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Review • Poppers and sexuality

3 April 2024
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Inhaled alkyl nitrites, commonly known as “poppers”, are psychoactive substances that include amyl nitrite, butyl nitrite and isopropyl nitrite. They present as clear liquids with a strong smell and their effects last for a few minutes. Alkyl nitrites were initially formulated to treat cardiac angina, as their main mechanism of action is vasodilation (increased flow through the blood vessels). Recreational use emerged during the 1960s and increased significantly in the following decade. Poppers have been known to cause side effects such as headaches and dizziness, and they carry a risk of hypotension (increased if combined with erectile dysfunction medications). One of the types of nitrites that can be found in poppers has been associated with a more severe, although rare, complication affecting the retina. In Canada, poppers were regulated in 1985, though sales were later prohibited in 2013. Their purchase, possession, and use remain legal. Poppers have been used in festive contexts for their euphoriant properties, however their primary use is related to sexuality. The desired effects are desinhibition as well as relaxation of vaginal muscles and anal sphincters. The use of poppers before and during sexual activity is particularly common in people who identify as gay, bisexual, or other men who have sex with men (gbMSM), of which rates of lifetime use are as high as 30% to 45%, according to some studies (Schuler & Ramchand, 2023; Vacher et al., 2020) . Most literature examining sexualized use of poppers does not consider that this practice qualifies as chemsex (or “party and play”; PnP). Poppers were once a part of gay culture in some settings. However, studies show that today, their use is less frequent in younger gbMSM populations. A significant portion of the available literature on poppers concentrates on the association between their use and STD risk, an association that exists because of a correlation with more at-risk sexual practices. 

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poppers, volatile nitrite, inhalant, psychoactive substance, chemsex, party and play, gay men, bisexual men, MSM

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