The history of poppers.

No drug is as tied to the stigma of gay male promiscuity as poppers are. Beginning in the early 1970s, as the number of gay bars and bathhouses exploded, the use of poppers grew in popularity for its euphoric effects and practical use of relaxing the anal sphincter for a more enjoyable romp.

Researched initially for use on heart disorders, poppers belong to a class of drugs called alkyl nitrites. These early alkyl nitrites were sold in small ampules that needed to be crushed (or popped; hence the slang name) to release a vapor that would be directly inhaled. Alkyl nitrites for medical use still exist and require a prescription to obtain, but poppers (now sold in small plastic bottles) are obtainable over the counter under-marketed uses such as “room deodorizer” or “cleaning solution” with warnings that they are not for human consumption. Despite these warnings, poppers remain a popular drug due to their ease of procurement.

Poppers, Meet Methylene Blue | Emergency Physicians Monthly
Credit: Emergency Physicians Monthly

What are alkyl nitrites, and how do they work?

Alkyl nitrites are a class of pharmaceuticals that, when inhaled, dilate blood vessels by relaxing the smooth muscle surrounding arteries. The relaxation of this smooth muscle causes a drop in blood pressure, resulting in the heart compensates by beating faster to stabilize the blood pressure. Because of this, there is a rush of blood that often causes facial flushing and a slight sense of euphoria. If the drop in blood pressure is severe enough, however, it is possible that alkyl nitrites can cause hypotension, dizziness, a fast heart rate, or a headache. Additionally, the relaxation of smooth muscles also causes the relaxation of involuntary muscles, such as the internal anal sphincter.

The most commonly used alkyl nitrite, amyl nitrite, is used by patients who suffer from cardiac chest pain, otherwise known as angina. In angina, blood flow may be temporarily compromised to a section of heart tissue resulting in a localized lack of blood flow and oxygen, which results in a sharp pain sensation. Rapid vasodilation through amyl nitrite causes the blood flow and oxygenation to be restored and the pain ceases.

How safe are alkyl nitrites?

The Merck Manual of Diagnosis and Therapy notes that inhaling alkyl nitrites has few significant hazards, but some safety concerns are to be aware of. Poppers are not intended to be swallowed. Swallowing poppers can result in overdosing and a sharp fall in blood pressure leading to fainting, heart attacks, strokes, or even death if the dose is severe enough.

Conversation from an individual recounting a story of a popper mishap.

In researching this article, I met a gentleman who requested to remain anonymous. He accidentally ingested poppers when his sexual partner jolted him by initiating sexual penetration as he was attempting to inhale the vapors of the bottle he was holding to his face. Thankfully, he was only inconvenienced by the undesirable taste of the liquid and survived without significant consequences. However, this can be extremely dangerous, and it is vital to communicate the risk to everyone involved to ensure accidental swallowing does not occur.

Similar stories to this one can be found on the niche Reddit subreddit r/popperpigs, where users detail their usage of the Nitrites.

Overuse of poppers can cause damage to the eyes since the drop in blood pressure may mean less blood flow to the eye and thus damage to the tissue of the eye through lack of oxygenation. As a result, habitual users may have vision loss, but some studies have found visual acuity returning with cessation of popper use.

This risk of vision loss is exacerbated by the concomitant use of other blood pressure-lowering or vasodilating drugs, particularly PDE-5 inhibitors used for erectile dysfunction such as Viagra and Cialis Levitra, and Stendra. The use of poppers and PDE-5 inhibitors together is contraindicated as the resulting low blood pressure can be severe enough to cause fainting, heart attacks, strokes, or even death.

Additionally, poppers can cause methemoglobinemia when inhaled consistently without adequate oxygenation between inhalation of the vapors. Methemoglobinemia is a severe condition where the red blood cells have diminished oxygen-carrying capacity and require urgent medical attention. Do not use poppers if you have an underlying heart condition, are on medications for a heart condition, take a PDE-5 inhibitor for erectile dysfunction, have had recent head trauma, have a history of cerebral hemorrhage, or have increased intracranial pressure. Talk to your doctor before doing any drugs.

Here at The Simple Herald, we believe in safe and informed drug use but do not condone drugs. The information in this article is meant solely for educational purposes and is not to be interpreted as medical advice. Always talk to your doctor before starting any drugs, as there may be severe side effects. As always, stay safe and seek routine testing for STDs.

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Raymond Hourst
Biologist, world traveler, and fine dining expert writing from Antananarivo, Madagascar to Detroit, Michigan

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