New laws relating to the sale of alkyl nitrite products – also known as 'poppers' – come into effect on 1 February 2020.
The changes, made through the Therapeutic Goods Administration (TGA), have created general confusion and led to concerns amongst the homosexual and bisexual community, who feel they are being unfairly targeted.
What Are Alkyl Nitrites?
Alkyl nitrites are the broad chemical name for a range of psychoactive chemicals including amyl nitrite, isoamyl nitrite, isopentyl nitrite and isopropyl nitrite.
The substances have been used to relieve a range of medical conditions, including angina and other heart conditions. But they are also used recreationally as a sexual aid, predominantly by homosexual and bisexual men.
The primary effect of ingesting alkyl nitrites is an increased heart rate and blood flow throughout the body.
Inhalation has a relaxing effect on involuntary smooth muscles, such as those in the throat and anus. As a result, the substances are used as a sexual aid for anal sex by increasing blood flow and relaxing sphincter muscles.
Alkyl nitrite products have been popular within the gay community since the 1970s, when they began to be sold in sex shops and used in gays bars and bathhouses.
Their popularity continues today – according to a recent survey, 32.1% of Australian gay and bisexual men in Australia have used alkyl nitrites as a recreational drug within the last 6 months.
In 2018, the TGA announced it would look at tightening the rules regarding the sale of alkyl nitrites due to their widespread, relatively unregulated sale within sex shops – where they are sometimes labelled as 'leather cleaners'.
The TGA also expressed concerns about a reports that the alkyl nitrites n-propyl nitrite and isopropyl caused eye damage.
The administration originally proposed rescheduling all alkyl nitrite products to Schedule 9 under the National Poisons Standard.
This caused a strong backlash amongst the LGBTIQ community, who saw it as a backdoor way of criminalising them by placing the substances in the same category of many other illegal drugs.
In a joint submission, the Australian Federation of AIDS Organisations and National LGBTIQ Health Alliance argued that the TGA "significantly overstates the toxicity of the substance and the potential for problematic use" and "ignores the benefits associated with the therapeutic use of alkyl nitrites as a muscle relaxant to make sex less painful for gay and bisexual men and sex workers."
In response, the TGA revised its approach to reflect community concerns. A final decision was made on 6 June 2019 to:
- Make all alkyl nitrite products 'prescription-only' substances by default (Schedule 4 under the Poisons Standard).
- Move amyl nitrite in preparations for therapeutic use to a category allowing for over-the-counter pharmacy sales (Schedule 3).
- Up-schedule n-propyl nitrite and isopropyl nitrite to being prohibited substances due to their implication in eye damage (Schedule 9).
This change was cautiously welcomed by some LGBTIQ groups, as it appeared to allow alkyl nitrite products to be purchased via prescription at pharmacies.
But once the dust settled, it became clear that this could lead to practical barriers to access.
Barriers to Access
Many in the LGBTIQ community believe that having to see a doctor for a prescription and then present that prescription to a pharmacist will cause significant embarrassment to members of an already heavily stigmatised community, and is unnecessary given the relative safety of poppers.
There are concerns that many, too embarrassed to go through the process, will simply not seek to access the substance.
In addition, LGBTIQ activist Joshua Badge found that when he attempted to have a prescription filled last year, there was significant confusion amongst both GPs and pharmacists about the relevant rules.
"Multiple doctor's visits, dozens of calls, hours of travel time, weeks of waiting... and nothing to show for it. In the end, LGBTIQ people and folks wanting to have enjoyable sex face a gauntlet of stigma, medical jargon, time-consuming hassle and criminalisation." Badge wrote in Junkee.
The quest to have an amyl nitrite product available over-the-counter at pharmacies also seems unlikely, as there are no current "preparations for human therapeutic use" on the market.
To be readily available on the market a manufacturer would need to register, manufacture and distribute an amyl nitrite to pharmacies, a process which hasn't occurred.
"It may be two years before we see amyl nitrites in the marketplace" predicted Simon Ruth. CEO of Thorne Habour Health, an organisation that specialises in services for the LGBTIQ community.
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