Correlational analysis indicated that reported difficulty controlling sexual behavior was associated with having more male sex partners and sex occasions over lifetime and in the 6 months prior to interview, with a greater number of one-time partners and out-of-home partners, with less monogamy, and with being abstinent in the prior 6 months. Mephedrone was classified as a Class B drug in April 2010 but studies and surveys conducted nationwide after this date found ongoing evidence of mephedrone use25 despite the rising price of the drug since classification.8,28 This was also demonstrated in surveys in these nightclubs where mephedrone was the most commonly used drug on the night and also the most favoured drug.25 This study, approximately 18 months since classification, confirms that mephedrone continues to be present. In a study of samples seized from the same nightclubs in 2006, 37.8% of the liquid drugs were aqueous solutions of GHB with the remaining samples containing GBL.18 GHB was classified under the UK Misuse of Drugs Act, 1971 as a class C drug in June 2003. GBL which is a pro-drug of GHB was also classified as a Class C drug in December 2009, but only when intended for human consumption. Most significant in a sexual context, phosphodiesterase-5-inhibitors (the class of medications that includes Viagra®) can interact with NO-releasing agents like nitrite poppers to cause substantial vasodilation, leading to serious cardiovascular complications and possibly death (Cheitlin, et al.
Since the 1980s, amyl nitrite has been restricted to medical uses in the United States and Europe, but a number of related alkyl nitrites continue to be available in legal or semi-legal form, including butyl nitrite, isobutyl nitrite, isopropyl nitrite, cyclohexyl nitrite, and others. Popular brands such as “Rush” and “Jungle Juice” are sold online and in sex shops catering to gay men as “video head cleaners” or “room odorizers.” These traditional poppers contain amyl nitrite, a chemical that relaxes smooth muscle tissue and dilates blood vessels. It therefore remains available when used in products which are not aimed for human consumption such as nail varnish remover and other chemical products. Drugs are often adulterated to enhance desired effects or to mimic the appearance and reduce the proportion of the active drug.26 Adulterants may include active pharmaceutical ingredients, which can have their own inherent toxicity, or pharmacologically inactive substances such as plaster of Paris which has historically been used as an adulterant in foods.27 Although substances such as plaster of Paris have no inherent toxicity, the user may take a number of these tablets/powders and not find the desired effect.
Addy, along with Adams, has mounted a campaign to persuade the authorities not to crackdown on the industry after the bill comes into effect in early April. The news will be a shock for many men who have sex with men, who from April will face a new legal reality. Researcher duty is motivated not just by objective measures of risk, but by harmful stereotypes of gay men and people who use drugs. Finally, not all drugs were analysed and there is the potential, for example, that herbal products assumed to be cannabis may have contained synthetic cannabinoid receptor agonists. It is also likely that some drugs may have been consumed prior to entry to the club and there is the potential that users may source drugs within the nightclubs. Analysis of amnesty bin samples is limited to what was discarded by the clubbers and/or found during door searches prior to entering the nightclub.
In addition, there were no specific measures in place to ensure consistency of the security checks performed at the door by staff which may be another source of bias. This may be in response to the decreased purity of the drug in the tablet form.29 Previous studies from our group have shown significant variation in the MDMA content of MDMA tablets.30 As a consequence, there may be increased health risks as the dose ingested becomes more difficult to control when taken in a powdered form. Their access to these things are denied and pushed underground, and any health consequences are blamed on the individual rather than any accountability being taken by the authorities that pushed us to this point. I conducted a critical interpretive synthesis examining the ways that the dominant medical model of health is influencing poppers literature. These constructs may provide a lens to more critically understand the poppers literature, and other bodies of marginal drug literature. Analysis was performed using close coding of five papers, resulting in two constructs termed “responsible action” and “risk ratchetting”.