It is well-known that “huffing” - inhaling organic solvents or propellants to achieve a “high” - is extremely dangerous, but less well known is that newer replacement products primarily used by homosexual men, called “poppers”, actually contain harmful solvents and propellants and pose the same health risks as huffing. 

The original poppers, based on alkyl nitrites and related to the medication amyl nitrite, got the name from their glass vials that “popped”, and they have been popular among gay men due to mild psychoactive effects and relaxing of smooth muscle, used to enhance sexual experience. 

New poppers, using brand names such as “Maximum Impact”, can instead cause the damaging health effects associated with harmful inhalants – delirium, potentially permanent impairment in memory and executive functioning, neuropathy and a rare but fatal arrhythmia in some individuals known as “sudden sniffing death”. 

Though the products are primarily used in gay culture, these dangers have gotten essentially no recognition in the LGBT press. Less surprising, due to their newness and the fact that toxicology researchers often only study something after it gets mainstream attention, is that searches in PubMed and Google fail to turn up systematic reporting on the issue. Depictions of huffing poppers have been seen in MSM-oriented online pornography since 2010.

The authors of the new analysis believe gay men can easily be introduced to these products through sexual partners without realizing the substances they are inhaling. That means clinicians must also recognize the increased risk in inhaling solvents over alkyl nitrite, despite the identical name.

Co-author Timothy M. Hall MD PhD has stated, “Clinicians are taught almost nothing about regular nitrite poppers. They’re little more than a footnote at the back of most addiction textbooks, lumped in with sniffing glue and huffing aerosols, even though the physiologic effects are quite different. Gay and bisexual men, on the other hand, have little exposure to huffing but tend to think of nitrite poppers as fairly benign. There’s a real risk here for MSM to be taking a much more harmful substance than they’re expecting, and for clinicians not to recognize the difference.”

Citation: Timothy M. Hall MD PhD, Steven Shoptaw PhD, Cathy J. Reback PhD, Sometimes Poppers Are Not Poppers: Huffing as an Emergent Health Concern among MSM Substance Users, Journal of Gay&Lesbian Mental Health, DOI: 10.1080/19359705.2014.973180