Health Canada over the years has issued several warnings to the public about the dangers of using poppers. The latest was published by Dave Dormer, CBC News (http://www.cbc.ca/news/canada/calgary/alberta-bc-ontario-sexual-enhancement-recall-1.4490445) on Jan 16 and is titled Sex enhancement pills and what’s know as “poppers” may pose serious health risks, warns Health Canada. I wish to give my opinions on this matter and state my reasons why I believe that “fear mongering” by our country’s health authority may be doing a disservice to the homophile community of Gay/bi men.
Poppers such as Rush, Jungle Juice, etc have been in use for many years by our community and are formulations of a class of chemicals referred to as Nitrites. Amyl nitrate was the first to be adopted by the community and followed by iso butyl or isopropyl nitrate. These drugs are used in medicine because of their effect on smooth muscle causing a relaxation of said muscle with dilatation of the blood vessels which leads to the sensation of warmth throughout the body but most noticeable in the face and a sensation of feeling flushed. The increased blood flow to the brain produces a sensation of euphoria. The anal sphincter is a smooth muscle and poppers may help to relax the sphincters making anal penetration more comfortable. Hence their popularity in gay culture.
Health Canada warns “ the products (poppers) are labelled as having been “assessed for efficacy and quality” when in reality, they have not passed inspection and could include extra ingredients, including prescription drugs at doses exceeding the recommended daily limit. Some of those prescription drugs include Sildenafil (Viagra), Tadalafil (Cialis) and Vardenafil (Levitra), which are used to treat erectile dysfunction…”.
This statement makes no sense and I suspect is bad reporting. I know of no one who would add viagra or other ED medication to their poppers. Medications for ED work by increasing the blood flow to the penis by relaxing the muscle fibres in the blood vessels of the penis. Bingo…that’s how poppers work. So the risk in combining poppers with drugs for ED, is that opening up the blood vessels in the penis and rest of body will cause a sudden drop in blood pressure with dizzinesss and possible loss of consciousness. But think about it….you would have to have a “very large” penis for it to steal enough blood for you to pass out with a hard on. In my opinion this is fear mongering and is not based on scientific data.
Another possible drug interactions with erectile dysfunction drugs is with blood pressure medications like nitrates and alpha blockers. Nitroglycerine for instance is used for patients who have chest pain from Angina. I agree that those having significant heart disease like angina should probably not use poppers or ED drugs. Blood pressure medications like alpha blockers, Beta blockers and ACE inhibitors are in common use. The risk of using in combination with ED drugs is that they could cause an enhanced effect of dilatation of the blood vessels with the end result that the blood pressure drops causing dizziness or fainting. These possible interactions appear on prescription drug labelling for both blood pressure medications and ED drugs so the public and medical community is adequately warned. It is a big leap of faith to state that poppers could be mixed with either blood pressure medications or ED drugs hence poppers should be banned. Soft drinks could be mixed with both ED drugs and blood pressure medications, yet a can of coke does not contain warnings about posing a “serious health risk”.
I believe that it is fear mongering to make a statement like poppers could contain prescription drugs like ED drugs and blood pressure medications without providing data that show this in fact has occurred. My search of Health Canada’s database failed to provide any cases where this has been reported. There was a previous Serious Health Warning from Health Canada several years ago when distribution of poppers was made illegal . This in my opinion was another example of “fear mongering” and was based on several cases reported to Health Canada where someone had overdosed on drugs, died and poppers were found in their possession. There was no evidence provided that the case subjects had used poppers or did the cases mention what other drugs were found in the blood of these overdose victims. I believe, it is much more likely that the cause of death was from heroin overdose or that their drug of choice was laced with fentanyl or other similar drug.
This leads to a discussion of the harm that fear mongering may produce. If sexually active adults are discouraged from use poppers, they are likely to try more dangerous drugs such as coke, or heroin or ecstasy which are very likely to be tainted with fentanyl. We all know the ravages of fentanyl to our community presently so in the author’s opinion, our Government Agencies like Health Canada should focus their energy on fentanyl rather than poppers. The basic principle of “harm reduction” is to legitimize the least harmful option. This is what our government is doing with cannabis. By decriminalizing cannabis, it is expected that the harmful behaviours associated with underground distribution of cannabis will be reduced. The same principle should be adopted with poppers since it is the least harmful option.
Maurice Genereux MD