To date, use of alkyl nitrites as a psychoactive substance among MSM has received little attention in addiction textbooks, where they are subsumed among other inhalants. These substances received little attention in addiction textbooks, and searches in PubMed and Google fail to turn up systematic reporting on the issue. Most addiction textbooks treat nitrite poppers as a marginal footnote in chapters covering other inhalants or so-called “club drugs.” This is partly because they have been largely perceived as a niche, gay drug since the end of the Disco era, and partly because their pharmacology was poorly understood before the 1990s (Moncada and Higgs 1993). Consequently, even addiction specialists and LGBT clinicians often have little familiarity with the mechanism of nitrite poppers and tend to assume that they are more or less similar to other inhalants. Ms Akano was left stunned after she commented that ‘people are born gay’ and Rev Hargreaves replied ‘paedophiles make the same argument’.
Poppers additionally have analgesic and muscle relaxant effects which make sex, particularly anal sex, more comfortable and pleasurable. The Home Office has confirmed that the bill will make poppers illegal, but to date, neither Addy nor Jimmy Adams – the director of the company that makes Pure Gold – have heard from the government about the ban. Additionally, there is no reason to believe that a ban would be effective. The TGA originally proposed the ban because of potential impairment to eyesight after long term, heavy use of poor-quality and poorly stored poppers. “I use poppers. I out myself as a poppers user,” said the MP. “I have been selling this product for 35 years and it was used as a medicine for 100 years before that.” “You can’t die from our product,” he adds. “I don’t know what kind of government would harm businesses and individuals’ lives by making people close down to then reopen again once their scientific findings are done,” he says. Indeed, there is scant evidence that criminalisation helps people, while there is a mountain of research that suggests that harm minimisation strategies, such as pill testing, saves lives.
But the experience of Australian women accessing the morning after pill suggests this may not always be a reality. The Pill had triggered a sexual revolution for the heterosexual community in the 1960s. Now, almost two decades after homosexual acts were legalised, it was our turn. Diligent searches in PubMed and Google have failed to turn up any systematic reporting on the topics of huffing among MSM, in either scholarly journals or the LGBT-oriented press. There is consequently potential here for gay and bisexual men and other MSM to be introduced through sexual partners to the practice of huffing solvents without quite realizing what they are doing. In a context where 80% of gay and bisexual men report using drugs (including amyl) over their lifetime, we might ask: what is drug criminalisation meant to achieve? But whatever the reason might be there is one thing that has the solution that can help them in this endeavor.
Furthermore, clinicians working with MSM should become well-versed on the difference between nitrite poppers and propellants or solvents commonly used in huffing, so they can recognize symptoms of use, and inform their patients of the differing health risks. Only London hospitals had dedicated Aids wards where patients could support one another. Support in South Kensington, London, when the reverend made the comparison. In the 1890s, South Australia and Queensland became some of the first jurisdictions in the world to enact laws prohibiting the non-medical use of a particular drug. These laws prohibited the manufacture, sale and use of opium, but, more than that, they specifically targeted Chinese migrants in their wording and application. As the world confronts the Covid pandemic – caused by a virus that, 12 months ago, we knew little about, but for which we now have numerous vaccines and health education campaigns – I am reminded of how very different those early days of Aids were.
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