Poppers

Poppers are a group of inhaled alkyl nitrites — including amyl, isopropyl, and isobutyl nitrite — that produce a brief rush and relax smooth muscle. Amyl nitrite was originally a 19th-century angina medicine. Poppers became associated with nightlife and, in particular, with sex (they relax muscles including the anal sphincter). They are sold in small bottles, openly but under cover labels such as 'leather cleaner', 'nail polish remover', or 'liquid incense'.

Alkyl nitrites release nitric oxide, which relaxes the smooth muscle lining blood vessels, causing them to dilate. This produces a sudden drop in blood pressure, a rush of blood, warmth, lightheadedness, and muscle relaxation. The same nitrite chemistry, however, can oxidize the iron in hemoglobin, converting it to methemoglobin, which cannot carry oxygen — the basis of their most serious toxicity.

Inhaled, poppers produce a short (seconds-to-minutes) rush of warmth, lightheadedness, euphoria, and muscle relaxation, along with facial flushing and a pounding heartbeat. Common immediate side effects include headache, dizziness, and a brief drop in blood pressure that can cause fainting. Effects fade quickly, which is part of why they are used repeatedly in a session.

Poppers' most serious danger is methemoglobinemia — the nitrites convert hemoglobin into a form that cannot carry oxygen, which can cause blue-tinged skin, severe breathlessness, collapse, and death; this is especially likely and severe when poppers are swallowed rather than inhaled, a mistake that has caused near-fatal poisonings, and the FDA has warned that ingesting or inhaling them can cause serious injury or death. The sudden blood-pressure drop can cause fainting and injury, and is acutely dangerous combined with erectile-dysfunction drugs (such as sildenafil/Viagra), which also lower blood pressure — the combination can cause a catastrophic drop. Nitrites can also cause chemical burns on skin and eyes, and can damage vision. People with heart conditions, low blood pressure, glaucoma, or anemia are at higher risk. Because products are sold under cover labels, actual chemical content varies. Anyone who has swallowed poppers, or who has blue lips/skin, severe shortness of breath, chest pain, or fainting, needs emergency care immediately — call 911, and Poison Control at 1-800-222-1222 can advise (methemoglobinemia has a specific antidote). This page has not yet been medically reviewed.