Poppers are a nitrite-based drug. Amyl nitrite is used medically to ease the chest pain caused by angina. The drug gets its name from the small glass capsules containing amyl nitrite for the treatment of angina which used to be 'popped' under the nose and inhaled. Amyl and butyl nitrite started to be used recreationally, and have been popular with gay men for many years.

In the UK poppers are sold in small brown bottles, which contain a liquid form of butyl nitrite. It is very rare for amyl nitrite to be used as poppers, as its sale is illegal without prescription under the Medicines Act. The legal status of butyl nitrite has been the subject of court cases in recent years. The sale of butyl nitrite poppers is legal, largely because they are sold as 'aromas' or 'room odourisers' rather than as a drug to be inhaled. The possession of poppers, in either amyl or butyl nitrite form, is legal.

When inhaled, poppers cause blood vessels to dilate, allowing more blood to reach the heart. They also cause blood to rush to the brain, speed up heartbeat and relax muscles, providing an intense high lasting a few minutes at most. The drug is widely used to intensify pleasure whilst dancing and having sex. Sniffing poppers relaxes the anal sphincter muscles allowing anal sex to take place more easily. As poppers dilate blood vessels, many men find that they lose their erection when sniffing them.

After-effects of sniffing poppers may include headache, skin rashes, weakness, sinus pains and burns if the liquid comes into contact with the skin. Sniffing poppers can also cause nausea and vomiting. People with heart or lung problems are advised to avoid poppers as they can cause breathing problems. Sniffing of poppers can cause the lips and skin to take on a blue tinge. In some cases vomiting, shock, and unconsciousness may follow. A very few deaths have been reported due to use of poppers.

The long-term effects of poppers has been a matter of considerable controversy, particularly as it was argued that their use caused AIDS and particularly Kaposi's sarcoma. However, this view is not supported by any scientific evidence and studies comparing the effects of poppers on HIV-negative and HIV-positive gay men found that only those with HIV suffered any immune damage or progressed to AIDS. However, some animal studies have shown that poppers can suppress immune responses and can have cancer-causing effects. These studies have been criticised because of the relatively large amounts of nitrites given to animals. Any long-term immune damage or cancer-causing effect in humans remains to be proven.

There are no documented interactions between drugs used to treat HIV and poppers.

However, sniffing poppers after taking anti-impotence drugs, such as Viagra or Cialis can result in a potentially dangerous drop in blood pressure.

The potential dangers from sniffing poppers after taking Viagra or Cialis are increased if you are also taking a protease inhibitor as part of your HIV treatment. Protease inhibitors cause the amount of Viagra or Cialis in the blood to increase, and for this reason it is recommended that people prescribed protease inhibitors take only half the normal dose of Viagra or Cialis and you are recommended not to use poppers at the same time.

As with any drug it may be wise to consider how using poppers affects your wider health and lifestyle, particularly if you are using poppers with other recreational drugs or alcohol.

Some people report that using poppers may act as a trigger for unprotected sex and if this is the case you may wish to have a strategy in place to help you manage this. There is also some evidence that HIV-negative men who use poppers and have unprotected sex have an increased risk of infection with HIV.

This factsheet has been written with UK law in mind. Readers in other countries should be aware that the legal status of poppers may differ from that described in this factsheet.