This article was clinically reviewed by: Michelle Forcier, MD; Ronica Mukerjee, FNP, Acupuncturist, PMHNP-c; and Jess Schwab, DNP.
Poppers is a name for a chemical inhalant called amyl nitrite. Packaged in small bottles, they can be sold as room aromas or deodorizers and even “VHS cleaners”. You’ve probably seen the brand, RUSH, in necklaces, back pockets, or purses. They’re a common part of gay nightlife and the overall queer cultural canon and beyond. In nightlife scenes, people inhale poppers by closing one nostril with their pointer finger and inhaling deeply with the other open nostril.
We know the role that poppers play in our community and we want to help you stay safe while using them. Here’s what you need to know about poppers and how they interact with medications prescribed by FOLX clinicians.
What are poppers?
When amyl nitrate was developed in the 19th century, it was used to treat those with chest pain or angina. Soon, its benefits were discovered as it became more known. While poppers can be used for different medical ailments, the queer nightlife’s use of poppers is purely recreational. Though amyl nitrate is a legal substance, it’s technically illegal to sell them over the counter for human consumption; however, they are still often sold “under” the counter at sex shops, online retailers, etc. making them still fairly accessible.
Adam Zmith, author of Deep Sniff: A History of Poppers and Queer Futures, describes how amyl nitrate got its colloquial name:
“Amyl nitrate was sold in sealed glass ampoules, which were crushed by users to release the vapour of the liquid inside. This action made a ‘pop’. This is how amyl nitrate, and similar substances, were packaged and used before the little brown bottles with safety caps came along. It’s also how they got their name ‘poppers’.”
Inhaling poppers can be used to enhance sexual experiences by relaxing the anal muscles as well as vaginal muscles. Historically, poppers have made anal sex easier and more pleasurable. Additionally, poppers produce a short-term, fun, euphoric, and mood-enhancing high where you’re able to experience and perceive the world in a different light, similarly to other drugs.
Poppers were originally developed in the UK, and therefore weren’t yet intertwined with gay culture in the United States until the 1970s. Corporations began targeting poppers advertisements to gay cisgender men during this time, initiating it into gay subculture, particularly through full-page display ads (including expensive inside and back covers) in gay magazines and newspapers. Zmith adds:
“Sniffing poppers in the 1970s was a huge part of gay life thanks to the ease of sending such a small product through the mail and the concentration of consumers in New York, Los Angeles, and San Fransisco. In New York, Pete Fisher, an activist and writer, was going to sex clubs where ‘poppers perfumed the thick, murky air.’”
At the beginning of the HIV epidemic, when scientists were still trying to figure out what causes AIDS, some scientists initially thought HIV transmission was linked to poppers. However, this misconception was debunked rather quickly.
Despite its historic popularity among gay cisgender men, people with all genders and sexualities consume poppers, including transgender men and women, nonbinary people, and cisgender women. Poppers are no longer just a gay relic, but a recreational drug popular enough to be consumed outside of primarily gay spaces.
What are the risks of using poppers?
Popper inhalation follows a quick, headrush and feeling of lightheadedness. Though this can also accompany euphoria and a cozy head high, some people report experiencing a short-term headache. This is a common side effect that typically goes away quickly momentarily, though check in with your health provider if the headache persists the morning after and beyond.
There are general risks for everyone consuming poppers, regardless of what medications you’re on. You can get chemical burns on the inside of your nose. Since it’s flammable, poppers can explode in your face when exposed to fire or high heat. Risks of using poppers increases when consumed alongside alcohol and other drugs which along with the high, also impair decision making. Poppers can interact with as stimulants/methamphetamines, causing irregular heartbeats. Poppers also can interact with ED medications like Viagra or Cialis for in that they can drop blood pressure in a dangerous way. Doing poppers in a plastic bag, in areas with poor ventilation or flame, can put someone at risk for asphyxiation or burns.
“You should never taste or swallow poppers as this can be fatal as it blocks blood cell ability to carry oxygen to your body,” explains FOLX clinician and MD Michelle Forcier.
The risk of using poppers increases when mixed with other drugs. For example, while mixing poppers with alcohol can increase the risk of reducing the oxygen supply to vital organs, it can also lead to poor judgment, thus further impairing your decision-making while under the influence. Additionally, mixing poppers with stimulants/amphetamines (including meth and coke as well as medications like Adderall, Ritalin, Concerta, etc.) can put an increased strain on your heart and lead to more stress on the body, increasing the risk of a cardiac event, especially in those with pre-existing heart conditions.
Though fatal overdoses are rare, they’re still possible. According to the Mayo Clinic, symptoms of an amyl nitrate overdose include bluish-colored lips, fingernails, or palms of hands; dizziness (extreme) or fainting; feeling of extreme pressure in the head; shortness of breath; unusual tiredness or weakness; and weak and fast heartbeat. If you or someone you know experiences any of these symptoms, please seek urgent medical attention, as they can lead to death.
“It's like any substance [where] you're using something in a way that's not intended, in a way that usually bypasses the safety systems for its intended use,” Forcier adds.
There isn’t any scientific evidence you can get addicted to poppers specifically. However, inhalant abuse (which can include poppers) is real and alive, especially within marginalized identities facing systemic oppression, such as the LGBTQ+ community. Like with any other drug, use can turn problematic when it interferes with other parts of your life, such as relationships, work, school, etc. We encourage you to seek community support. FOLX members can contact their clinician if they are concerned about their poppers use.
How can I use poppers safely?
For those with concerns about how poppers interact with medications prescribed by FOLX, rest assured. Though medical fearmongering around gender affirming hormone therapy will tell you otherwise, it’s still safe to use poppers while on GAHT. Forcier explains that using poppers while prescribed GAHT is not likely to cause additional problems or interactions.
It’s important to know that those on exclusively erectile dysfunction medication can have increased health risks, particularly around lowered blood pressure, which can lead to dizziness, lightheadedness, or fainting. Though fainting can lead to death in extreme cases, fainting more commonly just leads to falls or other injuries.
“Most of the time fainting does not lead to death,” adds Forcier. “However, fainting, a fall, multi-substance intoxication, and dehydration in a chaotic or unsupervised setting sure is dangerous!”
Now that you understand how poppers interact with medications prescribed by FOLX, here are some safety tips to plan to use poppers safely in advance, incorporating harm reduction values. “If you're on [a drug] that sort of gives you a high and changes the way you think and view the world, making decisions about physical health and safety become a little bit more distant,” explains Forcier.
Consider the “who” and “where” of your setting.
Plan ahead and consider what kind of environment you’ll be consuming in. This might look like packing a bottle of water and an electrolyte packet in advance to ensure you’ll be able to stay hydrated later. It can also look like bringing sunscreen if you’re outside. Also, consider the crowd of people you’ll be with. Do a vibe check!
Surround yourself with safe people, if possible.
Consume poppers (and any drug) with those you trust. If you’re with a sexual partner, for example, are you confident in their ability to consent in sex, to say “yes” and “no,” as well as “stop” and “go?”
If you’re consuming poppers, chances are you are in a nightlife or festival environment. You might be dancing and on your feet. Make an effort to drink adequate water to offset any chance of dehydration. Take breaks by sitting down and catching your break.
FOLX clinicians recognize harm reduction in healthcare and are here to support you through different lifestyle choices. FOLX members with questions about poppers are encouraged to start a conversation with their clinician. Message your clinician questions and/or schedule a time to meet with them.