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Nitrites

Also known as

TNT, thrust, rock hard, ram, liquid gold, kix, amyls, poppers, amyl nitrite, butyl nitrite, isobutyl nitrite, isopropyl nitrite, hardware, locker room, rush, snapper, stag, stud

Overview

Nitrites or poppers are yellow liquids which are inhaled for their intoxicating effects. In the UK they are usually sold in a small bottle. They may be inhaled directly from the bottle or from a cloth or cigarette dipped into the liquid.

Nitrites tend to have a sweet odour when fresh but this tends to turn to a 'dirty socks' smell when stale. The drug will go stale quickly once the bottle has been opened [1].

Poppers are usually found in the form of a liquid chemical sold in a small bottle. They are a group of chemicals called alkyl nitrites. Specific alkyl nitrites include butyl nitrite, isopropyl nitrite, isobutyl nitrite and amyl nitrite. They dilate the blood vessels and allow more blood to get to the heart [2].

The key effects of poppers can include -

  • a short, sharp head-rush like 'high',
  • enhanced sexual experiences,
  • chemical burns with the development of a rash around the nose and mouth, and/or irritation of the nose and throat,
  • feelings of sickness, faintness and weakness,
  • death - if swallowed; or if used by individuals with heart problems [2].

What does it look like?

Poppers are liquids in small bottles, often with a colourful wrapper. The contents evaporate into a breathable vapour at room temperature. Poppers are often sold labelled as 'room odourisers' as it can be illegal to sell them as a drug [3].

Poppers are usually in the form of a yellow/clear liquid found in small bottles. The name popper originated from the sound the bottles make when opening [4].

In the past when nitrites were used to treat angina they came in small glass capsules that were popped open and sniffed, hence the name poppers.

Poppers are commonly sold as room aromas or deodorisers in sex shops, some clubs, market stalls and online [2].

Yellowish liquid usually sold in small, dark brown bottles [5].

Clear yellow liquid, smells sweet when it's fresh and 'sweaty' when it's not [6].

Poppers come as a yellow liquid usually inhaled straight from the bottle or from an absorbent material such as a cloth. They have a very distinctive and strong smell similar to stale sweat or a mouldy room [7].

Source

Sold in sex shops, joke shops, Internet and other similar outlets [5]. They are also sold as leather cleaner, room odouriser, liquid aroma, and model airplane glue [8].

Street price

Approximately £2 - £5 per bottle [5].

Why take it?

Sought after effects

  • short intense rush [4],
  • intense exhilaration [9],
  • you get a huge rush of blood to the head - like you're hanging upside down or something,
  • if you're having sex, it increases all the good feelings every touch feels much nicer than normal,
  • you might feel light-headed, giddy, or just really hot,
  • some people feel like time has slowed down [10].

Undesired effects

  • dizziness,
  • flushing,
  • nausea,
  • vomiting,
  • headache,
  • disorientation,
  • fainting [11],
  • erection difficulties,
  • sore throat,
  • painful eyes,
  • nasty skin rash [10].

How long do its effects last?

Onset of effects

  • within a few seconds [12].

Duration of effects

  • 2 - 5 hours [6].
  • 1 - 2 minutes [12].

Pharmacology

Pharmacodynamics

Amyl nitrite, in common with other alkyl nitrites, is a potent vasodilator. It expands blood vessels, resulting in lowering of the blood pressure. Alkyl nitrite functions as a source of nitric oxide, which signals for relaxation of the involuntary muscles. Physical effects include decrease in blood pressure, headache, flushing of the face, increased heart rate, dizziness, and relaxation of involuntary muscles, especially the blood vessel walls and the anal sphincter [13].

Lethal dosage

In rats the LD50 is 2.8290 mol/kg [13].

Tolerance

There is no real tolerance to be gained through popper use [14]. There is some evidence that suggests that heavy, regular users may develop a tolerance and need to increase their use to achieve the same effects [2].

Mechanism of action

Poppers relax smooth muscle in the body. The loosening of smooth muscle surrounding blood vessels is why poppers cause a drop in blood pressure. The effect on blood pressure and blood vessels in the brain may be what causes some of the effects of poppers: light-headedness, dizziness and thumping sensations in the head. However, it is not known what effects of poppers are due to direct effects on the drug in the brain and what effects are due to the drop in blood pressure [3].

Mode of use

Most commonly are inhalations directly from the poppers bottles, however liquid can be absorbed into fabric and sniffed. Another method is allowing poppers to absorb into a cigarette, allowing it to dry and smoking it (not advisable unless you want to loose your eyebrows) [4].

Nitrites are usually inhaled straight from the bottle [5].

The vapour can be inhaled into the nose or mouth directly from the bottle, but this has some risks. If the liquid on the rim of the bottle touches the skin, or if it is spilt on skin, this can cause a crusty rash particularly around the nose and lips. Some users dip the end of a cigarette in poppers and inhale on it without lighting it (the cigarette should be thrown away after this as it becomes dangerously flammable). This method could be risky if any of the actual liquid gets aspirated.

Some users transfer a little of the liquid onto cotton wool or paper in another closable bottle or container, and then inhale from that container. This may minimise the risk of accidental contact with the liquid. If you ever swallow or aspirate any poppers liquid you should get medical help as soon as possible [3].

The effects come on quickly, but don't last for long and fade after a couple of minutes.

It is important to be careful as poppers are highly flammable - with stories of people mistakenly burning themselves or others or lighting cigarettes that have been dipped in poppers and burning off their eyebrows [2].

Effects

The desired effect of poppers is usually a very short intense rush, which occurs due to the dilation of blood vessels allowing more oxygen to rush to the heart. As a result of this rush poppers are extremely popular within the rave culture and gay community. Poppers have been associated with increased and enhanced sexual experiences [4].

When the vapour of poppers is inhaled it very quickly enters the bloodstream through the mouth, throat and lungs, causing strong but short-lasting effects (typically lasting 2 - 5 minutes).

The 'high' can be described as a dizzying head rush, which can be euphoric, often accompanied with sensations of warmth and sometimes a thumping feeling in the head. The drug may make the skin flush.

People report that it enhances sexual experiences (increasing intensity and making orgasms last longer). Users report that poppers create feelings of wellbeing and increase sex drive. It is also used to facilitate sex because it relaxes muscles in the anus and vagina. However, some men have also reported problems getting or maintaining an erection when using poppers.

The most common after-effect of the drug is headaches. People have also reported feeling nauseous and sick after using poppers. People may also feel very dizzy and can faint [3].

Short-term effects

  • fainting,
  • nausea,
  • headaches,
  • disorientation,
  • burning irritation can occur around the nose and mouth [4].

Long-term effects

  • problems with blood pressure - due to the dilation of blood vessels,
  • headaches,
  • scarring around the nose and mouth - from chemical burns,
  • respiratory problems,
  • death - can be a result of injury to red blood cells and reduced oxygen to vital organs [4].

Physical effects

Cognitive effects

Overdose

  • loss of consciousness,
  • sudden sniffing death syndrome - has been reported after sniffing as a result of heart rhythm changes [4].

Risks

Taking poppers is potentially dangerous for anyone with heart problems, anaemia or glaucoma [2]. The health risks of using poppers for healthy people are considered relatively low. They are much lower than other inhaled volatile liquids, often called 'solvents'. However, they are not always harmless [3].

Here's what poppers can do to you.

  • they can cause your blood pressure to drop to a dangerous level. So, you shouldn't take them if you have problems with your blood pressure, are on any blood pressure medication, or if you are taking Viagra,
  • you can die due to injury to red blood cells and reduced oxygen supply to vital organs,
  • you may lose consciousness and could die through choking on your vomit. Using poppers with alcohol can increase this risk,
  • poppers are linked with risky sexual behaviour and may lead to catching a sexually transmitted disease,
  • they can burn your skin on contact and can kill you if you swallow them,
  • they're highly flammable,
  • they can cause nausea, headache, and disorientation. Poppers are usually sniffed from the bottle. Some people prefer to dip a cigarette into the popper bottle and inhale rather than sniff straight from the bottle,
  • fatal 'sudden sniffing death syndrome' has been reported due to development of an abnormal heart rhythm when taking poppers,
  • there are a number of reports in recent years of cases of temporary and permanent loss of vision in users of poppers. This problem is referred to as 'poppers maculopathy'. If you are experiencing problems with your eyesight after having used poppers, we would strongly advise you get medical advice [2].

Poppers can cause poisoning which can even occasionally be fatal if you get enough into the body. This can happen easily through accidental swallowing, but inhaling poppers in very large quantities can cause overdoses too. The reason is that the chemical converts the red haemoglobin in the blood into methemoglobin, turning the blood chocolate brown. Haemoglobin is needed to deliver oxygen round the body, so the result of severe 'methemoglobinemia' is oxygen starvation, potentially leading to organ failure, blindness, brain damage, or in the worse cases, death.

There is no advice available on the quantities likely to cause these serious problems. However, overdoses of alkyl nitrite are rare, suggesting that ordinary use should not put someone into the danger zone. If someone is continuously taking a lot of any alkyl nitrite and they experience shortness of breath, a lack of energy, tiredness and bluish colouring of the skin, they may be developing methemoglobinemia and should seek urgent medical help. If someone swallows poppers they should go to a hospital by ambulance as soon as possible. As well as the poisoning risk, swallowing poppers would likely result in throat irritation, nausea and vomiting. Visual loss associated with damage to the retina has been reported, but appears rare. This may resolve over several weeks. More research is needed to evaluate this risk.

People who use poppers heavily have developed crusty skin lesions around the nose, mouth and lips. Poppers can cause a chemical burn if it gets on the skin and should be washed off as fast as possible. When users get the liquid in their eye it is very painful. This requires prompt first aid of flushing with plenty of water. If discomfort continues, users should seek medical advice as soon as possible.

Poppers are also very flammable. You should never try to heat up a bottle of alkyl nitrite or have an open bottle near a flame or lit cigarette. People sometimes dip cigarettes in poppers to inhale through the unlit cigarette. Some have been burnt after mistakenly lighting the cigarette [3].

Short-term

Accidents whilst under the influence. Swallowing the liquid rather than inhaling the fumes is extremely dangerous and there have been a small number of deaths from this. Reduces blood pressure, which can cause fainting [11].

  • pounding headaches,
  • nausea,
  • fainting,
  • bulging eyes [6].

Long-term

  • prolonged headaches,
  • decreased heart rate,
  • low blood pressure [11].

Purity

Purity is not usually an issue with poppers [2].

Addiction

Can you get addicted

There is no evidence to suggest that poppers are physically or psychologically addictive [2].

Dangerous interactions

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 [15], [14].

Withdrawal

There are no withdrawal symptoms [13].

Legality

  • Poppers are not controlled under the Misuse of Drugs Act 1971, but amyl nitrite is regulated under the Medicines Act 1968 and there have been cases where the Medicines Act was used to fine shops for selling poppers. Poppers are also covered by general consumer protection legislation.
  • Possession is not illegal but supply can be an offence.
  • Poppers are not covered by the Psychoactive Substances Act 2016 [2].

Did you know?

Like drinking and driving, it's illegal to drive if your driving has been impaired by taking drugs. With some drugs, you can even remain unfit to drive the next day. As well as this drug-impaired-driving offence, it's now illegal in England and Wales to drive over set levels for any of 17 named drugs (legal and illegal) in your body, whether or not you are impaired.

Very low limits have been set for some common illegal drugs such as cannabis, cocaine and MDMA. You can get a heavy fine, be disqualified from driving or even go to prison. Check out the Think! website for more details.

Allowing other people to supply or produce drugs in your house or any other premises is illegal. If the police catch someone supplying or offering to supply drugs in a club they can prosecute the landlord, club owner or person holding the party [2].

Mixing with other drugs

Mixing poppers with alcohol can increase the risk of reducing the oxygen supply to vital organs, unconsciousness and death [2].

Harm reduction

Most of the harms of poppers are associated with excessive use (e.g. overdose) or accidents (e.g. swallowing). Avoiding poppers or limiting your use is the most important step to minimise harm [3].

  • taking poppers is potentially dangerous for anyone with heart problems, blood pressure problems, anaemia or glaucoma (an eye disease),
  • it is extremely dangerous to take poppers when on Viagra due to increase blood pressure, therefore to do not mix,
  • do not mix with alcohol,
  • using poppers has been associated with risky sexual behaviour therefore make sure you always take precautions [4],
  • drinking an alkyl nitrite can cause organ failure, blindness, brain damage or death. If you or someone you know has drunk an alkyl nitrite they should get emergency hospital treatment [3],
  • be careful of poppers on the skin as it can cause chemical burns, a solution is to apply a petroleum based gel around the nose prior to inhalation [4]. If do you get it on your skin you should rinse it off with plenty of water [3],
  • poppers are extremely flammable so keep away from fire and sensibly consume and stay away from the cigarette method of administration [4],
  • whatever you do, DON’T SWALLOW THEM. You will die,
  • don't use them near a naked flame. They're really bloody flammable,
  • don't take poppers if you have anaemia, glaucoma, or heart or breathing problems. It messes with your blood pressure and can be fatal,
  • don't take them if you're pregnant because nitrites affect the placenta of your baby,
  • if they make you horny, please do use a condom [10].

Paraphernalia

Nitrites come in small bottles or glass vials [11].

History

Amyl nitrite was discovered in 1857 and used to ease chest pains (angina) by dilating the blood vessels to allow greater volumes of blood to be delivered to the heart. It originally came in small glass capsules that were 'popped' open - hence the name 'poppers'. However, this form of the drug is now rarely found in the UK. In recent years amyl nitrite has been replaced by other medicines and its only remaining medical use is as an antidote for cyanide poisoning.

Nitrites were popular in showbiz circles in the 1950's and as a street drug in America in the 1960's. Butyl nitrite has no medical uses and was originally sold in America as a room odouriser and aphrodisiac.

Nitrites first became popular in the UK on the disco/club scene of the 1970's and then at dance and rave venues in the 1980's and 1990's [1].

The history behind poppers can be traced back to 1844 when a French chemist - Antoine Jerome Balard discovered amyl nitrate. This was later adapted in 1916 by a Scottish doctor who used amyl nitrate to treat angina pectoris [4].


References