Poppers (Nitrates): Side Effects and Dangers

Nitrites belong to a class of drugs called inhalants. While many drugs can be inhaled, the term “inhalants” is reserved for those items that are only abused in this manner. They include household items, like glues or aerosol sprays, as well as solvents and gases.¹

What Are Poppers ?

The term “poppers” refers to nitrites. A nitrite is a particular type of inhalant that is different from most other inhalants that are often found around the house and are abused often by young people looking for a quick and easy high. ¹ Amyl nitrite is a medicine prescribed for angina (i.e., chest pain resulting from narrowing of coronary arteries that supply blood to the heart). It was originally available over-the-counter in ampules that could be “popped” open, which is why nitrites are often called “poppers.” ^1,2

While amyl nitrite is now available only as a prescription, similar alkyl nitrites (e.g., butyl nitrite, isobutyl nitrite and isopropyl nitrite) may be found over-the-counter in specialty stores or online. They typically are found in small bottles (e.g., 10 ml, 15 ml or 30 ml), often under the guise of another substance, such as:^{1, 2}

• Video head/tape cleaner.
• Room odorizer.
• Liquid fragrance/incense.
• Leather cleaner.
• Multi-purpose solvent cleaner.

Nitrite products may carry brand names like “Rush,” “Jungle Juice”, “Bolt,” “Iron Horse,” “Hardware,” “Locker Room” or “Climax.”^2,3

What Do Poppers Do?

Nitrites produce the effect of relaxing and expanding the blood vessels (vasodilation).¹

While most inhalants are abused for the brief euphoric high, nitrites are primarily abused to increase sexual pleasure and performance, especially among men who have sex with men.^{1, 2}

Poppers’ Side Effects

Inhaling nitrites can cause:^4,5,6

• A brief euphoria/rush lasting 30 seconds to 2 minutes.
• Reduced social and sexual inhibition.
• Increased sensation to the genitals and relaxation of the sphincter muscle.
• Heart pounding.
• Flushing of the skin.
• Warm sensation throughout the body.
• Dizziness.
• Lightheadedness.
• Weakness.
• Low blood pressure.
• Blurred vision.
• Throbbing headache.
• Irritation of the skin and eyes.
• Pressure in the eyes.

Are Poppers Dangerous?

Yes, poppers can be quite dangerous for several reasons. First, poppers are used primarily to enhance sexual pleasure, and they also decrease inhibition.¹ This combination can lead to risky sexual behaviors such as unprotected sex. Among men who have sex with men, poppers have been associated with an increased risk of the transmission of HIV and other infectious diseases.^3,7 Men who have sex with men may also engage in “chemsex,” where poppers are used in combination with more traditional drugs of abuse, such as crystal meth. Although the use of methamphetamine in men who have sex with men is associated with a higher risk of HIV, that risk is even higher when poppers are added to the mix.⁸

People who use poppers may also use Viagra (sildenafil) or other erectile dysfunction drugs (e.g, Cialis (tadalafil) and Levitra (vardenafil)). This is very dangerous, as its effects can be life-threatening.^6,9  The combination of erectile dysfunction medications and nitrites may cause extremely low blood pressure, which can result in:⁹

• Stroke.
• Heart attack.
• Death.

Nitrites are also flammable and caustic.⁶ Smoking while using nitrites may cause fires/serious burns.⁵ Getting a volatile nitrite on the skin can cause contact dermatitis and crusty lesions at the site of contact. Inhaling nitrites may lead to tracheobronchial irritation. In some cases, the irritation to the skin and trachea may be severe enough to warrant hospitalization.⁵

Another risk of sniffing nitrites is methemoglobinemia.^3,5 This condition hampers the ability of the red blood cells to carry and deliver oxygen to the tissues.^3,10 Someone with this condition may have bluish skin and low oxygen saturation levels.^3,11 In severe cases, untreated methemoglobinemia may result in death.¹²

A certain type of poppers may also negatively impact vision. Evidence suggests that isopropyl nitrite can damage a very important part of the retina, causing significant vision problems. These problems often resolve after stopping the use of poppers, but some users have experienced visual issues that persisted even after several months of not using.¹³

Poppers: Not Worth the Risks

While users may regard poppers as harmless, the risks suggest otherwise. While these drugs are not typically regarded as addictive, poppers are not benign.

People in recovery from addiction may also find that poppers are a threat to their sobriety. Abuse of nitrites is not that common in the general population but is more common among those who struggle with abuse of other drugs and those in addiction treatment.¹⁴ A survey of 99 people in recovery showed that 79% believed that poppers were somewhat or very dangerous to their recovery.¹⁵ If you’re unable to control your use of poppers or any other substance and you need help, we’re here for you. Call us at any time at to discuss our Nevada addiction treatment options at Desert Hope Treatment Center.

References:

1. National Institute on Drug Abuse. (2020). Inhalants DrugFacts.
2. Hall, T. M., Shoptaw, S., & Reback, C. J. (2014). Sometimes Poppers Are Not Poppers: Huffing as an Emergent Health Concern among MSM Substance Users. Journal of gay & lesbian mental health, 19(1), 118–121.
3. Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine, Sixth Edition. Philadelphia: Wolters Kluwer.
4. Schwartz RH, Peary P. (1986). Abuse of isobutyl nitrite inhalation (Rush) by adolescents. Clin Pediatr (Phila, 25(6), 308-10.
5. National Institute on Drug Abuse. (1988). Health Hazards of Nitrite Inhalants.
6. AIDS Committee of Toronto. (2015). Party Drug Harm Reduction.
7. National Institute on Drug Abuse. (2011). What are the unique risks associated with nitrite abuse?
8. Plankey, M. W., Ostrow, D. G., Stall, R., Cox, C., Li, X., Peck, J. A., & Jacobson, L. P. (2007). The relationship between methamphetamine and popper use and risk of HIV seroconversion in the multicenter AIDS cohort study. Journal of acquired immune deficiency syndromes (1999), 45(1), 85–92.
9. Kaiser Permanente. (2017). Medicines for Erection Problems: Reactions With Nitrate.
10. U.S. National Library of Medicine. (2020). Methemoglobinemia.
11. Benowitz, N. (2011). Poisoning & Drug Overdose, Chapter 13: Nitrates and Nitrites.
12. Rehman H. U. (2001). Methemoglobinemia. The Western journal of medicine, 175(3), 193–196.
13. “New chemical composition of ‘poppers’ linked to retinal damage: Harms associated with these recreational drugs should be reassessed, urge researchers.” ScienceDaily. ScienceDaily, 10 April 2017.
14. Miller, P. M. (2013). Principles of addiction. Amsterdam: Elsevier Acad. Press.
15. Fawcett, David. (2018). Are Poppers a Risk to My Sobriety?