When Poppers are not Poppers
In the Journal of Gay and Lesbian Mental Health, a team of researchers report on an a potentially dangerous product that’s being marketed towards gay men: poppers that aren’t actually poppers. These new products—advertised or described as poppers and sold online by retailers that also sell poppers—have more serious health consequences than the traditional amyl nitrite-based poppers oftentimes used recreationally by gay men to enhance sex.
Traditional poppers have been popular among gay men since the seventies. Popular brands such as “Rush” and “Jungle Juice” are sold online and in sex shops catering to gay men as “video head cleaners” or “room odorizers.” These traditional poppers contain amyl nitrite, a chemical that relaxes smooth muscle tissue and dilates blood vessels.
“Traditional nitrite poppers are fairly benign for most users,” explains Timothy Hall, MD, PhD, of the University of California, Los Angeles. He specifies that there are case reports from people, such as those who have a genetic disorder called G6PD deficiency, who experience sudden anemia due to ruptured red blood cells with popper use. “But, it’s relatively rare. If you’re looking at the medical complications of poppers, for a few people there are potentially clinically significant problems. But the vast majority of gay men who have used them feel like the worst thing that is likely to happen is that they’ll get a headache.”
The problem with the emerging trend reported by Hall and colleagues is that these “new poppers” aren’t poppers at all. Instead of amyl nitrite, they contain solvents such as ethyl chloride, and the products are sprayed into a rag or bag and then “huffed.” Hall explains that these aerosol products have a different physiological effect on the body, and can cause—in rare cases—death through heart arrhythmia. It’s more likely, says Hall, that they will cause significant and potentially permanent cognitive problems like memory loss, or liver, kidney, and nerve damage.
One brand he’s noticed on the market is called “Maximum Impact.” Hall explains that people who use poppers should be on the lookout for products that contain solvents like ethyl chloride, and know that they have greater potential to cause more serious health problems than traditional poppers.
“Huffing, sniffing glue, doing whippets—using nitrous oxide canisters like those that are used for aerosolized whipped cream—these are things that are usually done by adolescents from disadvantaged backgrounds. It’s not something that most gay and bi men have any real cultural knowledge of, and now it’s being marketed as a cheaper alternative to nitrite poppers. This is a concern—and why we wanted to publish this [report].”
Mike Discepola, director of the substance use health and harm reduction program at San Francisco AIDS Foundation, provides a word of caution for all men who use poppers—both amyl nitrites and other solvent formulations. “Popper use isn’t without risk—using poppers can cause health problems in the short-term, like headaches and problems breathing, and using them more frequently can lead to more significant problems like damage to your lungs and cognitive problems. Research studies also show a link between popper use and condomless anal intercourse—which means their use may be tied to HIV transmission and acquisition among men who have sex with men.”
For more information on poppers, read this update provided by the Seattle and King County Public Health Department.
Hall, T. M., Shoptaw, S., and Reback, C. J. Sometimes poppers are not poppers: Huffing as an emergent health concern among MSM substance users. Journal of Gay & Lesbian Mental Health. 2014.
Liu, A. A. and others. Sexual risk behavior among HIV-uninfected men who have sex with men participating in a tenofovir preexposure prophylaxis randomized trial in the United States. Journal of Acquired Immune Deficiency Syndrome. 2013.