HIV and Alcohol & Drugs

Chemsex

Alcohol

Poppers

Poppers are a nitrite-based drug. Amyl nitrite is used medically to ease the chest pain caused by angina. The drug gets its name from the small glass capsules containing amyl nitrite for the treatment of angina which used to be 'popped' under the nose and inhaled. Amyl and butyl nitrite started to be used recreationally, and have been popular with gay men for many years.

Poppers and the Law

All amyl and alkyl nitrate products (poppers) are now scheduled as a prescription only medication from 6th March 2020.

You can request them from your GP for the relief of painful intercourse. Any doctor can prescribe Amyl and alkyl Nitrites but there is no approved product currently available. An unapproved product in the original form of a single use “popper” format containing pharmaceutical grade amyl nitrate for the treatment of angina pectoris is now available locally (see below for full details). Speak with your GP to assess options to alleviate painful receptive intercourse. Rectogesic may be another option.

It may be possible for you and your doctor to import them as unapproved medicines. Here is some information on importing unapproved medicines:

You should discuss these options with your doctor.

You are able to legally import a 90 day supply under this scheme. The prescription needs to specify the chemical formula, the volume of the bottle, and the number of bottles being prescribed. For example: IsoPropyl nitrite, 30ml x 5 bottles. Previously we were able to access isopropyl nitrite locally if you want to continue using the same chemical formula in the future. You can switch to other chemical formulations but they must match exactly with the wording on the prescription. Other alkyl nitrite used in poppers include: amyl nitrite, isoamyl nitrite, butyl nitrite, isobutyl nitrite, octyl nitrite, pentyl nitrite.

The prescription should be sent to the supplier and included with the shipment in case customs needs to inspect the package. Customs will confirm the contents match the prescription before releasing the product. Customs may connect with your doctor to ensure that the product can be imported.

poppers-aromas.eu from France is a supplier that will include your prescription in the package and has a large range of nitrites available. There is no automatic way to add your prescription to the order, so once you place your order on their website, email them a scan of your prescription with the email subject as "NZ Prescription for Order: " followed by your order reference, to contact@poppers-aromas.eu (Their customer service can be quite busy, so this way they should see your email and prepare the document appropriately before dispatch.)

Dr Torrance Merkle at Hobsonville Family Doctors is able to supply a prescription if you would like to import a small number of bottles (up to 6), for more info see - hobsonvillefamilydoctors.co.nz/post/medsafe-forms-for-amyl-nitrate

Remember: Poppers are for inhalation only and should not be combined with anti-impotence drugs, such as Viagra or Cialis as this can result in a potentially dangerous drop in blood pressure.

Prescription Amyl Nitrite (Poppers) in New Zealand

In March 2020 all amyl and alkyl nitrate products were reclassified as a prescription only medication in New Zealand. While there are currently no approved products available, an unapproved product in a single use format containing pharmaceutical grade amyl nitrate for the treatment of painful receptive intercourse is now available locally. The Amyl Nitrite Inhalant USP comes in a box containing 12 single use inhalants, each containing 0.3mls of pharmaceutical grade amyl nitrate.

Directions for Use:

The inhalant should be held away from the face while activating the package. To break the inner vial, crush ONCE between the thumb and forefinger at the dot located at the centre of the inhalant. Carefully pass the inhalant back and forth close to the nose several times. Discard inhalant after use. Effects usually occur within one to three minutes.

Obtaining a Prescription:

Talk to your GP about obtaining a prescription for Amyl Nitrite. It should be prescribed as:
    Amyl nitrite 294mg /0.3mL inhalation: solution, ampoule
    Sig.: inhaled as directed
    Mitte: 1 x 12 ampoule

If you are not comfortable using our own GP, Dr Torrance Merkle at Hobsonville Family Doctors is able to supply a prescription (up to 3 boxes at a time). The consultation cost is $55 for the initial consult and prescription, with a fee of $19 for each repeat script. For more info see - hobsonvillefamilydoctors.co.nz/post/medsafe-forms-for-amyl-nitrate

Pharmacy Details & Cost:

The unapproved Amyl Nitrite product is currently only available from the following pharmacies. The current cost is $120 per box of 12 ($10 per vial).

    Chemist Plus, 435 Khyber Pass Road, Newmarket, Auckland 1023
    Phone: 09 520 0777 Email: info@chemistplus.co.nz

    Citycare Pharmacy, 419 Queen Street, Auckland CBD, Auckland 1010
    Phone: 09 558 1688 Email: Info@carepharmacy.co.nz

Effects of Poppers

When inhaled, poppers cause blood vessels to dilate, allowing more blood to reach the heart. They also cause blood to rush to the brain, speed up heartbeat and relax muscles, providing an intense high lasting a few minutes at most. The drug is widely used to intensify pleasure whilst dancing and having sex. Sniffing poppers relaxes the anal sphincter muscles allowing anal sex to take place more easily. As poppers dilate blood vessels, many men find that they lose their erection when sniffing them.

General Health Concerns

After-effects of sniffing poppers may include headache, skin rashes, weakness, sinus pains and burns if the liquid comes into contact with the skin. Sniffing poppers can also cause nausea and vomiting. People with heart or lung problems are advised to avoid poppers as they can cause breathing problems. Sniffing of poppers can cause the lips and skin to take on a blue tinge. In some cases vomiting, shock, and unconsciousness may follow. A very few deaths have been reported due to use of poppers.

Poppers and HIV

The long-term effects of poppers has been a matter of considerable controversy, particularly as it was argued that their use caused AIDS and particularly Kaposi's sarcoma. However, this view is not supported by any scientific evidence and studies comparing the effects of poppers on HIV-negative and HIV-positive gay men found that only those with HIV suffered any immune damage or progressed to AIDS. However, some animal studies have shown that poppers can suppress immune responses and can have cancer-causing effects. These studies have been criticised because of the relatively large amounts of nitrites given to animals. Any long-term immune damage or cancer-causing effect in humans remains to be proven.

Poppers and Interactions with Medicines

There are no documented interactions between drugs used to treat HIV and poppers.

However, sniffing poppers after taking anti-impotence drugs, such as Viagra or Cialis can result in a potentially dangerous drop in blood pressure.

The potential dangers from sniffing poppers after taking Viagra or Cialis are increased if you are also taking a protease inhibitor as part of your HIV treatment.

Protease inhibitors cause the amount of Viagra or Cialis in the blood to increase, and for this reason it is recommended that people prescribed protease inhibitors take only half the normal dose of Viagra or Cialis and you are recommended not to use poppers at the same time.

Practical Issues

As with any drug it may be wise to consider how using poppers affects your wider health and lifestyle, particularly if you are using poppers with other recreational drugs or alcohol.

Some people report that using poppers may act as a trigger for unprotected sex and if this is the case you may wish to have a strategy in place to help you manage this. There is also some evidence that HIV-negative men who use poppers and have unprotected sex have an increased risk of infection with HIV.

The above information sourced and edited for New Zealand form contained on www.aidsmap.com
It is intended to support, rather than replace, consultation with a healthcare professional. Please talk to your doctor or another member of your HIV specialist for advice tailored to your situation.

If you find that you can not control your use of alcohol or other drugs, would like to cut back or stop or would like any other support in this area, Body Positive may be able to help.

To talk to us about getting help, please contact us on 0800 HIV LINE

The NZ Drug Foundation has resources on being safer when using alcohol or drugs. They have also released The Level as a straight up guide for people who use drugs.

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