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Dr. Dick on Poppers: Are they harmful?

Dear Devoted Readers,
Many gay and bisexual men continue to ask me if using poppers is harmful. My answer is yes. Inhaling poppers can damage your health. And, recent studies show that guys who use poppers are more likely to take sexual risks, especially anal sex without condoms. Studies also show popper users are more likely to get an STD.

So, if you are going to use poppers, use them in small quantities. Here are some harm-reduction tips from San Francisco. Kudos to DanceSafe, Electric Dreams, and the Sisters of Perpetual Indulgence for putting these together.
Yours in good health,
Dr. Dick

P.S. For more great info on poppers get your hands on NEON's Hot Health Tip Poppers, Viagra™, & Crystal.

Poppers is the popular name for various alkyl nitrites, including isobutyl nitrite, butyl nitrite, and amyl nitrite. Doctors used to prescribe amyl nitrite for heart patients. The drug was packaged in capsules that were broken or "popped" to release vapors. Today, amyl nitrite is made and sold illegally. Most poppers are now isobutyl nitrite or butyl nitrite. They are sold in small brown bottles as video head cleaner, room deodorizer, or leather cleaner. Exact contents of these products are not known and they are not tested for safety.

Poppers are used by sniffing the vapors from an open bottle. The effects are felt within a few seconds and last for 1-2 minutes. Poppers cause muscles around blood vessels to relax, making your heart speed up to pump more blood. Because poppers cause muscles in the anus and vagina to relax, they are often used during sex.


  • If swallowed, call 911 or Poison Control.
  • Contact with the skin causes irritation and rashes.
  • Extensive use can damage the nose and lungs.
  • Some people experience headaches, sensations of spinning or falling, and loss of erection.
  • Poppers are highly flammable. Keep away from cigarettes, candles, and lighters.
  • Avoid forcing air into your nose if it is stuffed. This can cause ear and sinus infections.
  • Studies show that poppers reduce the functioning of the immune system for several days after use.
  • Studies show that guys who use poppers are more likely to get infected with HIV and other STDs.
  • Poppers pose extra risks for people who have suppressed immune systems, heart problems, low or high blood pressure, a history of cerebral hemorrhaging, or anemia. They also pose higher risks for women who are pregnant.
  • Avoid using poppers with other drugs, especially stimulants like speed and cocaine. Combining poppers and Viagra is dangerous and can be lethal, because both cause blood pressure to drop.
  • Poppers can affect your judgment when you are having sex. Put on a condom before you use them.
  • Poppers will burn skin. To prevent spilling, pour a small amount in a separate bottle filled with cotton.

For more info on poppers and drug-related health risks, check out these web sites:
DanceSafe www.dancesafe.org
Electric Dreams www.partysafe.org

Dizzy in Seattle: Poppers and Viagra, a dangerous combination

Hey Dick,
Last Saturday, I got high, took a Viagra ('cause sometimes I get crystal-dick) and went to my favorite bathhouse for my weekly sex-capade. I had fucked around with a few guys and was feeling pretty fine . . . that is until the guy who was fucking me shoved a bottle of poppers under my nose. Afterwards, I got really dizzy and had to go home in a taxi. One of my friends told me that the reason I got dizzy was because of the poppers and Viagra. Also, my friend said that poppers are bad for me. What's up with that?
Dizzy in Seattle

Dear Dizzy,
As you have found out, the combination of poppers and Viagra can be very dangerous, perhaps even deadly. When used at the same time, these drugs can drop your blood pressure. Low blood pressure can leave you feeling light-headed and dizzy and possibly cause you to faint or pass out. It could also cause heart or brain damage. You should consider yourself lucky.

"Poppers" are various kinds of nitrite or nitrate inhalants. Originally, they were made to treat certain heart problems. But in the gay community, they came to be used as sexual (and dance) stimulants. Some gay men inhale poppers to help relax the anal sphincter (butt hole) when they are getting fucked or fisted. Others find that orgasm is more intense with a quick whiff. When you inhale poppers, your blood vessels relax. This allows more blood to circulate through your body. Poppers used to be made of amyl nitrite. Congress banned the sale of some kinds of nitrites in 1990 because they were no longer the best heart medicines. Also, legislators found out that people were using them for fun and that they could be dangerous to a person's health. Popper manufacturers got around this ban by using different kinds of nitrites and calling them deodorizers, among other things. These products have never been tested on humans. So, their short and long-term medical risks are not known.

Poppers, HIV and STDs
The gay community has been looking at the effect of poppers on the immune system for years. Some studies show that poppers weaken the immune system. Other studies show a link between popper use and increased risk of getting HIV and STDs. Right now, no one really knows why this is. But there are a few good explanations.

  • Poppers cause the blood vessels to dilate -- become more open. This makes more blood flow to vessel-rich areas like the anus. This could make it easier for HIV to get into the blood stream during anal sex.
  • Some people use poppers to reduce the pain they feel with anal sex. If you use poppers to have long and hard butt sex beyond your normal limits, tears are more likely to happen. You might not feel a tear inside your butt. Even a tiny tear can be an opening for HIV or other bugs to get into your blood stream.
  • As a group, gay men who use poppers might be having more anal sex or more sex partners. This means more opportunities to get exposed to HIV and other STDs.
The truth is we aren't sure why popper users are more likely to get HIV and other STDs. But studies do show that there is a real connection.

Viagra risks
It is clear that poppers and other products that contain nitrites should not be mixed with Viagra. They should not be used within 24 hours of each other. Viagra works by increasing the flow of blood into the tissues of the penis. Contrary to popular belief, Viagra itself will not increase sex drive. So don't expect to get an instant hard-on unless you get turned-on! Also, it doesn't work for everybody.

Viagra works by inhibiting a certain chemical in the blood. Its' biggest effect is in the spongy tissue in the penis. When this chemical isn't around and you get turned-on, your penis will fill with blood. Like poppers, Viagra can lower blood pressure. So even without poppers, you might get dizzy when your brain doesn't get the blood it needs. Viagra can also cause other side effects like headaches, visual changes, and feeling "flushed."

If you are HIV positive, take protease inhibitors, and also use Viagra, you should decrease the amount of Viagra you take to 25 mg instead of the usual 50 mg dose. The same enzymes in your liver process Viagra and protease inhibitors. When used together, these drugs interact and the liver gets over loaded. It can't clear the drugs out of your body. This can result in too high a level of Viagra in your blood. The side effects can be serious, such as a sudden and severe drop in blood pressure, and, again, fainting, and worse. Too much Viagra can also cause a prolonged erection that could last for hours. Although this may sound like fun at first, a hard-on that lasts more than four hours can be really painful. It can also cause permanent damage to the penile tissue, leaving you a dick that may never inflate again.

If you are going to use poppers or Viagra, please remember these Dr. Dicklines:

  • Don't use poppers and Viagra together or within 24 hours of each other.
  • Don't inhale poppers until your head explodes. Cut back on the amount you inhale. Or cut back on how often you inhale. Cutting back will reduce the chance of significant harmful effects.
  • Know the limits of your anus! A bleeding butt hole is like putting out a welcome mat for HIV. If you are already HIV positive, you could also be more likely to give HIV to your partner.
  • As always, make a sexual safety plan ahead of time. Have condoms and lube on hand. And use them!Editor's Note
  • There was another warning from the people who make Viagra. The printed warning says that using cocaine with Viagra can be extremely dangerous or fatal. We contacted Pfizer, the manufacturers of Viagra, but they did not have any additional information on this issue. Until we know more, people should be very careful when using these drugs together.