Search

When inhaled, poppers products (alkyl nitrites) relax smooth muscle tissue and produce a pleasant "rush." As such, they are used by some gay, bisexual, and other men who have sex with men (sexual minority men), including during anal intercourse. In 2013, Health Canada cracked down on poppers sales by introducing threats of fines and imprisonment and seizing poppers in stores and at the border. While no new legislation was introduced, Health Canada takes the position that poppers fall within the definition of a "drug" under the Food and Drugs Act because they "modify organic function" in humans. This crackdown has not prevented poppers use and has added harms related to an illicit and unregulated drug supply. In an effort to reduce harms and advance more equitable and public health-centred approaches to poppers drug policy, we discuss how a series of anticipated outcomes (accessibility, equity, consumer safety, commercial feasibility, and stigma) relate to the following alternative approaches to regulation: (1) poppers as a prescription medicine; (2) poppers as a non-prescription drug (likely accessible 'over-the-counter'); (3) poppers as a consumer product rather than just a medicine; and (4) ending the crackdown without legislative changes. To improve health equity and reduce harms among sexual minority men in a way that is politically and commercially feasible, we recommend the last approach-ending the crackdown without legislative changes-including ceasing the confiscation of poppers products in stores and at the border., Competing Interests: Declarations of Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Background: Poppers (alkyl nitrites) are vasodilators used by many gay, bisexual, and other men who have sex with men (GBMSM) to relieve pain, enhance pleasure, and facilitate penetration during sex. In 2013, the Canadian government cracked down on the sale of poppers products, however prevalence of poppers use among GBMSM in Canada remains high. Poppers have been studied by medical researchers since the 1980s, yet qualitative and community-based research to inform federal policy, remains somewhat less common., Methods: We conducted a critical interpretive synthesis (CIS) to better understand poppers health literature using the medical model of health as a point of reference. Analysis was performed using inductive and deductive methods including reflexive note-taking, mind-mapping, and close coding. 153 publications were identified to inform this review of which 5 were chosen for coding based on a purposive sampling framework., Results: Our findings are unified within a theoretical construct we term responsibility. Responsibility is a construct we use to describe the bias we identified in health sciences literature regarding poppers use that tends to exaggerate the necessity for poppers cessation, and devalue both the benefits of poppers use and the perspectives and experiences of people who use poppers. The emphasis on individual behavior change within the literature appears to be motivated less by objective measures or assessments of health risks and outcomes, and more by harmful stereotypes that position gay men and people who use drugs as inherently irresponsible., Conclusion: We conclude by discussing how these findings have important implications for the review of current policy on poppers sales in Canada which remains influenced by a literature base prejudiced by factors such as homophobia, heteronormativity, and drug stigma, and recommend areas for future work., Competing Interests: Declarations of Interest The authors declare that they have no competing interests., (Copyright © 2021 Elsevier B.V. All rights reserved.)