Health

Boyz Doc: Dr Laura Waters on ‘Are poppers safe?’

Dear Dr Laura,

I know they are a bit old fashioned these days but I still love using poppers during sex. Can you tell me are they safe to use? Thanks.

Johnnie

Hi Johnnie,

Poppers are indeed quite retro but still very popular! The term poppers refers to a group of chemicals called alkyl nitrites which were used to treat heart problems in the 1860s. Poppers have been popular for recreational use since the 1970s, and are sold as liquids that can be sniffed directly from the small glass bottle they’re sold in or inhaled from a cloth. Some people dip the end of an unlit cigarette into poppers and inhale through it but this can cause burns if the cigarette is then lit – avoid this if you like your eyebrows!

Poppers are sold in sex shops, market stalls, bars and clubs and online, often labelled as something else, such as room deodoriser, boot cleaner or leather cleaner. Poppers are popular; more than 1 in 4 UK gay men with HIV and more than 1 in 3 HIV-negative gay men from London and Brighton used them in the last 3 months – in both these studies poppers were the most commonly used recreational drug.

Poppers work by dilating (opening) blood vessels and increasing blood flow – this gives a rush of blood to the head causing a short-lived ‘high’ feeling. Increased blood flow also explains the desired effects of relaxing muscles (which helps with sex, particularly anal), improving erections and enhancing sexual pleasure.

Negative effects of increased blood flow include a drop in blood pressure (which can make you feel dizzy), headache, feeling sick and flushing – mixing poppers with alcohol may make these worse and you should avoid poppers if you take blood pressure medication or Viagra for the same reason. People with heart problems or an eye condition called glaucoma should avoid poppers completely.

Side effects of the liquid itself include skin burns around the nose and mouth. Some men find poppers make getting an erection more difficult. Other harms are rare and include abnormal heart rhythm, visual damage (mainly seen in people who use poppers regularly and long-term – if you get changes to your vision seek medical advice) and a condition that affects the ability of your blood to transport oxygen – if you look blue or feel very unwell go to an Emergency Department and tell them you have taken poppers so they do the right tests. Don’t drink poppers – that can be fatal.

Studies show that people who use poppers have more sexual partners – people who also take crystal meth or drugs like Viagra are also more likely to have condomless sex and more likely to acquire HIV (though this is less likely now that most people with HIV are on treatment with an undetectable viral load meaning ZERO risk of transmitting the virus to sexual partners).

What about the law? A “Psychoactive Substances Act” in 2016 meant many drugs formerly considered ‘legal highs’ were not legal anymore. However, because the ‘rush’ from nitrites is not a direct effect on the brain, but an indirect effect from increased blood flow, poppers are not ‘psychoactive’ so are not illegal to possess or use. It’s a different matter if you sell poppers though – as they’re classed a medicine strictly speaking they should only be sold by licensed retailers (like high street chemists) – this is why they are sold under different names. Poppers aren’t addictive though if you use them regularly you might find you need to inhale more for the same effect. Also, unlike many drugs, there haven’t been any issues with impurities in poppers, the effects should be fairly predictable.

So, considering how often they are used, harm from poppers is very uncommon and mainly short-term side effects like headache, dizziness and skin irritation. Remember poppers are highly flammable and if you are using poppers during sex with new partners remember to get regular sexual health check-ups. Many clinics offer online testing including ours – check out the CNWL sexual health website at sexualhealth.cnwl.nhs.uk and you can have a test kit sent out within a few days!

The Boyz Doc is Dr Laura Waters, an HIV and sexual health consultant at the Mortimer Market Centre in central London. Dr Laura answers your questions every week in Boyz. If you have a question for Dr Laura please email her at boyzdoc@boyz.co.uk

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