They are colorless liquids with strong odors, inhaled for their psychoactive effects, sexual arousal and feelings of euphoria. The Psychoactive Substances Act 2016 aimed to ban the production and selling of all ‘illegals’ in UK from April 2016. However, Poppers were exempted as they don’t directly affect the CNS.
The principle chemical ingredient of poppers, Isobutyl nitrite was replaced by isopropyl nitrite since isobutyl nitrite was reclassified as cancer causing agent in 2006. Visual problems have emerged as a little-known side effect since the chemical composition of poppers was changed.
Case studies:
A small study published online in the British Journal of Ophthalmology revealed that new chemical composition of the legal high ‘poppers’ is linked to retinal damage at the back of the eye. Researchers analysed visual disturbances associated with poppers use in 12 (31 to 59 year) old men who underwent treatment at Eye specialty in Southern England between 2013-2016.
They were assessed by ophthalmologists, pictures of their retinas were taken and scanned using OCT (optical coherence tomography). This is like ultrasound, but OCT uses light rather than sound waves to achieve higher resolution pictures of the structural layers of the back of the eye.
The most frequent symptom was impaired central vision such as blurriness, or blind spots (scotoma) with symptoms starting within few hours or days of popper inhalation.
The data collected from three patients who used popper for 20years or more started noticing symptoms only after switching to new brand.
1 of the patient developed central scotoma after using Jungle juice containing Isopropyl nitrite. Previous usage of Jungle juice plus without isopropyl nitrite wasn’t associated with any visual issues.
2nd patient had symptoms after using Berlin XXX containing isopropyl nitrite for the first time. He had no issues while using other brands.
3rd patient frequently used isobutyl nitrites in the 1980’s with no visual side effects. He developed symptoms after heavy use for the first time.
However, visual disturbances linked to poppers usage vary with everyone. Researchers say almost all the users give a clear history of vision changes when switching over brands. Symptoms tend to decline when patients stopped the drug, although it didn’t disappear in all of them.
Drawbacks of the findings:
Researchers caution that most of the tested products were no the exact samples used by patients and the composition might be different when used for inhalation purposes. Popper products should be analysed further as different versions possess varied strengths and contaminants.
The basis of the findings conclude that Isopropyl nitrite is harmful to the fovea-a depression in the retina at the back of the eye which is responsible for visual acuity.
The rate of popper usage is high and of increasing concern because of mounting evidences suggesting serious effects of popper on central vision and less awareness among healthcare professionals.
The exclusion of Popper from legal banning may have given the false impression that they are largely harmless, suggest the researchers.
Researchers conclude that, the retinal damage could often resolve with usage cessation, however the symptoms can be prolonged, and the visual effects of newer brands are unknown. It is necessary to re-evaluate the level of harm associated with poppers usage.