To begin with, what are alkyl nitrites, the drugs at the center of this controversy? Essentially, alkyl nitrites are any chemical with the general formula R-O-N=O, where the R is any organic (carbon containing) subgroup. Admittedly, this is a rather dull description of a drug with a long and colorful history. Unbiased Internet sources reviewing the history of alkyl nitrites are, as I quickly found, few and far between. A two-hour search on the subject still left much to the imagination. Fortunately for the frustrated researcher, there is always Wikipedia. According to the cyberspace encyclopedia, amyl nitrite, the most familiar form of the chemical, has been used for over 150 years as a treatment of angina, or heart pain (Wikipedia 2006). It was also used as part of the treatment protocol for cyanide poisoning. While other drugs have replaced amyl nitrite for this medicinal use, for the last 50 years alkyl nitrites have been used mainly as a component of room odorant products (Wikipedia 2006). Sold in small glass bottles or capsules nostalgically referred to as poppers, in reminiscence of the glass capsules that housed amyl nitrite as a heart medication, these compounds are also widely used as a recreational inhalant to enhance sexual experience (Wikipedia 2006). Because of their ability to relax smooth muscle tissue in the body, which includes the anal sphincter (their success as an angina treatment was based on their ability to dilate the blood vessels), their use has long been popular in the male homosexual population to enhance sensation during anal intercourse and to prolong and intensify orgasm (Wikipedia 2006).
Many of us were first introduced to poppers through Hollywood, which depicted the drug in such cult classics as Score and Fear and Loathing in Las Vegas, and through the mainstream media, which was awash with stories concerning the use of the inhalant in the 1970s and 80s (Wikipedia 2006). Although more popular with adults than youths, the drug has been widely used in rave subculture to enhance the experience of lights and music on the dance floor since the insurgence of the phenomenon in the 1980s (Wikipedia 2006). Currently illegal in the United States after a long and particularly convoluted legal history, poppers are still easily accessible through the Internet and other adult sources (Wikipedia 2006). While the concern over a possible poppers-AIDS connection has certainly lapsed since the near hysteria surrounding this issue in the 1980s, it nonetheless still lingers, albeit under a new guise. Where researchers once looked for a direct connection between compound and disease, findings are more recently presented to support the idea that alkyl nitrites act as a co-factor in the development of Kaposi’s sarcoma in AIDS patients, and also as an immune suppressant accelerating the progression of AIDS. Is it possible that the majority of the world’s AIDS researchers erroneously discounted a link between poppers and AIDS? It’s an interesting possibility, but does the link stand up to scientific scrutiny?
