Sexual uses of poppers should weigh against ban, LGBT health advocates warn
The Therapeutic Goods Administration failed to consider the therapeutic uses of alkyl nitrites – including their use in receptive anal sex – when they proposed to ban the inhalants, LGBT health advocates have warned.
The TGA will meet sexual health physician Vincent Cornelisse and community health advocate Daniel Reeders on Thursday after the pair made a submission warning a ban would criminalise the practice of an estimated 90,000 adult gay and bisexual men who use the inhalant during intercourse.
After its interim decision in September, the TGA is conducting consultation on its proposal to ban alkyl nitrites, which has triggered a backlash over its discriminatory impact on gay and bisexual men.
Cornelisse, Reeders and three other co-authors have made a submission arguing that in its interim decision, the TGA failed to properly weigh the risks and benefits of alkyl nitrites, commonly referred to as “poppers”. Amyl nitrate is the most common form of the drug.
Poppers dilate the user’s blood vessels, helping receptive sexual partners comfortably enjoy anal sex. The proposal would list alkyl nitrites in schedule 9, along with the most serious drugs and effectively criminalise possession and use.
The TGA has claimed that there is a “high potential for misuse and abuse of alkyl nitrites for euphoric properties, and as sex aids due to their muscle relaxant properties” in “particular sections of the community”.
Reeders, Cornelisse and their co-authors accused the TGA delegate of “listing the benefits of use as risks of use”, which they argued “perhaps [reflects] a prejudgment of the scheduling decision”.
The authors also submitted the interim decision was contradictory because it claimed poppers had “little or no therapeutic benefit” despite conceding they are used for their “euphoric … analgesic and muscle relaxant effects”.
“Use as sex aids due to their muscle relaxant properties should not be considered misuse and abuse of these substances,” they argued. Instead, this was a “legitimate, beneficial and therapeutic use” of poppers, which help prevent spasms and tearing during anal sex.
The LGBT health advocates also called on the TGA to consider the mental health impact of a decision to “criminalise the practice of an estimated 90,000 adult gay and bisexual men, as well as an undetermined number of queer women, non-binary people, and heterosexual men and women who currently use nitrite inhalants”.
The submission presented evidence that poppers are widely used and adverse events associated with use are relatively uncommon – making criminalisation disproportionate to the risk.
The submission noted that an increase in “adverse events” – including ophthalmological damage – in recent years came after the European Union banned isobutyl nitrite in 2007, suggesting that substitution of isopropyl nitrite may to be blame for vision loss in some users.
In a statement Cornelisse and Readers said they will argue that the TGA could prevent risks of vision loss with “a more limited ban on isopropyl nitrite alone”.
The pair will warn that banning alkyl nitrites might lead to poppers users turning to more dangerous substances, such as “huffing” ethyl chloride or illicit drugs such as crystal methamphetamine.
The submission also notes that former AFP commissioner Mick Palmer warned in September that the proposed ban on alkyl nitrites was unlikely to be effective.
Reeders expressed hope that the consultation “signals the TGA are considering alternatives to prohibition that acknowledge queer and partygoer communities are capable of responsibly managing health risks”.
Cornelisse said the ban “could make patients think twice about telling their doctor about their poppers use”, undermining the “trust and full disclosure” needed for an effective relationship.
“Men who currently use poppers for more adventurous sexual encounters might consider illicit drugs for the same purposes – with greater risks of overdose and dependence,” he said.
A former AFP commissioner has warned the proposed ban on alkyl nitrites was unlikely to be effective.