Participants in a new study have reported a small but growing and worrisome trend among some gay American men. Often described as a new way to use poppers or as huffing poppers, in fact, the practice is simply inhaling organic solvents or propellants. This practice appears to have been going on for several years but may be increasing.

“Poppers” originally referred to recreational use of amyl nitrite, a substance that triggers production of nitric oxide and thereby produces a potent effect of widening of the blood vessels. It has been used to enhance sexual experience through relaxing smooth muscle and its mild psychoactive effects. Since the 1980s, amyl nitrite has been restricted to medical uses in the United States and Europe, but a number of related alkyl nitrites continue to be available in legal or semi-legal form.

The current trend does not involve the conventional poppers, which are inhaled directly from a bottle, typically in smaller amounts. The new huffing of solvents and propellants carries substantially greater risk both for death and for long-term neurocognitive damage than does the use of nitrite poppers. These new products now appear to be marketed toward or used by gay men, who may not recognize the difference between huffing solvents or propellants and the use of alkyl nitrite poppers.

It is difficult at this point to estimate the prevalence of this new huffing practice. Little if any systematic reporting on the topics of huffing among gay men, in either scholarly journals or the LGBTQ-oriented press has occurred. Consequently, even addiction specialists and LGBTQ specialist clinicians often have little familiarity with the mechanism of these new poppers and tend to assume that they are more or less similar to other inhalants. Therefore, most physicians likely do not realize that huffing organic solvents represents a marked increase in health risks over alkyl nitrite poppers.

To emphasize the need for education about these potentially dangerous “poppers,” Timothy M. Hall MD PhD stated:

“Clinicians are taught almost nothing about regular nitrite poppers. They are 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 [gay men] to be taking a much more harmful substance than they’re expecting, and for clinicians not to recognize the difference.”

Those healthcare professionals working with gay men should learn the difference between nitrite poppers and propellants or solvents commonly used in huffing.

Clinicians, whose patients exhibit potential symptoms of huffing such as cognitive impairment or neuropathy, or whose patients mention using poppers, should inquire more deeply regarding possible huffing. Education is an important key to prevent risky behavior and the resulting consequences.

Considering talking to a personal healthcare provider about additional health risks.