Alkyl nitrites (amyl)

How are they used?

Alkyl nitrites are inhaled, most often directly from the bottle.¹

Never swallow or inject alkyl nitrites. Incorrect use can cause serious harms including blindness, brain damage, organ failure and death.¹

Alkyl nitrites are used for their muscle relaxing and euphoric effects.¹ They’re commonly used to enhance sexual experiences.⁵ They’re also used in social settings to experience a general sense of pleasure and euphoria.⁶

Alkyl nitrites are often labelled for other uses, such as a boot/leather cleaner, room deodoriser or nail polish remover.¹ These labels often state ‘not for inhalation’, which can lead to confusion and, in some cases, people swallowing it instead.¹

Effects of alkyl nitrites

Use of any drug can have risks. It’s important to be careful when taking any type of drug.

Alkyl nitrites will affect everyone differently, based on:

• size, weight and health
• whether the person is used to taking it
• whether other drugs are taken around the same time
• the amount taken
• the strength of the drug
• environment (where the drug is taken)

The effects of different alkyl nitrites are similar, but some are more potent than others.⁷ Isopropyl and propyl nitrites are the strongest, followed by isobutyl or butyl nitrites and amyl nitrite.⁷

Onset and duration of effects

The effects are usually felt straight away, and last for around two to five minutes.^{1, 8}

Effects

They include:

• muscle relaxation, including for the purpose of sex
• euphoria
• increased skin sensitivity and sensual awareness
• increased heart rate
• low blood pressure
• skin irritation
• nose bleeds
• flushing of the face
• warming sensations.^{1, 9}

Inhaling a large dose or repeatedly inhaling alkyl nitrites can also cause:

• abnormal heart rhythm
• headaches
• nausea
• blurred vision
• dizziness or loss of coordination
• fainting.⁷

If someone is experiencing the above symptoms, sit them down so they don’t hurt themselves if they faint.⁷

Impact of mood and environment

• Drugs that affect a person’s mental state (psychoactive drugs) can also have varied Set: a person’s state of mind, previous encounters with psychedelic drugs, and expectations of what’s going to happen. For example, feelings of stress or anxiety before using alkyl nitrites may result in an unpleasant experience and make those feelings worse.¹⁰
• Setting: the environment in which someone consumes alkyl nitrites – whether it’s known and familiar, who they’re with, if they’re indoors or outdoors, the type of music and light. For example, using alkyl nitrites in a calm, quiet and relaxed environment can lead to, or contribute to, a pleasant experience but being in a noisy, crowded place may result in a negative experience.¹⁰

Being in a good state of mind, with trusted friends and a safe environment before taking alkyl nitrites reduces the risk of having a ‘bad’ experience.

Overdose

Swallowing alkyl nitrites is extremely dangerous and can cause death.¹ It interferes with the blood’s ability to transport oxygen through the body, a condition called methaemoglobinaemia.¹ Call an ambulance straight away if you or someone else has swallowed alkyl nitrites – even if no symptoms are present.

Inhaling too much of an alkyl nitrite rarely causes the same effects as swallowing. However there is still a possibility of death or serious injury from inhaling a lot of poppers over a long period of time.⁷

Call triple zero (000) and request an ambulance if you or someone else has any of the following symptoms (emergency services are there to help and can provide instructions over the phone):

• blue-greyish skin discolouration
• slow breathing
• loss of consciousness.^{1, 7}

Mixing alkyl nitrites with other drugs

Mixing alkyl nitrites with other drugs can have unpredictable effects and increase the risk of harm.

Mixing includes using more than one drug (including alcohol or medications) at the same time, or one after another. You should also consider what drugs you’ve taken in the last 24 hours.

• Alkyl nitrites + other vasodilators such as Viagra and Cialis: can cause cardiac arrest and death.¹¹
• Alkyl nitrites + stimulants: increases the strain on the heart, putting the whole body under extra stress.^{11, 12}

Using more than one drug or type of drug at the same time is called polydrug use.¹³

Reducing harm

There are ways you can reduce the risk of harm when taking alkyl nitrites:

• use somewhere you feel safe and with trusted people you are comfortable with.
• ‘start low, go slow’: try a small amount first and wait a while to see the effects.
• use while sitting or lying down to prevent injury if you fall or lose consciousness
• never swallow, inject or take any way other than inhaling.
• don’t use near lit cigarettes, candles, or any other open flames, they are flammable
• inhale directly from the bottle, using cloth or cigarette increases the risk of skin irritation
• keep the liquid away from your skin and eyes, as it can cause serious chemical burns
• if spilled on skin, wash with water immediately, if it’s in your eyes, seek urgent medical help
• isopropyl nitrite and N-propyl nitrite may have a higher risk of harms than other nitrites, because of this it’s recommended to avoid taking these.^{8, 11, 14, 15}

Some people are at an increased risk of experiencing harmful and even potentially deadly effects from using Alkyl Nitrites and should avoid using them, these include:

• people who are anaemic
• people who have glaucoma
• pregnant people
• people with a heart condition
• people who have increased pressure within the skull (head injury or bleeding in brain).^{11, 16}

Coming down

Not long after the effects wear off, you may experience comedown effects for around 1-5 minutes.¹⁵ These effects include:

• headaches
• dizziness
• nausea.¹⁷

Long-term effects

Long-term effects can vary depending on how much, how often and how alkyl nitrites are consumed.

The risk of experiencing significant harms from the long-term use of alkyl nitrites are generally low.

One of the more common effects of long-term, frequent use is a rash around the mouth, nose and eyes, or any skin that is in regular contact with the vapour.¹

There are also some uncommon, including potentially life-threatening, conditions that can be caused by long term use of alkyl nitrites. These include:

• respiratory complications, including inflamed or swollen airways and coughing up blood.
• a reduction in the immune system’s ability to fight off infections, these effects are reversed after a person stops taking alkyl nitrites.
• loss of vision, most commonly associated with propyl or isopropyl nitrite, some people reported their vision returns with time after they stop taking alkyl nitrites, but others have experienced long-term vision loss.^{1, 18}

For people who have glaucoma there’s an additional risk of fluid pressure build-up within the eye.^{9, 14}

Alkyl nitrites and mental health

There is no significant relationship between the use of alkyl nitrites and poor mental health.¹⁹

Tolerance

Regularly taking alkyl nitrites may lead to developing a tolerance, which means you need to take larger amounts to get the same effects, but this hasn’t been proven through research yet.¹

Dependence

Alkyl nitrites will not cause a physical dependence, however there are reports of some people feeling psychologically dependent on them for engaging in sex.

Withdrawal

Withdrawal refers to the symptoms that can occur when someone who is dependent on a drug, or who has been using it regularly over time, stops or reduces their use.²⁰

Withdrawal can include physical symptoms (such as headaches, or nausea) and psychological symptoms (such as anxiety, or depressed mood).²⁰

Symptoms - including how strong they are and how long they last - will vary depending on the type of drug and a person’s history of use.²⁰

There are no known alkyl nitrite withdrawal symptoms, however if you experience symptoms after stopping or reducing your use, or have concerns, contact your doctor or the help and support services listed below for advice and support.⁸

Pregnancy and breastfeeding

It’s believed that nearly all inhalants cross the placenta and enter the baby’s bloodstream. For this reason, it’s important to stop using inhalants during pregnancy.²¹

Alkyl nitrites may also harm the unborn baby by significantly reduce the blood flow from the pregnant person to the baby.²²

The effects of alkyl nitrite use during breastfeeding are still being researched. While inhalants are unlikely to pass through breast milk to the baby in a significant amount, breastfeeding while affected by alkyl nitrites is not safe or recommended.²¹

Getting help

If your use of alkyl nitrites is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about a someone, there is help and support.

• Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs
• Use the Path2Help portal to get matched with information and services specific to your needs
• Search our Help and Support database directly to find your preferred supports, by adding your location or postcode and filtering by service type.