FDA Warns Against Nitrite "Poppers"

J.Adderton, BSN, MSN

The FDA recently noticed an increase in hospitalizations and deaths linked to using nitrite “poppers”. On June 24, 2021, the agency issued a statement warning consumers not to buy or use poppers that are typically sold on-line and in adult novelty shops. They are marketed under the brand names of Super RUSH, Jungle Juice, Extreme Formula, Quick Silver, Premium Ironhorse and Super Rush Nail Polish Remover.

What Are Poppers?

Poppers are usually sold as a liquid and packaged as room deodorizers or leather cleaner. They are usually packaged in 10mL to 40mL bottles that look like energy shot products. The chemicals in the liquid produce a vapor that causes vasodilation in the body when inhaled. It is actually related to the nitrate inhalation medications that are prescribed by physicians for angina attacks. Street names may include:

Aimes
Aimees
Snapper
Bold
Liquid gold
Rush
Purple haze
Buzz

How Are They Used?

Poppers are usually used by inhaling the vapors from the bottle. Some people dip the end of a cigarette into the bottle and inhale through the cigarette to avoid sniffing the chemicals directly from the packaging.

Why Are They Used?

Poppers are typically used recreationally to produce a feeling of euphoria or to enhance sexual experiences.

Instant High

People often use poppers for the “head rush” that is caused by the sudden increased blood flow. This can cause a euphoric feeling or instant high that general lasts only a few minutes. Some have described the rush as a “warm fuzzy” feeling that is caused by the side effects of vasodilation, including:

Sudden drop in blood pressure
Dizziness
Increase in heart rate
Lightheadedness
Warm sensation throughout the body

Sexual Enhancement

The vasodilation effects of amyl nitrites also relax smooth muscles in the orifice and lady parts, making sex more comfortable and sensations more intense. Some men also take use poppers to prolong erections.

Serious Side Effects

The FDA released the warning against poppers based on an increase in hospitalizations and deaths with problems such as

Severe headaches
Dizziness
Increased body temperature
Shortness of breath
Extreme hypotension
Methemoglobinemia
Brain death

Here is a look at other problems people may experience when using poppers.

Respiratory problems (sinus issues, respiratory infections, wheezing)
Chemical burns around lips or nose
Allergic reactions
Increased eye pressure
Heart palpitations
Nausea
Poor coordination
Nosebleeds
Lowered inhibitions
Impaired judgement

Dangerous With Other Drugs

Poppers are often used in combination with other illegal drugs to increase the high, including, cocaine, marijuana, methamphetamines and hallucinogens. This increases the risk of both psychiatric and physiological side effects. The following medications when taken with poppers can cause a dangerously low blood pressure:

Viagra
Monoxidil (Rogaine)
Diuretics (I.e. furosemide, hydrochlorothiazide)
Beta Blockers (I.e. carvedilol, atenolol)
Calcium channel blockers (I.e. diltiazem, nicardipine)
Angiotensin II receptor antagonist (I.e. losartan, valsartan)
Vasodilators (I.e. terazosin, apresonline)

There is also research that suggests amyl nitrate can reduce the effectiveness of certain HIV medications, particularly protease inhibitors, such as indinavir, saquinavir mesylate and ritonavir.

Who Uses Poppers?

Amyl nitrite began being used for a recreational drug in the gay community during the 1960s. Its use became widespread throughout the 70s, 80s and 90s in the club scene. Today, people of all ages, races and sexual orientations use poppers.

Are Poppers Addictive?

Repeatedly using poppers can lead to a substance use disorder (SUD). This occurs when someone continues to use poppers despite health problems or issues in everyday life. Signs of a SUD including failing to meet personal responsibilities at home, work or school. A SUD be mild to severe, and an addiction would be the most severe.

People who have tried to quit using inhalants may have the following withdrawal symptoms:

Nausea
Poor appetite
Sweating
Sleep problems
Mood changes

For more information on inhalants and addiction, visit this National Institute on Drug Abuse website.

Do you have a clinical or personal experience with inhalants you are willing to share?

References

Is amyl nitrite safe? Who uses poppers?

Nitrite ‘Poppers’: Here’s Why FDA Warned Against Their Use For Fun, Sex