A 2013 federal crackdown on alkyl nitrites, commonly known as “poppers,” may be putting gay, bi and other men who have sex with men at risk by driving them to access an unregulated – and potentially unsafe – supply, according to a new study from researchers at the British Columbia Centre on Substance Use (BCCSU) and the University of British Columbia (UBC).
The study, published today in the International Journal of Drug Policy, describes how government restrictions limiting the availability of poppers risk worsening health inequities experienced by sexual minority men.
“Sexual minority men are forced to buy poppers illicitly and from untrusted sources, and our research shows that this is a worry for many young men in that community. Health Canada’s policy on poppers is undermining the ability of sexual minority men to make safe and informed decisions.” says Dr. Rod Knight, Research Scientist at the BCCSU and senior author on the paper. “The crackdown on poppers needs to be revisited as a matter of urgency, especially given that it is occurring against the backdrop of existing health inequities experienced by sexual minority men and Two-Spirit, lesbian, gay, bisexual, transgender and queer people (2SLGBTQ+) more generally.”
Researchers from the BCCSU examined the experiences and views on poppers of 50 young (aged 18-30) sexual minority men in Vancouver, Canada. The study found that many young sexual minority men associated poppers with their identities as gay and bi men, and used poppers as a means of enhancing sexual experiences and avoiding injury. However, participants in the study also expressed uncertainty and concerns over the regulatory framework surrounding poppers, as well as about the actual health risks related to poppers use. In general, participants were unclear on how to source poppers from safe, reliable and non-judgmental sources, owing to a federal “crackdown” on poppers in force since 2013.
At that time, Health Canada initiated enforcement action on poppers, severely restricting their availability through retailers by means of product seizures and warnings of fines and imprisonment. A 2013 public communication from Health Canada stated that “[in] Canada, products containing alkyl nitrites are considered drugs under the Food and Drugs Act and must be authorized by Health Canada to be legally sold.” As of May 2019, no such products had been authorized for sale in Canada.
However, data collected by the Community-Based Research Centre (CBRC) in Vancouver has found that the prohibition on poppers has been ineffective at limiting access and consumption, forcing gay, bi and other sexual minority men in Canada to purchase unregulated and potentially harmful products from untrusted sources, putting their health at risk.
“Survey data from across the country indicate that in spite of the crackdown on poppers, people continue to use them. For many men who have sex with men, alkyl nitrites are the only product that allow them to have enjoyable sex without injury,” says Len Tooley, Advancement and Evaluation Director of the Community-Based Research Centre. “Health Canada should reconsider its policies on poppers – which amount to an effective blanket ban. Consultation with the affected community should be at the heart of this process.”
In Canada, the use of poppers has been common in nightlife and sexual contexts since the 1970s, predominantly among gay, bi and other men who have sex with men. When inhaled, poppers heighten the experience of pleasure and cause the dilation of cerebral blood vessels, giving the user the perception of a “rush.” Poppers also induce the relaxation of smooth muscle and prevent spasm and injury (e.g. tearing of the inner sphincter) during receptive anal intercourse.
“The evidence is clear that this ban on poppers is both discriminatory and ineffective, and must be reversed,” says Richard Elliott, Executive Director of the Canadian HIV/AIDS Legal Network, an organization that is advocating alongside the BCCSU and CBRC for a review of Health Canada’s policy on poppers. “Regulation must be careful, nuanced, grounded in science and made in consultation with affected communities.”