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Poppers is a slang term given to the chemical class called alkyl nitrites that are inhaled for recreational purposes, especially in preparation for sex. Today, poppers are mainly sold in cap vials.
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 EU in 2007. More rarely sold is the compound butyl nitrite.
In 1844, the French chemist Antoine Jérôme Balard synthesized amyl nitrite. Scottish physician Sir Thomas Lauder Brunton (1844–1916) famously pioneered the use of amyl nitrite to treat angina pectoris (now treated with nitroglycerin). He was inspired by earlier work with the same reagent by Arthur Gamgee and Benjamin Ward Richardson. Brunton reasoned that the pain and discomfort of angina could be reduced by administering amyl nitrite to dilate the coronary arteries of patients, thus improving blood flow to the heart muscle.
Time and the Wall Street Journal reported that popper use among homosexual men began as a way to enhance sexual pleasure, but "quickly spread to avant-garde heterosexuals" as a result of aggressive marketing. A series of interviews conducted in the late 1970s revealed a wide spectrum of users.
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 being oxides of nitrogen, water, the alcohol, and polymerization products of the aldehyde.
(Sutton, 1963 for amyl nitrite, butyl nitrite, isobutyl nitrite):
|Alkyl nitrite||CAS||Formula||Molecular weight (g·mol−1)||Physical state||Boiling point (°C)||Specific gravity|
|Amyl nitrite (isoamyl nitrite, isopentyl nitrite)||110-46-3||(CH3)2CHCH2CH2ONO||117.15||Transparent liquid||97–99||0.872|
|Butyl nitrite||544-16-1||CH3(CH2)2CH2ONO||103.12||Oily liquid||78.2||0.9144 (0/4 °C)|
|Isobutyl nitrite (2-methylpropyl nitrite)||542-56-3||(CH3)2CHCH2ONO||103.12||Colorless liquid||67||0.8702 (20/20 °C)|
|Isopropyl nitrite (2-propyl nitrite)||541-42-4||(CH3)2CHONO||89.09||Clear pale yellow oil||39 °C at 760 mmHg|
The dose administered can easily be determined by subtracting the weight of a small vial after inhalation from its weight before inhalation. Two-cm vial openings, now being more common, are broad enough to cover the nostrils; smaller vial necks distribute lower doses.
Inhaling nitrites relaxes smooth muscles throughout the body. Smooth muscle surrounds the body's blood vessels and, when relaxed, causes these vessels to dilate, resulting in an immediate decrease in blood pressure.
User surveys are hard to come by, but a 1988 study found that 69% of men who had sex with men in the Baltimore/Washington DC area reported they had used poppers, with 21% having done so in the prior year. The survey also found that 11% of recreational drug users in the area reported using poppers, increasing to 22% among "heavy abusers," with an average age of first use of 25.6 years old. Both survey groups used poppers to "get high." It was reported that this group reduced usage following the AIDS epidemic, while the drug users had not. A 1987 study commissioned by the US Senate and conducted by the Department of Health and Human Services found that less than 3% of the overall population had ever used poppers.
Use by minors is historically minimal, due in part to the ban on sales to minors by major manufacturers for public relations reasons, and because some jurisdictions regulate sales to minors by statute. A 2005 paper examined use of poppers self-reported by adolescents aged 12–17 in the (American) 2000 and 2001 National Household Surveys on Drug Abuse. In all, 1.5% of the respondents in this age group reported having used poppers. This figure rose to 1.8% in those over 14. Living in nonmetropolitan areas, having used mental health services in the past year (for purposes unconnected with substance use treatment), the presence of delinquent behaviours, past year alcohol and drug abuse and dependence, and multi-drug use were all associated with reporting the use of poppers.
The 2005 Merck Manual of Diagnosis and Therapy reported that there is little evidence of significant hazard associated with inhalation of alkyl nitrites. 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.
In the early days of the AIDS crisis, widespread poppers use among the earliest AIDS cases drove speculation that poppers contributed to, or even caused, the immune suppression culminating in AIDS. Isolated arguments to this effect persist in "AIDS dissident" sectors (that deny that a virus causes AIDS), but are almost universally dismissed. Some modest, short-term reductions in immune cells have been seen in animal and human studies. Overall, however, evidence that poppers cause any significant degree of immune suppression is sparse, and very little research on the subject is recent.
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. Accidental aspiration of amyl or butyl nitrites may lead to the development of lipoid pneumonia.
Alkyl nitrites are interactive with other vasodilators like sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis), to cause a serious decrease in blood pressure, leading to fainting, stroke, or heart attack.
Poppers 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. 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. Another study described foveal (daylight vision) damage in six habitual poppers users. 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. http://www.nature.com/eye/journal/v26/n11/full/eye2012191a.html
Common side effects of popper use include headaches and temporary erectile problems. Other risks include burns if spilled on skin. Adverse effects on the retina are a recently described issue following inhalation of poppers. The term 'Poppers Maculopathy' has emerged to describe the clinical signs. 
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.
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. In 2007, the government extended this prohibition to all alkyl nitrites that were not authorized for sale as drugs. After litigation by sex shop owners, this extension was quashed by the 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.
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. Those containing amyl nitrate are "very unlikely" to be sold as that compound is regulated as a medicine and isobutyl nitrite is "effectively banned" under The Dangerous Substances and Preparations (Safety) Regulations 2006. The Advisory Council on the Misuse of Drugs noted in 2011 that poppers "appear to fall within the scope of The Intoxicating Substances (Supply) Act 1985" if sold to minors.
In the U.S., amyl nitrite was originally marketed as a prescription drug in 1937 and 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 observation of an increase in recreational use. Other alkyl nitrites were outlawed in the U.S. by Congress through the Anti-Drug Abuse Act of 1988. The law includes an exception for commercial purposes. The term commercial purpose is defined to mean 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. The law came into effect in 1990.
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.