Volatile substances

Alkyl nitrites

Alkyl nitrites are related to nitrous oxide (laughing gas) and are clear yellow volatile liquids. They are available for sale at pubs, clubs and some retail outlets such as sex shops and record shops, and by mail order.

Drug name	Brand name	Street name
Amyl nitrite		Poppers
Butyl nitrite	Liquid Gold, TNT, Ram, Rush	Poppers
Isobutyl nitrite

Drug effects
Vasodilators - cause dilation of the blood vessels leading to the heart. This is accompanied by a drop in blood pressure and increased heart rate. Users report a 'rush' and experience euphoria and dizziness. Effects are virtually instantaneous and last 2-5 minutes. Nitrites also increase sexual arousal and cause the rectal sphincter to relax, easing anal intercourse.

Therapeutic use
Amyl nitrite is used as an antidote to cyanide poisoning. Butyl and isobutyl nitrite have no recognised medical use.

Street use
Inhaled from bottle or cloth containing substance. Alkyl nitrites are used mainly by members of the male gay community who inhale the volatile fumes to enhance sexual arousal and performance. Recreational and experimental use have also been reported among other groups.

Dependency
Tolerance develops within 2-3 weeks if used on a daily basis, but this is lost following a few days of abstinence. Dependency does not appear to be a problem.

Withdrawal
No reports of withdrawal symptoms.

Long term use
Alkyl nitrites are excreted rapidly from the body and there do not appear to be any serious consequences of long term use in healthy adults. People with a history of heart problems and glaucoma may be at risk because of increased strain on the cardiovascular system.

Overdose risk
Excessive use can lead to lack of oxygen in the blood. Users become cyanosed which gives their skin and lips a blue colour. This is usually accompanied by severe vomiting and can lead to clinical shock and loss of consciousness. Deaths have occurred when nitrites have been swallowed.

Legal status
Amyl Nitrite is a Prescription Only Medicine. Butyl and isobutyl nitrite are theoretically unrestricted. In a test case, however, a shopkeeper was found guilty of selling nitrites and fined £100. The Royal Pharmaceutical Society of Great Britain successfully argued that, as they are chemically similar to amyl nitrite, they should be treated in law as if they were amyl nitrite.

Special note
There are reports of the use of Viagra with amyl nitrite, which - like Viagra - causes a drop in blood pressure. This can result in dizziness, fainting, heart attack or stroke.