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Last updated September 6, 2020. 4 minute read

What are poppers? What are they used for? Are they safe?

The recreational drug is the same substance as that used by medical professionals to treat heart disease by increasing blood flow to the heart. Because they widen the blood vessels, they cause a rush, making them a popular club drug.

Linnea Zielinski Written by Linnea Zielinski
Reviewed by Dr. Yael Cooperman, MD

Here’s what you need to know about ‘poppers’

“Poppers” is a slang term for a group of recreational drugs called alkyl nitrites or nitrite inhalants. Amyl nitrite has gained popularity as a recreational drug in some countries since the 1980s but has been used in a medical setting since 1867 (Zhang, 2017; Haverkos, 1994). The recreational drug is the same substance as that used by medical professionals to treat heart disease by increasing blood flow to the heart. Because they widen the blood vessels, they cause a rush, making them a popular club drug.

Vitals

  • Poppers is a slang term for recreational inhalant drugs that contain a substance called nitrites. 
  • These medications are used by healthcare providers to treat patients with heart disease.
  • Because nitrites widen blood vessels in the body, they cause a range of effects, among them a “rush” sensation caused by a sudden increase in blood flow to the brain.
  • When used inappropriately, poppers can cause serious side effects and even death.

Amyl nitrites were marketed as a prescription drug for the treatment of chest pain in people with ischemic heart disease starting in 1937. In the 1960s, the U.S. Food and Drug Administration (FDA) briefly lifted the prescription requirement, offering the medication over-the-counter, but restored the need for a prescription when young, healthy people were making a lot of the over-the-counter purchases.

The alkyl nitrites that were developed later (butyl and isobutyl nitrite) were never made by pharmaceutical companies. Instead, they were marketed as “room deodorizers” and “liquid incense” in the 1970s. Since the labels of these products stated they weren’t for human consumption, they weren’t regulated by the FDA and became a replacement for amyl nitrite when the prescription requirement made it hard to get a hold of again (Haverkos, 1994).

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What are poppers used for?

Poppers are often illicitly used by men who have sex with other men to relax the muscles around the anus and facilitate anal sex (Lampinen, 2007; Romanelli, 2004). Poppers are liquid at room temperature but produce vapors that can be inhaled and are commonly described as having an unpleasant fruity odor. The nickname “poppers” comes from the noise of crushing the small bottles in which they come. Inhaling the vapors causes a person’s blood vessels to open up (Haverkos, 1994).

Because poppers open up blood vessels, they allow for more blood to reach the brain very quickly, causing lightheadedness, dizziness, and a warm sensation. They also have a relaxation effect on the anal sphincter. Their use as an illicit club drug frequently has to do with how they relax smooth muscle, including the anal sphincter, making anal sex easier. Although nitrites are regulated in the United States, poppers are sold illegally online and at different venues such as clubs and bars (Romanelli, 2004).

Are poppers safe?

Poppers can cause serious side effects and even death. Side effects of poppers range in severity from mild allergic reactions to a condition called methemoglobinemia, a life-threatening blood disorder in which oxygen isn’t delivered properly to the cells. Methemoglobinemia may cause a bluish tinge to the skin, fatigue, altered mental state, giddiness, headache, and shortness of breath (NIH, 2018). Poppers may also cause severe heart palpitations, blurred vision, erectile dysfunction, confusion, ringing in the ears, and vomiting (Zhang, 2017). Skin irritation, inflammation of the throat, and allergic reactions with wheezing and itching may also occur (Perry, 2020).

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It’s also common for men who have sex with men to combine poppers with erectile medications (De Ryck, 2013). Since amyl nitrite and ED medications called PDE5 inhibitors both increase blood flow by widening blood vessels, taking them together may cause dangerously low blood pressure (hypotension), which can result in dizziness and loss of consciousness (Schwartz, 2010).

Amyl nitrates should only be used if prescribed by a medical professional. They are currently approved by the FDA to treat cyanide poisoning. While amyl nitrite is available as a prescription treatment for relieving chest pain associated with coronary artery disease, an alternative medication class known as nitrates (which come as tabs that patients put under their tongues) is the preferred method for treatment as their effects are longer-lasting (FDA, 2019).