doi=10.1136/emj.19.3.270 |pmid=11971852 |pmc=1725875}}</ref>
===Lethal dosage===
===Lethal dosage===
The only consistently safe [[routes of administration|route of administration]] used with poppers is inhalation. Oral use of the liquid can prove fatal enough to result in a lethal dosage.<ref>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</ref><ref>Radiology of recreational drug abuse (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/17620459</ref> It is near impossible to overdose through the conventional use of poppers.
The only consistently safe [[routes of administration|route of administration]] used with poppers is inhalation. Oral use of the liquid can prove fatal enough to result in a lethal dosage.<ref>{{cite journal | vauthors=((Dixon, D. S.)), ((Reisch, R. F.)), ((Santinga, P. H.)) | journal=Journal of Forensic Sciences | title=Fatal methemoglobinemia resulting from ingestion of isobutyl nitrite, a “room odorizer” widely used for recreational purposes | volume=26 | issue=3 | pages=587–593 | date= July 1981 | issn=0022-1198}}</ref><ref name="Hagan2007">{{cite journal | vauthors=((Hagan, I. G.)), ((Burney, K.)) | journal=Radiographics: A Review Publication of the Radiological Society of North America, Inc | title=Radiology of recreational drug abuse | volume=27 | issue=4 | pages=919–940 | date= August 2007 | issn=1527-1323 | doi=10.1148/rg.274065103}}</ref> 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.<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><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 = 587–93 | date = July 1981 | doi = 10.1520/JFS11404J | pmid = 7252472 }}</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 = 2370–3 | 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 = 313–6 | year = 2004 | pmid = 15362601 | doi = 10.1081/clt-120037435 | s2cid = 9389458 }}</ref><ref>Emergency Medicine: Principles and Practice. Harper & Collins, 2nd edition. 2008. pp. 42–51.{{full citation needed|date=June 2016}}</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 = 919–40 | date = July–August 2007 | pmid = 17620459 | doi = 10.1148/rg.274065103 }}</ref> Methylene blue is a treatment for methemoglobinemia associated with popper use.<ref name="Hagan2007"/><ref>{{cite journal | vauthors=((Pruijm, M. T. C.)), ((Meijer, P. H. E. M. de)) | journal=Nederlands Tijdschrift Voor Geneeskunde | title=[Methemoglobinemia due to ingestion of isobutyl nitrite ('poppers’)] | volume=146 | issue=49 | pages=2370–2373 | date=7 December 2002 | issn=0028-2162}}</ref><ref>{{cite journal | vauthors=((Stalnikowicz, R.)), ((Amitai, Y.)), ((Bentur, Y.)) | journal=Journal of Toxicology. Clinical Toxicology | title=Aphrodisiac drug-induced hemolysis | volume=42 | issue=3 | pages=313–316 | date= 2004 | issn=0731-3810 | doi=10.1081/clt-120037435}}</ref><ref>Emergency Medicine: Principles and Practice. Harper & Collins, 2nd edition. 2008. pp. 42–51.</ref> Accidental aspiration of amyl or butyl nitrites may lead to the development of lipoid pneumonia.<ref name="Hagan2007"/>
An overdose via ingestion (rather than inhalation) may result in cyanosis, unconsciousness, coma, and even death. Methylene blue is a treatment for methemoglobinemia associated with popper use.<ref>Radiology of recreational drug abuse (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/17620459</ref><ref>Methemoglobinemia due to ingestion of isobutyl nitrite ('poppers') (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/12510403</ref><ref>Aphrodisiac drug-induced hemolysis (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/15362601</ref><ref>Emergency Medicine: Principles and Practice. Harper & Collins, 2nd edition. 2008. pp. 42–51.</ref> Accidental aspiration of amyl or butyl nitrites may lead to the development of lipoid pneumonia.<ref>Radiology of recreational drug abuse (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/17620459</ref>
It is strongly recommended that one use [[responsible drug use|harm reduction practices]] when using this class of substances.
It is strongly recommended that one use [[responsible drug use|harm reduction practices]] when using this drug.
===Tolerance and addiction potential===
===Tolerance and addiction potential===
There is no real tolerance to be gained through popper use. There does not seem to be any addictive potential.
There is no real tolerance to be gained through popper use. They are considered to have little to no 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.<ref name="pmid3430141">{{cite journal |vauthors=O'Toole JB, Robbins GB, Dixon DS |title=Ingestion of isobutyl nitrite, a recreational chemical of abuse, causing fatal methemoglobinemia |journal=J. Forensic Sci. |volume=32 |issue=6 |pages=1811–2 |date=November 1987 |doi=10.1520/JFS11240J |pmid=3430141}}</ref>
===Dangerous interactions===
===Dangerous interactions===
Alkyl nitrites are interactive with other [[vasodilation|vasodilators]] like sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) to cause a serious decrease in blood pressure, leading to fainting, stroke, or heart attack.<ref>Recreational use of sildenafil by HIV-positive and -negative homosexual/bisexual males (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/15113986</ref>
Alkyl nitrites are interactive with other [[vasodilation|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.<ref>{{cite journal | vauthors=((Romanelli, F.)), ((Smith, K. M.)) | journal=The Annals of Pharmacotherapy | title=Recreational use of sildenafil by HIV-positive and -negative homosexual/bisexual males | volume=38 | issue=6 | pages=1024–1030 | date= June 2004 | issn=1060-0280 | doi=10.1345/aph.1D571}}</ref>
==Legal issues==
==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.<ref>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.</ref>
*'''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.<ref>{{Citation | title=Health Canada cracks down on poppers, Xtra Magazine | url=https://xtramagazine.com/power/health-canada-cracks-down-on-poppers-50163}}</ref>
*'''European Union:''' Since 2007, reformulated poppers containing isopropyl nitrite are sold in Europe; isobutyl nitrite is prohibited as it is considered carcinogenic.<ref>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.</ref>
*'''European Union''': Since 2007, reformulated poppers containing isopropyl nitrite are sold in Europe; isobutyl nitrite is prohibited as it is considered carcinogenic.<ref>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.</ref>
*'''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.<ref>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.</ref> In 2007, the government extended this prohibition to all alkyl nitrites that were not authorized for sale as drugs.<ref>http://www.legifrance.gouv.fr/affichTexte.do?dateTexte=20090901&cidTexte=JORFTEXT000000341445 | "Decree 2007-1636 of 20 November 2007" (in French). Legifrance.gouv.fr.</ref>
*'''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.<ref>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.</ref> In 2007, the government extended this prohibition to all alkyl nitrites that were not authorized for sale as drugs.<ref>http://www.legifrance.gouv.fr/affichTexte.do?dateTexte=20090901&cidTexte=JORFTEXT000000341445 | "Decree 2007-1636 of 20 November 2007" (in French). Legifrance.gouv.fr.</ref>
*'''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.
*'''Germany''': Poppers are not controlled under the BtMG (Narcotics Act) or the NpSG (New Psychoactive Substances Act).<ref>BtMG | http://www.gesetze-im-internet.de/btmg_1981/BtMG.pdf</ref><ref>NpSG | https://www.gesetze-im-internet.de/npsg/NpSG.pdf</ref> They are legal, as long as they are not sold for human consumption, according to §2 AMG.<ref>{{Citation | title=§ 2 AMG - Einzelnorm | url=https://www.gesetze-im-internet.de/amg_1976/__2.html}}</ref>
*'''United States of America:''' 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.
*'''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.
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.
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
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.
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 PsychonautWikicontributors. 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
Headaches - Users are sometimes left with a headache due to the expansion of blood vessels in the brain.[12]
Changes in gravity - Many users report feelings that they are falling or that the room is spinning.
Decreased blood pressure - Since nitrites are vasodilating, they often substantially decrease blood pressure.[13]
Muscle relaxation - Inhaling nitrites relaxes smooth muscles throughout the body, and are particularly effective at relaxing the sphincter muscles in the anus. They are popularly used in the LGBT community for this purpose.[13]
Vasodilation - The vasodilation of poppers is intense and sudden. It results in feelings of blood rushing to the brain accompanied by a sensation of heat throughout one's body (but particularly in the face/head region).[13]
Time distortion - Some users may experience the impression of time slowing down.
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:
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 no 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.
↑ 13.013.113.2Israelstam, Stephen; Lambert, Sylvia; Oki, Gustave (1978). "Poppers, A New Recreational Drug Craze*". Canadian Psychiatric Association Journal. 23 (7): 493–495. doi:10.1177/070674377802300711. ISSN0008-4824.
↑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. ISSN1474-547X.
↑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. ISSN0022-1198.
↑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. ISSN1538-3601.
↑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.
↑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. ISSN0022-1198.
↑ 24.024.124.2Hagan, 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. ISSN1527-1323.
↑"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.
↑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. PMID7252472.
↑Pruijm MT, de Meijer PH (December 2002). "[Methemoglobinemia due to ingestion of isobutyl nitrite ('poppers')]". Nederlands Tijdschrift voor Geneeskunde. 146 (49): 2370–3. PMID12510403.
↑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. PMID15362601.Unknown parameter |s2cid= ignored (help)
↑Emergency Medicine: Principles and Practice. Harper & Collins, 2nd edition. 2008. pp. 42–51.Template:Full citation needed
↑Hagan IG, Burney K (July–August 2007). "Radiology of recreational drug abuse". Radiographics. 27 (4): 919–40. doi:10.1148/rg.274065103. PMID17620459.
↑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. ISSN0028-2162.
↑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. ISSN0731-3810.
↑Emergency Medicine: Principles and Practice. Harper & Collins, 2nd edition. 2008. pp. 42–51.
↑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. PMID3430141.
↑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. ISSN1060-0280.
. PMID 11971852.