Poppers* & AIDS
(With Annotated Bibliography)
Poppers* & AIDS
(With Annotated Bibliography)
by John Lauritsen and Hank Wilson
Cover design by Wulf.
Prepared in collaboration with the
Committee to Monitor Poppers
55 Mason Street
San Francisco, CA 94102
[Address no longer valid.]
This publication supercedes POPPERS & AIDS,
by John Lauritsen and Hank Wilson, Second
Edition (July 1985). The earlier work
has been revised and considerably expanded.
Copyright 1986 by Pagan Press
All rights reserved
Printed in the USA
Library of Congress Catalog Card No. 86-60791
I. POPPERS & AIDS
II. NITRITE INHALANTS: A BIBLIOGRAPHY
III. THE POPPERS INDUSTRY AND
APPENDIX A: Koch's Postulates:
The Case Against LAV/HTLV-III's
Being the Sole, Sufficient, or
Necessary Cause of AIDS
APPENDIX B: A Toxicologic Model
APPENDIX C: Occam's Razor:
The Drugs Connection
I. POPPERS & AIDS
Don't use poppers. This is the first and the last thing to be said about them.
are a liquid mixture of isobutyl nitrite and other chemicals, packaged
in small bottles under such names as “Rush”, “Ram”, “Thunderbolt”,
“Locker Room”, and “Crypt Tonight” (gallows humor?). Poppers are
advertised and sold to gay men, who make up virtually the entire market
for the commodity. When inhaled just before orgasm, poppers seem to
enhance and prolong the sensation. With regular use, they become a
sexual crutch, and many gay men are incapable of having sex, even
solitary masturbation, without the aid of poppers.
have become an accepted, even obligatory part of the gay male lifestyle
in some cities. The odor of poppers is ubiquitous in New York City
bars, backrooms and baths. At gay discos, men shuffle around on the
dance floor, zombie-like, holding popper bottles under their noses.
subject of poppers is one which arouses intense emotions. Ordinarily
rational men become hysterical when it is suggested that the nitrite
inhalants are harmful to the health and may play a role in causing
AIDS. This is understandable. Since poppers have become necessary for
them to function sexually, giving up poppers would seem, at least in
the beginning, like giving up sex itself.
every drug in the U.S. must undergo extensive testing before it can be
sold legally. Not poppers. They are subject to no testing or quality
control whatsoever. In 1981, the Stanford Medical Laboratories tested
some samples of different brands of poppers, and found them to contain
kerosene, hydrochloric acid, and sulfur dioxide, among other impurities.
biggest money-maker in the gay business world is believed to be the
poppers industry. Gross profits were estimated to be $50 million in
1978, and may well be double or triple that by now. (Sigell 1978)
manufacturers have impudently labelled their product a “room odorizer”,
with the astounding consequence that the federal Food and Drug
Administration (FDA), the California and New York Departments of
Health, and other government regulatory agencies have intransigently
looked the other way. What a farce! Not even an idiot would use
poppers as a “room odorizer”. Everyone knows that poppers are inhaled
as a drug. A large and growing body of medical research indicates that
poppers are dangerous, and almost certainly implicated in causing AIDS.
And yet the government agencies blithely accept the lie that poppers
are only a harmless “room odorizer”.
have the appropriate government agencies refused to regulate poppers in
any way? We don't know, but it's doubtful that they really
believe the “room odorizer” marketing subterfuge. If a drug like butyl
nitrite can be marketed as a “room odorizer”, then anything could be
sold as anything. Heroin could be sold as a mosquito-bite remedy (“for
external use only”). Live hand grenades could be sold as “paperweights”.
is commonplace that government regulatory agencies come to be
controlled by the very industries they were intended to regulate. One
recalls the many recent scandals pertaining to the Environmental
Protection Agency (EPA) or, a couple of decades ago, the
subservience of the U.S. Department of Health to the tobacco industry.
The poppers industry has a large war chest, and they know how to
“influence” government agencies.
are now illegal in New York State. On June 18, Governor Cuomo signed
into law Assembly Bill #890, making it illegal to possess or sell
“hazardous inhalants”, including amyl and butyl nitrite, that cause
can be anticipated that some gay men will protest the new law as an
intrusion of the state into their private lives, an infringement of
their right to pursue chemical pleasures.
protests would be misguided. Anyone who has studied the medical
literature on poppers can only applaud the New York State legislature
and Governor Cuomo for having done the right thing. Poppers are
dangerous, and they should never have been sold legally in the first
Poppers as co-factor for AIDS
present, most if not all AIDS researchers believe that an important
role in causing AIDS is played by a virus named
Lymphadenopathy-Associated virus (LAV) by the French scientists who
isolated it in 1983. (The same virus was “rediscovered” in 1984 by an
American government scientist, Robert Gallo, who called it “HTLV-III”,
by which name it is known, for political reasons, in the U.S.)
LAV virus has so far failed to satisfy Koch's postulates; therefore,
its role in causing AIDS remains a matter of conjecture. The
designation, “AIDS virus”, is not scientifically justified; the most
one can say at present is that the LAV virus is associated with AIDS:
perhaps as primary cause, perhaps as a subsidiary co-factor, or perhaps
only as a harmless marker.
several years, government agencies have discouraged any approaches to
AIDS other than the single-infectious-agent hypothesis. Researchers who
advanced drug abuse or multifactorial hypotheses tended to be
ostracized and unfunded. After Robert Gallo's “discovery” of HTLV-III,
it became obligatory to regard this as the primary or even sole cause
of the Syndrome.
preliminary testing has shown that up to 80% of urban gay men have LAV
antibodies, and yet only a minute percentage of them have developed
AIDS. It would seem that LAV is not sufficient by itself to cause AIDS,
that co-factors (like drug abuse) may be necessary for AIDS to develop.
AIDS researchers now believe that mere exposure to the putative virus
is not sufficient to cause AIDS-that a necessary precondition may be an
alreadyweakened immune system. Attention is being focussed on possible
co-factors in the lifestyles of gay men and IV drug users, the two
major risk groups.
effects of amyl nitrite (the pharmaceutical predecessor of “Rush”,
“Locker Room”, etc.) have been known for years. With the outbreak of
the AIDS epidemic, medical researchers began to suspect that poppers
may play a role in causing AIDS in gay men-either as the primary cause
or in conjunction with other factors. (Durack 1981)
gay men, physicians, or AIDS researchers seem to be aware how extensive
and powerful the evidence against poppers is. Anyone who has studied
even a portion of the medical literature can only shake his head in
amazement that this dubious commodity has not been banned — except in
Massachusetts, Wisconsin, and, as of June 1985, New York State. (In
Massachusetts, where poppers have been banned for years, only 378 cases
of AIDS had been reported as of 31 March 1986. In contrast, there had
been 6265 cases in New York, where poppers had been sold legally in sex
shops, baths, discos, and even neighborhood smoke shops.)
evidence against poppers has continued to accumulate. For several
years, major articles in the most prestigious medical journals in the
world have discussed the immunosuppressive and other harmful effects of
poppers, and their possible role in causing AIDS. The question is no
longer whether, but rather how much of a role poppers play in causing
AIDS. Are poppers a relatively minor or a very major co-factor?
So far as the effect of poppers on the health, there is no doubt that
they are harmful. For some individuals, even a single episode of
snorting poppers can be life-threatening.
section that follows will summarize medical findings on poppers.
However, the reader should bear in mind that this is a summary of
hundreds of pages of reports and articles. Researchers concerned with
the poppers connection should consult the Annotated Bibliography in
Section II of this monograph.
* * *
THE SCIENTIFIC PICTURE
evidence against poppers comes from many different types of studies,
and is remarkably consistent. Whether from epidemiological, mice, or
laboratory studies, the data support each other in demonstrating the
harmful properties of poppers and implicating poppers in the etiology
of AIDS. Despite rumors which originated with the poppers industry in
1983, there is no evidence that could reasonably be interpreted as
we know very little about the characteristics of people with AIDS. Most
of the published epidemiological studies of gay men with AIDS were
conducted several years ago, and had serious shortcomings. CDC studies,
in particular, tended to be poorly designed, executed, and analyzed. We
cannot assume that gay men diagnosed as having AIDS in 1986 have the
same profile as the first 50-100 gay men with AIDS, who were studied in
the absence of recent, large-scale, well-conducted epidemiological
studies, one may give a cautious hearing to less “scientific” evidence,
such as reports from those who have known many people with AIDS. Such
evidence should be evaluated critically, though it may actually be
worth more than the quantitative “data” from a poorly executed survey.
Following are a few epidemiological highlights:
• 96-100% of the gay men with AIDS used poppers,
usually quite heavily. These men were also heavy users of many other
“recreational” drugs, including amphetamines (“speed”), cocaine,
heroin, quaaludes (“ludes”), LSD, barbiturates (“downers”), and ethyl
chloride. (Friedman-Kien 1982, Haverkos 1982/1985, Jaffe 1983)
• Case-control studies have implicated poppers as a
statistically significant and important risk factor for the development
of AIDS. (Marmor 1982, Newell 1985)
• In gay men who do not (yet) have AIDS, popper usage
is correlated with immunological abnormalities similar to those found
in AIDS patients. (Goedert 1982)
• Among men with swollen lymph nodes (all of whom had
used poppers), heavy popper users were more likely to develop AIDS.
• A recent study compared two groups of gay men who
were antibody positive to the LAV (HTLVIII) virus: people who were
clinically sick with AIDS, and people who were not sick. Usage of the
nitrite inhalants proved to be one of the most important risk factors
for developing AIDS, and especially, Kaposi's sarcoma. The heavier the
popper usage, the greater the risk. (Moss 1985)
• Leaders of People With AIDS, who have known
hundreds of PWA's, state that most of them were heavily into drugs, and
all of them used poppers.
• W.J. Wallace, the manager of the Mineshaft, stated
in an interview, “I really don't know anybody who's had AIDS who hasn't
• Finally, there is the crucial point that for 5
years AIDS, unlike a truly communicable disease, has remained
compartmentalized. Gay men accounted for three-quarters of the AIDS
cases 5 years ago, and account for the same proportion now in 1986.
Poppers are used by gay men. They are used by very, very few straight
men, and by virtually no women at all.
different experiments have demonstrated that poppers are mutagenic.
That is, they cause genes to mutate. (Quinto 1980, Osterloh 1984)
It is very unwise to inhale mutagenic substances, as almost all such
substances are also carcinogenic. If nothing were known about poppers
other than these two studies, they alone would be sufficient warrant
for the categorical recommendation: Do not use poppers.
nitrites like poppers combine with other substances to form deadly,
cancer-causing compounds (N-nitroso compounds, nitrosamines — Jφrgensen
1982, Newell 1984, Osterloh 1984). Danish scientists Karl Jφrgensen and
Sven-Olov Lawesson describe N-nitroso compounds as being so deadly as
to have “the capacity to induce cancer after only one dose”.
AIDS researchers have suggested that poppers may play a role in causing
the cancer, Kaposi's sarcoma, in gay male AIDS patients. KS is found in
about half of the gay men with AIDS, but in a very small percentage of
PWA's from the other risk groups. It is gay men who use poppers, not
straight IV drug users or Haitians.
Blood cell studies (in vitro)
different laboratory experiments have shown that exposure of human
blood cells to amyl, butyl or isobutyl nitrite causes sharp decreases
in immunological function, as well as striking alterations in cell
structure (“cytoplasmic protrusions with pseudopod-like extensions”,
etc.). (Marmer 1982, Hersh 1983, Jacobs 1983)
One research team concluded:
“These abnormalities can help in explaining the role of amyl nitrite
cellular toxicity in immunosuppressed male homosexuals.” (Marmer
Another research team stated:
“These in vitro studies strongly suggest that the inhalant nitrites may
indeed be dangerous, and their use should be condemned by those
physicians who treat patients who use these drugs regularly.”
evidence against poppers comes from experiments on mice, which have
firmly established that poppers suppress the immune system and are
otherwise harmful in vivo (in a living animal).
• Five different studies found that exposure to amyl
or isobutyl nitrite, either through injection or inhalation, caused
immunological deficiency in mice. (Watson 1982, Neefe 1983, Lotzova
1984, Gangadharam 1985, and Ortiz 1985)
One research team concluded:
“The results of these studies indicate that immunosuppression should be
added to the other reasons why isobutyl nitrite should not be used by
man.” (Lotzova 1984)
of these studies further found that the mice exposed to nitrite vapors
suffered gross pathological lung damage, weight loss, and, most
significantly, reversed T-cell ratios:
“Our studies do show that chronic inhalation of AN [amyl nitrite] can
lead to an altered T-cell helper/suppressor ratio, the same phenomenon
which occurs in AIDS victims. It does look, then, that there seems to
be a link between AN inhalation and cellular immunity
depression.” (Ortiz 1985)
• In a sixth study, mice exposed to low dosages of
isobutyl nitrite vapors developed methemoglobinemia and thymic atrophy.
(Lynch 1985) The first finding is relevant, since poppers are known to
cause methemoglobinemia in humans (Horne 1979, Guss 1985) and since
anemia is typically part of the AID Syndrome. (Methemoglobinemia is a
form of anemia where the blood turns brown and where the oxygen supply
to critical organs is reduced.) The finding of “thymic atrophy” is
suggestive. Autopsies of AIDS victims show the thymus gland to be
destroyed in 100% of the cases. No thymus gland, no immune system.
Obviously any drug that destroys the thymus gland will play a role in
• A seventh mice study could not be carried through
to completion. Regardless of whether the isobutyl nitrite was ingested,
inhaled, or injected, all of the mice died. (Maickel 1982)
of amyl nitrite caused a depletion of the helper (T4) T-cells in mice
(Ortiz 1985) and in humans (Gerblich 1984). Some researchers consider
this condition--a reversed T-cell ratio--to be the primary
immunological defect in AIDS patients.
aside from the risk of getting AIDS, poppers are known to be hazardous
to the health in many different ways. Poppers cause Heinz body cell
anemia, methemoglobinemia, lung damage, serious skin burns, death or
brain damage from cardiovascular collapse or stroke, dizziness, and
headaches. Poppers have been used successfully to commit suicide (by
drinking) and murder (victim gagged with sock soaked with poppers).
(Sigell 1978, Horne 1979, Haley 1980, Dixon 1981, Romeril 1981, Guss
1985, Lynch 1985, Ortiz 1985)
AIDS: Why now?
chronology is suggestive: Poppers became a fad among gay men beginning
in 1972, just seven years before the first cases of AIDS began to be
diagnosed. (Newell 1984)
* * *
is obvious from the above that poppers are dangerous and should not be
used by humans or other animals. In the context of the AIDS epidemic,
when keeping one's immunological system up to par is a life or death
matter, the only sane course of action is to stop using poppers
with considerable human resources and millions of dollars committed to
finding a solution, it may very well take many years before researchers
are able to describe, with scientific rigor, how AIDS is caused. In the
meantime, it is imperative that intelligent guidelines for reducing the
risk of getting AIDS, based on existing knowledge, be given now. Lives
are at stake.
light of what is known now, gay men should continue to follow “safe
sex” guidelines. In conservative terms, this would mean either
practising celibacy or limiting sex to simple body contact and mutual
masturbation. The simple rule for safe sex is: “On me, not in
the same time, it is crucial for gay men to bolster their immune
systems by living in a healthy way: eating nutritious food, getting
enough sleep and rest, reducing stress, and getting plenty of exercise.
They should avoid the use of any and all “recreational drugs” —
especially including poppers.
II. NITRITE INHALANTS: A BIBLIOGRAPHY
for Disease Control. “An Evaluation of the Immunotoxic Potential of
Isobutyl Nitrite”. MMWR, pp. 457-58, 64, 9
This news item briefly described an experiment in which mice were
exposed to isobutyl nitrite vapors, in various concentrations, for time
periods ranging from 3 to 18 weeks. It asserted, “None of the animals
exposed to IBN showed any evidence of immunotoxic reactions”.
The poppers industry used this little item as the basis for an
advertising campaign which claimed that poppers had been “exonerated”,
and that there was no connection between poppers and AIDS.
When a report on the mice study was finally published two years later,
it became clear that the MMWR account had been grossly misleading.
The dosages administered were too low to test the hypothesis that
poppers might be immunosuppressive or otherwise harmful to men who
inhaled them as “recreational” drugs. The study had selected exposures
“to mimic an occupational exposure setting...rather than to conduct
brief, high-level exposures to imitate exposure by nitrite
abusers.” (See entries under Lewis and Lynch.)
It should be noted that other mice experiments (Gangadharam, Lotzova,
Maickel, Neefe, Ortiz, and Watson) have demonstrated that mice exposed
to alkyl nitrites do develop immunological deficiency, as well as being
harmed in other ways.
The anonymous author(s) of the MMWR piece stress that the nitrite
inhalants are not harmless, for “these drugs do have toxic effects”,
and they proceed to list a number of toxic effects, ranging from
“dizziness” to “sudden death”. They add that “their role as a cofactor
in some of the illnesses found in this syndrome has not been ruled
D'Eramo, James E. “Poppers: The Writing on the Wall”. New York Native, p. 9, 4-17 June 1984.
This article reports on recent findings that tend further to implicate
the nitrite inhalants as playing a role in causing AIDS.
The popular media are currently touting the LAV/HTLV-3 virus as being
the only cause of AIDS. However, D'Eramo reports that one of the French
scientists who discovered the virus puts forward a multifactorial model
“Dr. J.C. Chermann (a member of the Parisian Pasteur
Institute team that discovered the probable viral cause of AIDS -
LAV-HTLV-3) presented a model for the development of AIDS during a
lecture on May 22 at Sloan-Kettering Memorial Hospital in New York
City. He believes that the T-cell population must be repeatedly
stimulated with foreign antigens (like LAV, sexually transmitted
diseases, and drugs) for full-blown AIDS to develop. Repeated usage of
poppers may play an important role in the antagonistic stimulation
of the helper T-cell population. According to Dr.
Chermann's model, very limited or infrequent exposures to LAV would not
in themselves lead to the development of full blown AIDS.”
“The untoward effects of inhaling poppers are
becoming clearly recognized, especially as a co-factor in the
development of AIDS.”
D.S.; Reisch, R.F.; and Santinga, B.S. “Fatal Methemoglobinemia
Resulting from Ingestion of Isobutyl Nitrite, a 'Room Odorizer' Widely
Used for Recreational Purposes”. Journal of Forensic Sciences, pp.
587-93, July 1981.
A clinical account of a 30-year old black male who died from “acute
nitrite poisoning”. He had apparently swallowed some poppers liquid.
Contains a description of unsuccessful emergency procedures used,
results of the autopsy, as well as a discussion of other butyl
nitrite-related fatalities and the various hazards of alkyl nitrite
David T. “Opportunistic Infections and Kaposi's Sarcoma in Homosexual
Men”. New England Journal of Medicine, pp. 146567, 10 December 1981.
This lead editorial poses the question of why AIDS is apparently
new, since both viruses and homosexuality are at least as old as
“Some new factor may have distorted the hostparasite
relation. So-called 'recreational' drugs are one possibility. They are
widely used in the large cities where most of these cases have
occurred, and the only patients in the series reported in this issue
who were not homosexual were drug users.... Perhaps one or more of
these recreational drugs is an immunosuppressive agent. The leading
candidates are the nitrites, which are now commonly inhaled to
intensify orgasm.... Let us postulate that the combined effects of
persistent viral infection plus an adjuvant drug cause immuno- suppression in some genetically predisposed men.”
Alvin E.; Laubenstein, Linda J.; Rubenstein, Pablo; et al.
“Disseminated Kaposi's Sarcoma in Homosexual Men”. Annals of Internal
Medicine. pp. 693-700, June 1982.
A study of 19 men with KS. “All of the patients had used amyl or butyl nitrite inhalants.”
P.R.J.; Peruman, V.K.; et al. “Immuno suppressive
Action of Isobutyl Nitrite” (Presentation to the International
Congress on Immunopharmacology, Florence, Italy, May 1985.) (Also
press release reported in various newspapers)
at the National Jewish Center for Immunology and Respiratory Medicine
in Denver found evidence confirming long-held suspicions that the
“recreational” use of nitrite inhalants (poppers) greatly increases the
risk of developing the Acquired Immune Deficiency Syndrome (AIDS).
Their studies involved exposing mice to RUSH\ (isobutyl nitrite) “by
inhalation in a closed environment, simulating the practice of the
homosexual patient”. One group of mice was exposed to RUSH\ daily;
another group, every other day; and a third group, twice per week.
According to the principal investigator, P.R.J. Gangadharam, PhD, after
breathing isobutyl nitrite the animals became highly susceptible to
disease and death caused by Mycobacterium intracellulare. This group of
organisms, related to tuberculosis, is among the leading killers of
people with AIDS. Mice of the same breed, who were exposed to the
bacteria but not to the drug, had far lower illness and mortality rates.
The Denver scientists also linked specific, dose-related immune-system damage to isobutyl nitrite exposure:
“The animals exposed to the compound had decreased
numbers of lymphocytes and macrophages, blood cells that are important
in defending the body against infections.”
Dr. Gangadharam made the point that only a very small percentage of
people exposed to the putative AIDS virus (LAV) become sick, and even
fewer develop AIDS. “This makes is very important to investigate other
possible contributing factors.”
The researchers concluded:
“We believe our findings establish that inhaling
isobutyl nitrite should be considered dangerous to homosexuals and
others at high risk for developing AIDS.”
Adi A.; Campbell, Ann E.; Schuyler, Mark R. “Changes in T-cell
Lymphocyte Subpopulations After Antigenic Bronchial Provocation in
Asthmatics”. New England Journal of Medicine, pp. 1349-52, May 1984.
In this study it was found that some kinds of inhaled agents caused a
depletion of the helper (T4) T-cells. Some researchers consider this
condition--a reversed T-cell ratio--to be the primary immune defect in
In a communication to Dr. D'Eramo of the New York Native, Dr. Gerblich
stated: “The same results have been found upon inhalation of
James J.; Neuland, Carolyn Y.; Wallen, William C.; et al. “Amyl Nitrite
May Alter T Lymphocytes in Homosexual Men”. The Lancet, pp. 412-16, 20
This study collected clinical, virological, and immunological data on 2
homosexual men with KS and on 15 healthy homosexual volunteers. Both
men with KS had been regular amyl/butyl nitrite users. Of the men who
did not have KS, 8 were regular nitrite users (1-20 times per month)
and the other 7 were not (i.e., fewer than 10 doses ever).
Immunological abnormalities were found in all of the nitrite users, but
in only one of the non-users. The authors conclude:
“The data suggest that nitrites may be immunosuppressive in the setting
of repeated viral antigenic stimulation and may contribute to the high
frequency of KS and opportunistic infections in homosexual men.”
David A.; Normann, Sven A.; and Manoguerra, Anthony S. “Clinically
Significant Methemoglobinemia from Inhalation of Isobutyl Nitrite”.
American Journal of Emergency Medicine, pp. 46-47, January 1985.
A case report of a 21-year old gay man who almost died from
methemoglobinemia which resulted from an episode of inhaling poppers.
The night before admission to the emergency room he had swallowed
methaqualone (Quaalude\), had inhaled cocaine, and had inhaled
'Hardware' (isobutyl nitrite) every 2-3 minutes for a period of 5-6
hours. His skin was purplish (“cyanotic”), and he had “severe headache,
nausea, vomiting, chest pain, and shortness of breath.” “Arterial
blood gas samples were extremely dark.... Methemoglobin was 37% of all
hemoglobin.” Emergency measures were successful; the patient
survived, and was found to have normal methemoglobin reductase levels.
The authors comment:
“Compared with the patient reported by Horne and
associates [see Horne entry], our patient presented with severe
systemic symptoms, had a methemoglobin level of more than twice that
previously reported, and had normal methemoglobin reductase levels. In
addition, our patient presented more than 12 hours after his last
exposure to nitrites. Considering that the estimated half-life of
methemoglobin is 55 minutes, this suggests peak levels of methemoglobin
were probably considerably greater than those measured.”
This report is important for two reasons: First, it demonstrates that
life-threatening methemoglobinemia can result from butyl nitrite
inhalation, even in an individual whose body has a normal ability to
reduce methemoglobin. Second, it strongly suggests the possibility of
drug interaction effects, whereby the combination of butyl nitrite plus
one or more other “recreational” drugs may be much more deadly than any
one of these drugs by itself.
Thomas H. “Review of the Physiological Effects of Amyl, Butyl, and
Isobutyl Nitrites”. Clinical Toxicology, pp. 317-29, 1980.
Contains a two-page summary of “human toxicology” re nitrites. 115 references listed. A few highlights:
“The toxic effects of amyl nitrite inhalation
include rapid flushing of the face, pulsation in the head, cyanosis,
confusion, vertigo, motor unrest, weakness, yellow vision, hypotension,
soft thready pulse, and fainting. Accidental prolonged inhalation of
amyl nitrite has resulted in death from respiratory failure....
Fatalities have occurred in workers exposed to organic nitrates after
strenuous exercise 1 to 2 days after cessation of exposure. Nitrite
causes a loss of tone of the vascular bed and pooling and trapping of
blood in the veins of the lower extremities, resulting in marked
arteriolar constriction and the induction of anoxemia in vital tissues,
causing death. Hypertrophy of the left ventricle occurs in workers
handling nitroglycerine, and they suffer from shortness of breath on
undue exertion. The formation of methemoglobin by aliphatic nitrite
interferes with oxyhemoglobin, causing anoxia of vital organs....The
use of volatile nitrites to enhance sexual performance and pleasure can
result in syncope and death by cardiovascular collapse.”
Harry W.; Pinsky, Paul F. et al. “Disease Manifestation among
Homosexual Men with Acquired Immunodeficiency Syndrome (AIDS): A
possible role of nitrites in Kaposi's sarcoma”. A study of the CDC AIDS
Activity, Center for Infectious Diseases, 1982. Abridged version
published in Sexually Transmitted Diseases, pp. 103-08,
87 of the first cases of homosexual men with AIDS were classified
according to disease manifestation: Kaposi's sarcoma (KS) only,
Pneumocystis carinii pneumonia (PCP) only, or both KS and PCP. Each
group was compared to the others as well as to controls from an earlier
CDC study. (See Jaffe 1983.)
The researchers concluded that “using nitrite inhalants may be
associated with the occurrence of KS in patients with AIDS.”
The Haverkos study gives us important information on the lifestyle
characteristics of the homosexual men who were diagnosed as having AIDS
in 1981 and early 1982. Dr. Haverkos and his colleagues found a high
degree of drug abuse. Among the total 87 gay men with AIDS, the
following levels of drug usage were recorded: Nitrite inhalants
(poppers) - 97%, marijuana - 93%, amphetamines - 68%, cocaine - 66%,
LSD - 65%, quaaludes - 59%, ethyl chloride - 48%, barbiturates - 32%,
heroin - 12%, any drug intravenously - 17%.
Multiple drug usage was the rule: 58% of the subjects used five or more
different “street drugs”. Furthermore, the 87 gay men with AIDS tended
to use their drugs heavily. Following are the median numbers of
different days on which the various drugs were used: Marijuana - 720,
nitrite inhalants - 384, amphetamines - 120, barbiturates - 96,
quaaludes - 60, LSD - 36.
Evan M.; Reuben, James M.; Bogerd, Hal; et al. “Effect of the
Recreational Agent Isobutyl Nitrite on Human Blood Leukocytes and on in
Vitro Interferon Production”. Cancer Research, pp. 1365-71, March 1983.
The effect of isobutyl nitrite on cellular immunological functions was
studied. The experimenters found that minute quantities of isobutyl
nitrite caused irreversible impairment of immunological function. They
“We speculate that these immunosuppressive effects,
combined with the ability of nitrites to convert amines to
nitrosamines, may be related to the development of opportunistic
infections and Kaposi's sarcoma in homosexuals who use this agent.”
Dr. Hersh and his colleagues further state:
“These in vitro studies strongly suggest that the
inhalant nitrites may indeed be dangerous, and their use should be
condemned by those physicians who treat patients who use these drugs
III, McDonald K; Waterman, Michael R.; et al. “Methemoglobinemia from
Sniffing Butyl Nitrite”. Annals of Internal Medicine, pp. 417-18,
A man was admitted to a hospital emergency room, “complaining of a
grayish complexion which developed after inhaling butyl nitrite”. He
was diagnosed as having methemoglobinemia, a form of anemia where the
blood turns brown, and where the oxygen supply to critical organs is
reduced. Several months later, the same man reappeared, again suffering
from methemoglobinemia, again after butyl nitrite inhalation.
The patient was found to be methemoglobin reductase deficient, as was his father.
An experiment was performed in which the patient and 6 non-familial
subjects were asked to sniff butyl nitrite (Locker Room “room
odorizer”) directly from the bottle for 12 minutes. As a result, the
patient “clearly became gray”, and had high methemoglobin
concentrations. The 6 normal subjects also developed methemoglobinemia,
to a lesser degree. The authors conclude:
“Sniffing butyl nitrite theoretically could lead to
significant methemoglobin accumulation even in normal subjects, if the
nitrite exposure were intense or if inadequate time were allowed
between nitrite inhalations for methemoglobin reduction. The risk of
clinical methemoglobinemia would, of course, be much higher in a person
whose methemoglobin clearance rate is abnormally slow and who therefore
requires a longer interval between sniffs to reduce the newly formed
Richard F.; Marmer, Daniel J.; et al. “Cellular Immunotoxicity of
Amyl Nitrite”. Journal of Toxicology- Clinical Toxicology, 20(5), pp.
[Abstract] “Functional deficits in lymphocyte interaction
following occasional or chronic exposure to inhaled nitrites may be a
potential contributing but not the [primary] etiologic factor in the
acquired immunodeficiency syndrome (AIDS). We evaluated the effect of
amyl nitrite vapors on mononuclear cell function and demonstrated
functional deficits and structural alterations in these cells. In this
closed, in vitro system, exposure of cells to amyl nitrite for up to 30
minutes did not affect cell viability. The functional deficits
demonstrated were: inhibition of lymphocyte erythrocyte (E) rosette
formation, a suppression of lymphocyte mitogen (phytohemagglutinin) and
antigen (cytomegalovirus) transformation, a block in the S, G2 and M
phases of cell cycling and diminished cell cytotoxicity to CMV infected
cells. These effects on cellular function were demonstrated following
5, 0, and 15 minutes of amyl nitrite vapor exposure; some effect on all
cellular functions was demonstrated at 5 minutes. The structural
alterations seen on scanning and transmission electron micrographs
were: reduction of filopodia, smoothing of the cell profile,
cytoplasmic protrusions with pseudopod-like extensions, an increase in
rough endoplasmic reticulum with swollen cisternae, alterations in size
and distribution of golgi components and exocytotic vesicles in the
outer membrane of the nuclear envelope. These vesicles and increased
membrane proliferation suggests an effect on the membrane synthesis
mechanism in these cells. These effects may be a potential factor in
the alterations of phenotypic markers on T Lymphocyte populations, as
well as, a potential contributing factor in the functional deficit of
mononuclear cells in patients with AIDS.”
Harold W.; Keewhan, Choi; Thomas, Pauline A.; et al. “National
Case-Control Study of Kaposi's Sarcoma and Pneumocystis carinii
Pneumonia in Homosexual Men: Part 1, Epidemiologic Results”. Annals of
Internal Medicine, pp. 145-51, August 1983.
In this study of the first 50 AIDS patients, 96% used nitrite inhalants
(and this would be 100% if the 2 “non-users” had misunderstood the
question). Moreover, the AIDS patients were extremely heavy users, with
a median lifetime exposure to nitrite inhalants of 336 doses. Most of
the AIDS patients were also heavy users of many other “recreational
drugs”, including marijuana, cocaine, heroin, amphetamines (“speed”),
barbiturates, quaaludes (“ludes”), LSD, ethyl chloride, and
The control sample selected for this CDC study
proved to be seriously flawed. Drawn from venereal disease clinics and
private practices, many of the controls were far from healthy. Some had
immunological abnormalities and swollen lymph glands, and several of
them developed AIDS after the study was completed. Further, many of the
controls appeared to belong to the “fast lane” segment of the gay male
community, as witness such findings as that 51-60% of the controls were
cocaine users, or that 21% of the private practice controls had been
Aside from the major sampling problems described above, the inherent
bias of this study design is a bias towards unity. That is to say, the
tendency would be falsely to overlook real risk factors, rather than
falsely to identify risk factors that were not real. The authors of the
study admit as much:
“The expected impact of these potential problems in
control selection and classification would be to minimize differences
between cases and controls rather than to create false differences.”
In light of the fatal flaws in sample design and selection, all
analyses based upon comparison between the AIDS patients and the
controls would be dismissed by most survey research professionals as
“garbage in, garbage out”. The comparative data are worthless, and
should be ignored. The authors of this study did draw comparative
conclusions, but they were wrong to do so.
Karl A. and Lawesson, Sven-Olov. “Amyl Nitrite and Kaposi's Sarcoma in
Homosexual Men”. (letter) New England Journal of Medicine, pp.
1893-94, 30 September 1982.
The authors give the chemical formula whereby amyl or butyl nitrites
can form carcinogenic N-nitroso compounds in the body--compounds so
deadly as to have “the capacity to induce cancer after only one dose”.
“We therefore find it appropriate to suggest that
amyl nitrite may cause Kaposi's sarcoma in homosexual men.”
Jφrgensen's and Lawesson's theories are developed more fully in an
article in the Danish medical journal, Ugeskr Laeger, of 13 December
Daniel M.; Koller, Wayne; et al. “Subchronic inhalation of Isobutyl
Nitrite in BALB/c Mice: II. Immunotoxicity Studies”. [See also Lynch
1985 below.] Journal of Toxicology and Environmental Health, pp.
This is a belated report on the research conducted in 1982-83, which
the CDC newsletter MMWR of 9 September 1983 had summarized as
indicating no “evidence of immunotoxic reactions”. (See Centers for
Disease Control 1983.) The MMWR news item was used by the poppers
industry as proof that poppers had been “exonerated”. As reports on
other experiments began to appear (Gangadharam 1985, Lotzova 1984,
Neefe 1983, Ortiz 1985, and Watson 1982), all finding that exposure to
alkyl nitrites was immunosuppressive and otherwise harmful for mice,
the CDC/National Institute for Occupational Safety and Health study
became “odd man out”.
Now that a report on the study has finally been published, it is clear
why the government researchers failed to find “immunotoxicity”, when
all of the independent researchers did find it. The dosages
administered, via inhalation of vapors, were far too low. The study, in
effect, evaluated the effect of nitrite vapors approximating levels to
be encountered as background exposure (“room odorizer”, workers in a
poppers factory), rather than those encountered when using poppers as a
drug (i.e., inhaling directly from the bottle). The study is thus in
the tradition of the “Poppers Bible”. (See entry under
Nickerson.) At the end of their “discussion”, Lewis et al. issue
a revealing disclaimer:
“The relevance of these dosages to human usage of
these compounds is uncertain because persons who abuse aliphatic
nitrites recreationally would have intermittent exposures of variable
frequency at very high dosages with chemicals of unknown purity. Thus,
this study did not attempt to model the recreational use of these drugs
[emphasis added], but rather to simply evaluate the immunotoxic
potential, in any, of these compounds.”
Eva; Savary, Cherylyn A.; Hersh, Evan M.: et al. “Depression of Murine
Natural Killer Cell Cytotoxicity by Isobutyl Nitrite”. Cancer
Immunology Immunotherapy, pp. 130-134, vol. 17, 1984.
This important mice experiment demonstrated that isobutyl nitrite was
NK-cell-suppressive in vivo after intravenous administration and, most
importantly, also after inhalation.
In their “discussion” the authors state:
“Since in experimental animals NK cells have been
implicated in the mediation of immune surveillance against tumors and
resistance to various types of infections, the depression of NK-cell
cytotoxicity by this agent could underlie the susceptibility of
homosexual men to opportunistic infection and Kaposi's sarcoma.
Furthermore, the observation that cytotoxic potential of activated NK
cells was also reduced by this agent suggests that an attempt to
augment NK-cell activity to promote resistance to infections and
malignant disease in patients with severe immunodeficiency syndrome
could fail in patients who continue to use isobutyl nitrite. Since a
multifactorial depression of immunity and a certain duration of this
depression probably sets the stage for successful infection of the
presumed AIDS agent, the continued and prolonged use of isobutyl
nitrite may play an important role in AIDS.”
“The results of these studies indicate that
immunosuppression should be added to the other reasons why isobutyl
nitrite should not be used by man.”
Dennis W.; Moorman, William J.; et al. “Subchronic Inhalation Toxicity
of Isobutyl Nitrite in BALB/c Mice: I. Systemic Toxicity”. [See also
Lewis 1985 above.] Journal of Toxicology and Environmental
Health, pp. 823-33, 1985.
This CDC/NIOSH study was intended to “present the toxicologic results
of subchronic exposures of BALB/c mice to inhaled IBN.”
(“Subchronic” apparently means something like “less than acute”.)
The salient point of their methodology is that the dosages administered
were low, simulating those experienced by workers in a poppers
factory (or by a feeble-minded individual using poppers as a “room
odorizer”). Lynch et al. are reasonably candid in making their
“Exposures were selected to mimic an occupational
exposure setting in order to fill this gap in the existing literature,
rather than to conduct brief, acute high-level exposures to imitate
exposure by nitrite abusers.”
In light of the low dosages administered, it would not have been
surprising if the mice had suffered no ill effects whatever, but this
was not the case. The main toxic effects observed were mild damage to
the lung tissues and the formation of methemoglobin. In addition, some
of the mice developed thymic atrophy. The finding of methemoglobinemia
is relevant, since poppers cause methemoglobinemia in humans (see
Dixon, Guss, and Horne entries) and since anemia is typically part of
the AID Syndrome. The finding of thymic atrophy is most suggestive: in
autopsies of AIDS victims, the thymus gland is found to be destroyed in
100% of the cases. No thymus gland, no immune system. Obviously any
drug that destroys the thymus gland will play a role in causing AIDS.
Roger P. “Acute Toxicology of Butyl Nitrite”. Research Communications
in Chemical Pathology and Pharmacology, 26:75-83, 1979.
This paper discusses laboratory techniques for analyzing the various
butyl nitrites. Butyl nitrites were administered intravenously to mice,
with liver damage and death resulting.
“Administration of isobutyl , n-butyl, sec-butyl or
tert-butyl alcohols to mice produced similar hepatoxicity, suggesting
that butyl alcohols may play a role in the hepatotoxicity observed
after sBN or tBN administration.”
______ (interview). Moneysworth, January, 1982.
USERS OF DISCO DRUG DIE OF ITS DELIGHTS
CHICAGO — Butyl nitrite — a legal but potentially
lethal substance used to enhance sexual pleasure and drive disco
dancers to ecstatic frenzy — is creating a new type of hazard, a
“If you get enough of it in your body, the chances
of saving you are zero,” Purdue University professor Roger Maickel says
of the chemical marketed variously as “Rush,” “Locker Room,” “Climax,”
and “Discorama.” “And you may be an unwitting victim,” he adds.
“It has been reported that these compounds are sprayed out over disco
floors to rev up dancers.”
Although no deaths from inhalation have been
reported, Maickel says, in the last year there have been at least two
reported deaths from swallowing the drug.
He says a Purdue study found butyl nitrites were
fatal to mice in fairly small doses. “The blood turns brown — it can't
carry oxygen,” he says. “What's interesting is that the butyl nitrites
were fatal no matter how they were administered — orally, by injection
or just by exposing the mice to the compound in the air.”
Government agencies have not banned butyl nitrite,
he says, because they have not been marketed as drugs. “Some federal
agency ought to take a stand,” Maickel asserts, “before there is a
spate of deaths that could have been avoided.”
D.J.; Jacobs, R.F.; and Steele, R.W. “In Vitro Immunotoxicity of Amyl
Nitrite.” Clinical Research, p. 5, vol. 30, no. 5, 1982.
Exposing mononuclear cells to amyl nitrite vapors resulted in various
cellular abnormalities. The authors conclude:
“These abnormalities can help in explaining the role
of amyl nitrite cellular toxicity in immunosuppressed male homosexuals.”
Michael; Friedman-Kien, Alvin E.; Laubenstein, Linda; et al. “Risk
Factors for Kaposi's Sarcoma in Homosexual Men”. The Lancet, pp.
1083-87, 15 May 1982.
A study of 20 homosexual men with KS and 40 healthy controls. All of
the men with KS had been nitrite users. Multi-variate analysis
indicated that use of amyl nitrite was an independent and
statistically significant risk factor for KS.
In the light of their data, the authors consider a tenable hypothesis to be:
“Use of amyl nitrite may have caused Kaposi's
sarcoma either by directly causing immunosuppression, thereby allowing
expression of a sexually transmitted oncogenic virus; or by allowing an
unknown carcinogenic agent, otherwise controlled by the immune system,
to operate; or by acting as a direct or metabolically activated
Usha; Enlow, Roger W.; et al. “Longitudinal Study of Persistent
Generalised Lymphadenopathy in Homosexual Men: Relation to Acquired
Immunodeficiency Syndrome”. The Lancet, pp. 1033-38, 12 May 1984.
The authors conducted a 30-month tracking study (commenced in February
1981) of 42 homosexual or bisexual men with persistent lymphadenopathy,
not attributable to an identifiable cause.
Although intravenous drug users were excluded from the sample,
“Non-parental [non-needle] recreational use of drugs, including
amphetamines, marijuana, and cocaine, was common, and all had inhaled
nitrite.” (emphasis added)
In the course of the study, 8 subjects (19%) developed AIDS. Previous
heavy nitrite inhalant use proved to be the most important factor
distinguishing the 8 patients who developed AIDS from the 34 who did
“The nitrite use/outcome association was still
statistically significant (p<0.01) after adjustment for numbers of
sexual contacts. The contacts/outcome association was only marginally
significant after adjustment for nitrite use (p<0.1).” [In
other words, based on this study, nitrite inhalant use is implicated
more strongly than multiple (100+/year) sexual partners as a factor in
causing AIDS. “Promiscuity” might therefore be regarded as a marker for
the use of poppers, rather than the other way around.]
Usha; Mildvan, Donna; et al. “Follow-up at 4 1/2 Years on Homosexual
Men with Generalized Lymphadenopathy”. (letter) New England
Journal of Medicine, 12 December 1985.
The authors report on their study of 42 male homosexual patients with
lymphadenopathy (unexplained and persistent lymph gland swelling). They
had observed these patients medically for four and a half years,
making this the longest tracking study of its kind so far.
By this time, twelve of the 42 patients (29%) had developed
full-fledged AIDS. A previous history of moderate to heavy use of
nitrite inhalants appeared to be implicated in causing these men to
develop AIDS, and in particular, Kaposi's sarcoma.
“Nitrite inhalants may act alone or in combination
with other, as yet unidentified cofactors after AIDS retrovirus-induced
immunodeficiency, by promoting the specific disease manifestation of
Kenneth H. “Inhalation-Induced Immunosuppression: Sniffing Out the
Volatile Nitrite-AIDS Connection”. Pharmacotherapy, pp. 235-36,
In this editorial, accompanying the article by Guy Newell and colleagues (which see), Mayer states:
“Newell at al. develop several interesting lines of
reasoning as to how nitrite inhalation could be clinically important.
Volatile nitrite inhalation might potentiate the development of AIDS
because of perianal vasodilation that could enhance the absorption of
an immunosuppressive substance or infectious agent. The nitrites could
be significantly immunosuppressive themselves, or the conversion to
nitrosamines could result in increased mutagenic or carcinogenic
events. These are plausible theories that are not deflated by the
elucidation of HTLVIII/LAV....”
“They have raised sufficient concern about the use
of volatile nitrites to warrant unequivocal disapproval of the use of
these drugs at this time.”
Mayer, Kenneth and D'Eramo, James. “Poppers: A Storm Warning”. Christopher Street, pp. 46-49, issue 78.
A useful summary of medical knowledge about poppers, their deleterious
side effects and possible role in the etiology of AIDS.
Andrew. “A Case-Control Study of Risk Factors for AIDS in San
Francisco”. (Presentation to the CDC AIDS Conference in Atlanta, 15
This study compared two groups of gay men who were antibody positive to
the LAV (HTLV-III) virus: people who were clinically sick with AIDS,
and people who were not sick.
Usage of the nitrite inhalants proved to be one of the most important
risk factors for developing AIDS, and especially, Kaposi's sarcoma. The
heavier the popper usage, the greater the risk.
J.R.; Ganjii, A.; and Goedert, J.G. “Daily Amyl Nitrite Inhalation
Decreases Mouse Splenocyte Response to Concanavalin A”. (abstract
3850) Federation Proceedings 42 (4): 949, 5 March 1983.
Inhalation of amyl nitrite for 2 minutes, 5 days per week, caused
progressive immunosuppression in mice. “After as little as 5 days
exposure, a trend to decreased response to the T cell nitrogen Con A...
The authors conclude:
“These data suggest that nitrites may have a primary or contributory role in AIDS.”
Guy R.; Adams, Stephen C. et al. “Toxicity, Immunosuppressive Effects
and Carcinogenic Potential of Volatile Nitrites: Possible relationship
to Kaposi's Sarcoma”. Pharmacotherapy, pp. 235-36, September 1984.
This article provides an overview of research demonstrating the adverse
effects of poppers. Especially useful for its chronological history of
the abuse of nitrite inhalants as recreational drugs and for data on
how deadly, cancer-causing N-Nitroso compounds are formed by an
interaction of nitrites with any of a long list of common drugs and
chemicals, including artificial sweeteners, antihistamines, pain
killers and methadone.
Guy R.; Mansell, Peter W.A.; Wilson, Michael B.; et al. “Risk Factor
Analysis among Men Referred for Possible Acquired Immune Deficiency
Syndrome”. Preventive Medicine, pp. 81-91, January 1985.
In this case-control study, lifestyle factors of 31 homosexual men with
AIDS were compared with those of 29 symptom-free homosexual men. The
object was to identify risk factors for developing AIDS.
Use of nitrite inhalants proved to be a highly significant risk factor
for the development of AIDS. Further, the nitrite inhalants showed a
“dose-response gradient”: the heavier the nitrite usage, the greater
the risk of developing AIDS. For the nitrite inhalants, the “odds
ratio” (OR) increased from 4.0 for occasional users [once per 6 months
to once per month] to 6.3 for frequent users [once per month or more
Other statistically significant (95% confidence level) odds ratios were
found for cigarette smoking (OR = 3.4), marijuana use (OR = 3.7),
frequenting bathhouses (OR = 7.6) prior syphilis (OR = 3.4), and
fist-rectal sexual practices (OR = 3.5).
The authors compare their results with those of the
other two case-control studies of homosexual men (Marmor 1982 and Jaffe
1983), and note that both of these also identified use of poppers as a
risk factor for the development of AIDS. “We confirmed the finding of
nitrite inhalation as a significant risk factor for KS/OI.... In the
CDC study, lifetime use of nitrites was significantly greater among
patients than for either of the control groups.”
“We believe there are several compelling reasons for
considering nitrite inhalation a possible causal factor for development
of AIDS and KS/OI. These are (a) volatile nitrites used as recreational
drugs have been shown to be immunosuppressive both in vitro and in
vivo; (b) metabolic properties of N-nitroso compounds produce mutagens,
teratogens, and carcinogens; (c) of 290 N-nitroso compounds tested, 252
(87%) are carcinogenic; (d) of 39 different animal species, none is
known to be resistant; (e) N-nitroso compounds are among the most
highly potent chemical carcinogens for animals; (f) their use is
extremely common among male homosexuals; and (g) a definite
dose-response relationship was shown by both Marmor et al. and us. The
combination of cigarette smoking, marijuana use, and nitrite inhalation
could predispose the lungs to opportunistic infections.”
Mark; Parker, John O.; Lowry, Thomas P.; and Swenson, Edward W.
“Isobutyl Nitrite and Related Compounds”. 95 pages. Published by
Pharmex, Ltd., 1978.
Known as the “Poppers Bible”, this work was commissioned by the late W.
Jay Freezer, chair of Pharmex, Ltd, the company that makes the popper
brands Rush and Bolt, at a cost of $200,000. It was instrumental in a
decision by the California Department of Health to permit poppers to be
sold free from regulation, testing, or control of any kind, provided
they were advertised as “room odorizers” or “incense”. As a piece of
special pleading published by the poppers industry, the scientific
value and credibility of this study are nil. Nevertheless, it is still
cited by defenders of poppers.
The falseness of this report is revealed in the very first sentence:
“For the past several years there has been
considerable controversy regarding the use of butyl nitrite in consumer
products used for odorizing purposes.” [Emphasis added.]
This is the tack of the hired “experts” (each of whom has an MD
degree): to lend credence to the claim that poppers are used as “room
odorizers”, and to determine whether or not they are safe when so used.
Not surprisingly, given the underlying “room odorizer” premise and the
interests of their patron, the authors conclude that the product
studied (not referred to as “poppers”) is quite safe. They
enthusiastically fulfill their assignment:
“It is difficult to envision any product with a better record of public safety.”
Appendix V, by Parker, is a study of the effects of ambient popper
fumes upon workers in a poppers factory. In his Introduction, Parker
begins by stating, “Butyl nitrite and isobutyl nitrite are employed in
preparations intended for use as room odorizers.” [Emphasis
added.] Then, he states the purpose of his “study”:
“This study was undertaken to ascertain whether the
inhalation of isobutyl nitrite in concentrations far in excess of those
encountered in its normal usage [emphasis added] would have any
significant clinical, circulatory or hematological effects.”
Through this verbal trickery, Parker has defined “normal usage” of
poppers as being usage as a room odorizer. His conclusion 6 pages later
is hardly unexpected: “This study has shown that inhalations of
isobutyl nitrite, far in excess of those encountered during the normal
use [emphasis added] of this agent, exert no harmful clinical,
cardiovascular or hematological effects.”
It is stated in the Preface, “This study took nearly two years to
accomplish....” It seems odd that in two years of collaboration
with Pharmex, Ltd., the academics who wrote this study were not
informed that Rush, Bolt, etc. are used as drugs, not as room
odorizers. The “room odorizer” claim is a lie, and the report as a
whole is therefore a lie. These lies may have led to the deaths of many
Jesse S. and Rivera, Vilma L. “The Effect of Amyl Nitrite on T-Cell
Function in Mice”. (Presentation to the American Public Health
Association Convention, November 1985)
Mice were exposed to amyl nitrite inhalation 5 days a week, for 21
weeks. A matched control group of mice was maintained in an identical
environment, but was not exposed to amyl nitrite.
The main findings were:
1. In the mice exposed to amyl nitrite: “A decrease
in mean body weight was found after accumulative exposure time of 8
weeks, and this decrease continued until the end of the experiment.
After 21 weeks of exposure time both body weight and weight gain
were significantly decreased (p<0.2; p<0.01).”
2. “Mice exposed to AN had extensive pathological
damage to the lungs and this damage was statistically significant
(p<0.01). The gross pathology observed in the lungs of the
AN-exposed group consisted of: a) hemorrhagic spots, b) petechiae all
over the lungs, c) collapsed consolidated sections which were red and
showed the appearance of an emphysematous lung, and d) air pockets with
large air bubbles.... It is therefore apparent that the chronic use of
amyl nitrite may have profound pathological damage to the lungs.”
3. Amyl nitrite inhalation caused a severe depletion
of the helper T-cells, and consequently, an inverted T-cell
helper/suppressor ratio. In the group of mice exposed to AN, the
helper/suppressor ratio was only 0.25, whereas in the control group it
was 1.69 (p<0.01). A significant degree of correlation (p<0.01)
was found between T-cell ratio and the independent variables (body
weight and weight gain) in the exposed group, whereas in the control
group, no significant degree of correlation between these variables was
found, thus further confirming the causal relation between AN
inhalation and the reversed helper/suppressor T-cell ratio.
“Our studies do show that chronic inhalation of AN
can lead to an altered T-cell helper/suppressor ratio, the same
phenomenon which occurs in AIDS victims. It does look, then, that there
seems to be a link between AN inhalation and cellular immunity
J. and Goldfield, D. “Butyl Nitrite Transformation In Vitro, Chemical
Nitrosation reactions, and Mutagenesis”. Journal of Analytical
Toxicology, pp. 164-69, July/August 1984.
The authors studied “the transformation of n-butyl nitrite added to
whole blood, plasma, and water, using anion exchange high pressure
liquid chromatography, spectrometry, and gas chromatography”.
They confirmed the findings of Quinto (which see) that butyl nitrite is
mutagenic (and therefore likely to be carcinogenic as well).
Osterloh and Goldfield conclude:
“Chemical reactions indicate that nitrosation of
amines is possible and mutagenicity studies have been confirmed.
Because these experiments indirectly suggest the potential in vivo
nitrosation by butyl nitrite, the authors join Jφrgensen and Lawesson
in warning that use of alkyl nitrite may be hazardous and requires
Vincent. “The Acquired Immunodeficiency Syndrome:
Current Status”. Yale Journal of Biology and Medicine, pp. 443-52, 1982.
This lead editorial reviews current research and theories, stressing
the likelihood that amyl nitrite may be a causative factor, perhaps in
conjunction with an infectious agent.
Quagliarello puts strong emphasis on the “drug hypothesis”, making the
point that all of the non-homosexual AIDS cases were drug abusers. He
refers to studies of heroin addicts “demonstrating evidence for opiate
receptors on lymphocytes in vitro, as well as depression of T-cell
number and function in vivo opiate addicts.”
I. “The Mutagenicity of Alkylnitrites in the Salmonella test”.
(translation from the Italian) The Institute of Biological
Chemistry, Faculty of Medicine, University of Naples. Bolletino Societa
Italiana Biologia Sperimentale, 1980, 56:816-20.
The effects of 5 forms of alkylnitrites on bacteria were studied, using
“the Salmonella method, which is currently believed to be one of the
best tests of mutagenesis”.
Both amyl nitrite and isobutyl nitrite were found to be direct
mutagens, “with or without metabolic activation”. This finding is
“During the last 5 years, the problem of the
correlation that exists between mutagenicity and carcinogenicity in
chemical products has been studied with great attention. The results of
the experiments obtained up till now (about 90% of chemical carcinogens
are mutagens) have revealed that an actual correspondence exists
between the two properties.”
Quinto concludes by relating his findings to the abuse of nitrite inhalants in the U.S.:
“The originality of our experiment is the
presentation of alkylnitrites as a new class of chemical mutagenic
agents and the importance of stressing the oncogenous risk linked to
the use and abuse of amyl nitrites and isobutyl nitrites. In
particular, isobutyl nitrite has had a rapid and increasing diffusion
as a drug on the American market during the past five years. In fact,
in 1978, the companies manufacturing the chemical estimated that about
five million Americans used their product. The accusation of
mutagenicity of this compound urgently calls for a more thorough
inquiry into the oncogenous risks to which millions of users of this
drug may be exposed.”
K.R.; and Concannon, A.J. “Heinz Body Haemolytic Anaemia after Sniffing
Volatile Nitrites”. The Medical Journal of Australia, pp. 302-03, 21
The authors report on two separate cases in which young Australian men
developed Heinz body hemolytic anemia (anemia characterized by
excessive destruction of red blood cells). Each of the men had used
amyl nitrite over the two days before being hospitalized, and had been
regular users of the drug for at least 3 months, sometimes sniffing the
drug up to 20 times per session. Each of them would feel “tired and
washed out” for several days after a sniffing episode.
Extensive tests ruled out other possible causes of the Heinz body
hemolytic anemia. In both cases the men were warned of the dangers of
amyl nitrite sniffing and were released from the hospital. Both men
returned to the hospital after one month, during which time they had
avoided the use of poppers; their blood was tested again: the anemic
condition had gone away, and their red blood cell morphology was normal.
Leonard T.; Kapp, Frederic T. et al. “Popping and Snorting Volatile
Nitrites: a Current Fad for Getting High” American Journal of
Psychiatry, pp. 1216-18, October 1978.
A valuable pre-AIDS history of volatile nitrite drug abuse, with insights into the business aspects.
“Common settings in which these agents are used include the bedroom,
parties, backrooms of pornographic bookstores, pornographic theaters,
bars, and dance floors. Some users have told us that a few discotheques
use special lighting effects to indicate that they are about to spray
nitrite fumes over the dance floor.” [emphasis added]
“The snorting of volatile liquid nitrites for hedonistic purposes has
created a large business estimated to total $50 million a year. Sales
have reportedly averaged 100,000 bottles a week in one city alone.”
Joseph; Witkin, Steven S.; Purtillo, David T. “Acquired
Immunodeficiency Syndrome, Opportunistic Infections, and Malignancies
in Male Homosexuals: A Hypothesis of Etiologic Factors in
Pathogenesis”. Journal of the American Medical Association, pp. 2370, 6
This article, an influential statement of the “multifactorial
hypothesis”, takes issue with the prevailing view “that a
yet-to-be-identified virus causes AIDS”. The authors develop a model
whereby “Multiple factors, rather than a novel virus, probably induce
The main emphasis in this model is placed upon the exposure of “a
subset of men to the immunosuppressive impact of sperm and CMV”.
However, various other potentially immunosuppressive co-factors are
considered, including “the recreational use of drugs”.
The important point is made that the etiology of AIDS in homosexual men
may not be identical to the etiology of AIDS in other risk groups:
“We cannot, at this time, explain why AIDS is
thought to be occurring in Haitians, hemophiliacs, and others. Acquired
immunodeficiency has many causes, including malnutrition, hormonal
alterations, use of opiates and other IV drugs, and acute viral
Walters, C.L. “The Exposure of Humans to Nitrite”. Oncology, pp. 289-296, vol. 37 (1980).
This article does not deal with the nitrite inhalants, but rather
nitrite in food and the environment in general. Nevertheless, it makes
an important point relating the intensity of nitrite exposure to the
carcinogenic potential. It seems the potential for formation of the
deadly, carcinogenic N-nitroso compounds is much greater from a brief,
high-level dosage (the situation involved in snorting poppers), than
from a longer, low-dosage exposure.
“Since the rate of nitrosation of an amine is
dependent on the nitrite concentration to a power of greater than
unity, it is probable that nitrite ingested in one application over a
short period will be more active in the synthesis of N-nitroso
compounds than a continuous supply at lower concentrations over long
Waterson, A.P. “Acquired Immune Deficiency Syn drome”. British Medical Journal, pp. 743-46, 5 March 1983.
In evaluating theories on the etiology of AIDS, Waterson considers the most promising to be:
“Firstly, the 'hot bed' theory argues that the
traffic in human material in certain quarters by abnormal routes has
reached such a level that, combined with the effects of drug abuse of
various kinds, the sheer weight of chemical and microbial insult to the
body in general, and to T lymphocytes in particular, goes beyond the
tolerable limit. Eventually irreparable damage is sustained, which
becomes manifest clinically in one or other of the variety of
components of the syndrome.”
“Secondly, the drug theory points to drug abuse as
the common denominator between the non-homosexuals and the main mass of
patients. Much attention has focused on amyl and butyl nitrite as
relative newcomers to the scene, but they are scarcely enough alone to
cause all the damage.”
E. Sue; Murphy, James C. “Use of Amyl Nitrite May Be
Linked to Current Epidemic of Immunodeficiency Syndrome”. Unpublished
letter sent to the Journal of the American Medical Association, October
The authors report on an experiment which investigated the “effects of
amyl nitrite on the primary humoral and cellular immune responses of
“Groups of mice were exposed to a single capsule of amyl nitrite
(Vaporole\, 0.3 ml capsule, Burroughs Wellcome\) in an 18 liter sealed
container for 4 minutes, twice daily for 5 consecutive days beginning
the day of immunization. The humoral immune response to sheep red blood
cells was normal in mice exposed to amyl nitrite. However the cellular
response to DNFB was reduced by 30-45% in mice exposed to amyl nitrite.”
Dr. Watson also sent a letter to Robert McQueen , Editor of the Advocate, in which she stated:
“Our studies show that amyl nitrite strongly
suppresses the segment of the immune system (cellular immunity) which
normally protects individuals against Kaposi's sarcoma, Pneumocystis
pneumonia, herpes virus, Candida, amebiasis, and a variety of other
opportunistic infections. The upshot of this research is that persons
using nitrite inhalants may be at risk for development of AIDS....
Publication of this letter in the Advocate will serve to alert the
community to the health risks of using amyl nitrite. I hope you will
see fit to include this information in the news section of the
After receiving no response from the Advocate, Dr. Watson telephoned
Editor McQueen. She was told, “We're not interested”. It may be noted
1. The Advocate was interested in AIDS, as several
pages in every issue were devoted to this topic.
2. Since the Advocate is the world's largest gay
paper, tens of thousands of gay men looked to it for guidance on how
they could reduce their risk of getting AIDS.
3. For years the poppers industry had been the Advocate's largest advertiser.
III. THE POPPERS INDUSTRY AND ITS INFLUENCE
to a 1978 study, the poppers industry was grossing $50 million a
year — a figure which may well have doubled or tripled since then.
a 1981 article, Arthur Evans cited some disturbing aspects of the
poppers industry. In 1978 a major poppers manufacturer, W. Jay
Freezer, hired “experts” (at a cost of $200,000) to prepare a
study which concluded that butyl nitrite products were safe “when
used for odorizing purposes”. On the basis of this impudently
irrelevant study, the California Department of Health permitted poppers
to be sold, free of any regulation, testing, or control, provided only
that the products be advertised as “room odorizers or incense”.
“In fact, both the popper makers and the California Department of
Health committed a criminal fraud. By hiding behind the lie that
poppers are being used as a room odorizer or incense, they have
completely circumvented the normal safety net of testing which every
drug in this country must be subject to in order to be sold.”
point to be noted here is that the poppers industry can afford to spend
large amounts of money in “influencing” research, government agencies,
and public opinion, and was apparently quite successful with the
California Department of Health.
major campaign of “disinformation” commenced on 1 April 1983, when a
press release was issued by Joseph F. Miller, “president of Great Lakes
Products, Inc., the nation's largest manufacturer of nitrite-based
odorants”. It was entitled, “U.S. Government Studies Now Indicate that
Nitrite-Odorants Not Related to AIDS!” [New footnote.]
to Miller, “the assistant director of the Center for Infectious
Diseases (a part of the Centers for Disease Control in Atlanta), Dr.
James Curran, invited him to Atlanta in late November of last year to
discuss the work being done by CDC relative to its AIDS
investigations”. [If true, this meeting would be a very serious
indiscretion on Curran's part, raising the possibility of collusion
between the poppers industry and CDC officials.] According to
Miller's press release, the CDC assured him that “no association exists
between nitrite-based odorants and AIDS”.
In a charming exercise of equivocation, Miller's press release states:
“Although his company does not advocate the misuse of HARDWARE\ or
QUICKSILVER\ as inhalants, Miller says the company is greatly relieved
to know that recent Government studies clearly show that such misuse
poses no health hazard.”
months later (27 September 1983) Dr. James Curran sent an angry letter
to the poppers manufacturer, with a copy to the Advocate (which never
printed it). Curran did not deny having met with Miller in Atlanta, but
he objected strongly to some of his statements:
“Other health hazards from misuse of these drugs have been documented.
Your press release and advertisements in the Advocate are misleading
and misrepresent the CDC findings and their implications.”
Curran's letter concludes:
“While it is unlikely that nitrites will be implicated as the primary
[emphasis added] cause of AIDS, their role as a cofactor in some of the
illnesses found in this syndrome has not been ruled out. I must insist
that you discontinue the misuse and misinterpretation of CDC findings.”
No study has ever been done, as of November 1982 or subsequently, that
could reasonably be interpreted as “exonerating” poppers — as
demonstrating, in the words of Miller's press release, that “no
association exists between nitrite-based odorants and AIDS”. The little
MMWR news item (CDC 1983), which asserted an absence of “immunotoxic
reactions” in mice exposed to popper fumes, was grossly misleading.
When the study was finally reported on, two years later, it turned out
that the mice had been exposed to low dosages intended to “mimic an
occupational exposure setting” rather than the much higher dosages that
would “imitate exposure by nitrite abusers”. (Lewis 1985, Lynch
1985) No fewer than six other mice studies (Gangadharam 1985,
Lotzova 1984, Maickel 1979, Neefe 1983, Ortiz 1985, Watson 1982) have
demonstrated that exposure to amyl, butyl, or isobutyl nitrite is
highly immunotoxic and otherwise harmful to mice.
The CDC weasels on poppers
several years the Committee to Monitor Poppers has regularly sent
copies of research to the CDC and other public health agencies. On 21
April 1985, Hank Wilson of the Committee to Monitor Poppers wrote a
letter to Dr. James Curran, requesting that the CDC assist in the
formulation of risk reduction guidelines by issuing a statement
condemning the use of poppers.
“There should be no question that popper use is quite extensive among
gay males. Inhalant nitrites continue to be marketed and promoted to
the gay male community as if they had no harmful health effects, nor
any role in the development of AIDS.”
“CDC should issue an alert to popper users. Popper users need to know
that initial research indicates that poppers may be immunosuppressive.
Users need to know that epidemiological research links poppers and KS.
Users need to know that inhaling nitrites may result in cellular
changes which make them vulnerable to an AIDS virus infection. A
warning can be issued with the qualification that 'more research is
needed', but the least CDC can do is to alert the popper users about
what is already known. Better to err on the side of caution than to say
Curran responded with a most evasive letter:
May 6, 1985
Dear Mr. Wilson:
Thank you for your letter of April 21 and the enclosures.
Some of the studies you cite are outdated and some are quite current.
You have edited and amalgamated them skillfully. The data presented by
Haverkos and Moss and their respective collaborators at the recent
International Conference on AIDS are intriguing and deserving of
further attention. The issues they raised warrant further investigation
into the whole field of cofactors and their role in AIDS causation. It
is possible that heavy use of nitrites, or another factor correlated
with such use, may contribute in some as yet undefined way to the
development of Kaposi's sarcoma in those already infected with HTLV-III
or who have AIDS.
I agree that this information should be disseminated and I acknowledge
the active role you have played in this effort. On the other hand, the
present data do not justify an absolute “anti-popper” campaign.
We certainly wish to point out that no data exist to indicate that
using nitrites is a safe, risk-free practice. Gay men should consider
decreasing use of this substance until more data are available to
assess those risks that may exist.
Thank you for your interest in this issue.
James W. Curran, M.D., M.P.H.
Chief, AIDS Branch
Division of Viral Diseases
Center for Infectious Diseases
comments on the Curran letter: What does it mean to say, “Some of
the studies you cite are outdated”? Which studies? And how
so? — because they have been a) superceded by better studies?, or b)
contradicted by later studies? At any rate, what about the really
important studies, any one of which provides a reasonable warrant for
banning poppers now, not just issuing warnings about them. Why does
Curran refuse to address himself to a single specific issue? And
what does Curran mean, “the present data do not justify an absolute
‘anti-popper’ campaign”? Would it be an “absolute ‘anti-popper’
campaign” to come right out and say “Don't use poppers”, or “Poppers
are harmful to the health”, or “Poppers are a risk factor for
AIDS”? There is plenty of information right now to take a stand
on poppers, and no excuse for weaseling on the issue.
statement, “Gay men should consider decreasing use of this substance
until more data are available to assess those risks that may exist”, is
preposterous. Gay men should not “consider” anything at this point;
they should act. And they should stop using poppers, not just decrease
the use of them.
Setbacks for the poppers industry
Wisconsin last year, the poppers industry, under the leadership of
Joseph Miller, waged an all-out battle to prevent poppers from being
banned. A formidable legal brief was prepared, which sanctimoniously
adhered to the “room odorizer” tack. (“Those who denigrate the room
odorizer effect of Great Lakes' products...are actually expressing
nothing more than their personal distaste for the butyl nitrite
experts were flown in to testify as to the harmlessness of poppers,
including the Professor of Medicine, John Parker, a co-author of the
expert witness for Great Lakes Products, Inc. was Bruce Voeller, a
founder and former Co-Director of the National Gay Task Force.
According to a Wisconsin paper, “Voeller said all studies linking AIDS
and butyl nitrite were 'utterly flawed and without foundation'”.
Another paper noted dryly that Voeller's “expenses for appearing at the
hearing were paid by a butyl nitrite manufacturer”.
legislators were not favorably impressed by the “expert” testimony, and
poppers are now a “banned hazardous substance” in Wisconsin.
California, both San Francisco and Los Angeles have moved to ban the
use of poppers in public, and to require point-of-sale warnings that
their use is linked to the development of AIDS. In testifying in Los
Angeles, Joseph Miller took several steps backwards:
“We recognize that the nitrites can be misused as inhalants. We have a
responsibility for consumers; that's why we have warning labels that
they should not be inhaled.” [Emphasis added.]
poppers continue to be sold legally, this is due in part to
disinformation from the poppers industry, disinformation which
undoubtedly lies behind the striking disparity between current medical
knowledge regarding the nitrite inhalants, as reported in the best
medical journals, and the near-blackout on such information in the
popular press and much of the gay press.
regulatory agencies have behaved shamefully in accepting the “room
odorizer” lie. (“The makers have done their homework”, said Edward
Nida, an FDA spokesman, “there's not a damn thing we can do about
it.”) This is utter madness. Everyone knows that poppers are
inhaled as a drug. Everyone who has studied the issue knows that
poppers are dangerous, and almost certainly implicated in the etiology
of AIDS. And yet the popper profits continue to roll in, and gay men
continue to die.
long as public officials refuse to do their duty, it is up to each of
us individually to spread the word about the dangers of using poppers.
Critical judgment is called for. The bottom line is:
DO NOT USE POPPERS!
A: Koch's Postulates: The Case Against
LAV/HTLV-III's Being the Sole, Sufficient, or Necessary Cause of AIDS
medical science, the standards for proving that a particular
micro-organism causes a disease are three classic laws known as “Koch's
Postulates”. So far, the so-called “AIDS virus” (LAV or HTLV-III),  has
ignominiously failed to fulfill even one of the bacteriologist Dr.
Robert Koch's three laws for “establishing the specificity of a
first Postulate requires that the microbe be found in all cases of the
disease. In various samplings of AIDS patients, anywhere from 20% to
64% do not have the LAV virus, and about 10% do not even have
antibodies. CDC officials cavalierly attribute this awkward finding to
“poor testing methods”, failing to acknowledge that the burden of proof
is on those who claim that the “AIDS virus” is the cause of AIDS.
second Postulate requires injection of the micro-organism into
susceptible animals, with the result that the same disease is produced.
For years researchers have been injecting several species of monkeys
with fluids from people with AIDS. Whatever microbes were in the blood
of the AIDS patients — whether viruses, bacteria, or other — whether
named LAV or HTLV-III or ARV or something else — these microbes would
have been transmitted, in large quantities, to the blood of the
monkeys. And none of the monkeys has yet developed AIDS.  Further, there
have been several hundred carefully monitored cases of health care
workers who accidentally stuck themselves with needles that had been
used on AIDS patients. In no case has AIDS resulted from one of these
third Postulate requires that the agent create the disease upon
transfer from animals made ill by inoculation. Obviously this condition
has not been met, as no animal has yet been made ill by inoculation.
is certainly possible that the LAV virus may play some role, perhaps
even an important role, in causing AIDS. However, LAV clearly cannot be
regarded as a necessary factor in causing AIDS if substantial
proportions of AIDS patients do not have the virus. This is the
inescapable logic of Koch's first Postulate.
that up to two-thirds of the AIDS patients do not have the virus in
their bodies, one may question the wisdom of treating these patients
with toxic and experimental antiviral drugs, such as ribavirin, which
at best may prevent the virus from replicating. If the virus is not
present in the patient's body, there is nothing to prevent from
government's insistence that the “HTLV-III” virus is the cause of AIDS,
sole and sufficient, has stifled independent research and thinking, and
has dangerously misled people as to the risk-factors for AIDS.
Intravenous drug users have not been told to quit using drugs, only
that they must stop “sharing needles”. (Actually, there is no evidence
that all, or even most, of the IV drug users with AIDS did “share
needles”.) Gay men have been told that they must restrict their
sexual activities, but not that they ought to stop using cocaine,
heroin, quaaludes, amphetamines, ethyl chloride, PCP, marijuana, LSD,
barbiturates, poppers, and the other “recreational drugs” (a sick
euphemism) that are prominent in the lifestyle of many gay
government's unreasoning dogmatism is well expressed in Robert Gallo's
statement: “If you get run over by a truck, you don't need
co-factors.” The “AIDS virus” is hardly a truck, and it may be
the “co-factors” that cause AIDS.
APPENDIX B: A TOXICOLOGIC MODEL
“AIDS virus” etiology has been put forward thousands of times in the
media, complete with color fluorescence micrograph photographs, and the
public has come to believe it. Nevertheless, the “virus only” theory is
not tenable. Repeating a hypothesis does not verify it. Propaganda is
theory of how AIDS is caused must come to grips with the fact that for
five years AIDS, unlike a truly communicable disease, has remained
compartment- alized. More than nine out of ten AIDS cases are either
intravenous drug users or homosexual/bisexual men.
science recognizes that illnesses can have infectious causes, or
non-infectious causes, or both types of causes acting together. Some
illnesses are caused primarily by communicable microbes. Others — like
radiation-induced leukemia, black lung disease, alcoholic cirrhosis of
the liver, emphysema from cigarette smoking, or the dioxin (“Agent
Orange”) syndrome of diseases — are caused by toxins.
reasons unknown, the U.S. Public Health Service adheres with military
rigidity to the line that AIDS must be explained in terms of the “AIDS
virus”, and that research efforts must be based solely on this premise.
Risk-reduction measures are to be predicated solely on preventing
transmission of the putative virus. 
officials have taken an adversary stance against the possibility that
toxic agents play a role in causing AIDS. They have, for example, laid
down the line that IV-drug users develop AIDS, not from the drugs they
use, but from allegedly “shared needles”, an unproved assumption.
Considering that heroin is known to be immunosuppressive, and
specifically to cause depression of T-cells, the government's
intransigent dismissal of the drugs, while focussing on “shared
needles”, is bizarre and irresponsible. It is truly a case of
“straining at a gnat and swallowing a camel”.
actuality, such epidemiological information as we have seems more
consistent with a toxicologic than with the prevailing microbial model.
To illustrate another way of looking at AIDS, we have developed the
accompanying diagram, in which toxins represent the primary causative
factor. By no means a finished explanation of how AIDS is caused, the
model is intended to portray possible relationships, to generate
hypotheses and provide directions for research.
in the diagram is part of the typical AID Syndrome, though the exact
relationships involved, or the relative importance of the various
components, remain to be determined. Some factors may be relatively
trivial, while others may be crucial. In the center are various toxins,
some peculiar to the lifestyles of IV-drug users and/or urban gay men,
others affecting much of the population. The model is multifactorial,
for disease, like health, is multifactorial. However, one should bear
in mind that some drugs are capable of causing AIDS all by themselves.
vicious circles are in operation, for example, “Dietary/Metabolic
Imbalance”, a condition caused by many different drugs. There are
addicts who seem to live on nothing but candy bars and sugar water.
When the carbohydrate diet is joined to an impaired immunological
system and the use of antibiotics (like tetracycline), a yeast
infection (“thrush”) commonly develops, which further depresses
immunological functioning and creates even greater craving for
another vicious circle, the inhaled “recreational” drugs cause lung
damage (Newell 1985, Ortiz 1985), which depresses the immune system (of
which the lungs are a crucial component) and prepares the way for
pneumocystis carinii pneumonia, which further impairs the immune
system, damages the lungs, and requires antibiotics, which themselves
aggravate the condition.
research needs to be done, as there is amazingly little information on
the characteristics of people with AIDS. To begin with we need studies
of large, representative samples of AIDS patients — information on
their diets, before and after diagnosis; their drug habits in detail,
including combinations, amounts, and frequency of use; cigarette
smoking; infectious disease histories; medical drug histories, with
special attention to antibiotics. Were there many PWA's in good health
prior to developing AIDS? — who had not smoked cigarettes, used drugs,
drunk excessively, or had a history of venereal infections with
antibiotic treatment? — who had followed a well-balanced diet?
The “virus only” theory (“you don't need co-factors”) would imply many
such people; the toxicologic model, very few.
ETIOLOGY OF AIDS: A TOXICOLOGIC MODEL
APPENDIX C: Occam's Razor: The Drugs Connection
have we argued that poppers are the cause of AIDS. Obviously poppers
are not, as there are AIDS patients who have never used them. At the
same time, the “AIDS virus” (LAV or HTLV-III) cannot be the cause
either, as substantial numbers of AIDS patients do not have the
virus in their bodies, and yet remain sick. To be honest one must say
that the cause of AIDS is unknown. There may be more than one route to
AIDS, or it may be that multiple factors in combination are required to
cause the condition.
generally prefers the “most parsimonious” explanation that accounts for
the facts. The principle was formulated by the 14th-century
philosopher, William of Occam, whose Razor states, “What can be done
with fewer [assumptions] is done in vain with more.”
drugs, such as the medications used during transplant operations, can
cause the AIDS condition, immune deficiency, all by themselves. It is
also known that “recreational” drugs, like heroin, are
immunosuppressive. And it is now firmly established that poppers are
immunosuppressive. More than a quarter of the AIDS cases have occurred
among intravenous drug users, and most of the remaining AIDS cases have
occurred among gay men who used poppers (as well as other
injectors of immunosuppressive heroin, or inhalers of immunosuppressive
poppers, develop AIDS, Occam's Razor suggests parsimoniously assuming
that their drugs were the cause. Microbes, diet, and other lifestyle
and environmental factors probably played a role, but these represent
In any event, common sense dictates not using immunosuppressive drugs. Do not use poppers.
1. See Appendix A: Koch's Postulates: The Case Against LAV/HTLV-III's Being the Sole, Sufficient, or Necessary Cause of AIDS.
By “recreational drugs”, we are not referring to coffee or chamomile
tea. The drugs that were used heavily by the gay men with AIDS who were
studied in 1981-1982 included not only poppers, but barbiturates,
amphetamines, cocaine, heroin, ethyl chloride, LSD, PCP, and quaaludes
(“ludes”). (Haverkos 1985) Looking at this menu of drugs, the
question is not, “Could it be that one of these drugs is
harmful?” They are all harmful. Ethyl chloride, for example,
causes brain damage every time it is inhaled.
Heroin is known to be immunosuppressive, causing, among other things, a
depression of T-cell number and function in opiate addicts. (References
in Quagliarello 1982.)
And then there is alcohol, which may be benign when used in moderation,
but which is one of the most toxic of all drugs when used heavily.
Physicians in New York City, who have treated many hundreds of patients
with AIDS, have stated that a large proportion of these men were
Anyone who feels he may have a drug/alcohol problem should get help.
Unless emergency medical attention is needed, the best first step would
probably be to telephone Alcoholics Anonymous or Narcotics Anonymous,
depending on the nature of the addiction.
Such workers were the focus of Appendix V by John O. Parker in the
“Poppers Bible”. (See entry under Nickerson.) Oddly, the
government researchers list this poppers industry publication under
their “References”, as though it were a legitimate source.
In a letter of 25 March 1983 (a copy of which is in the archives of the
Committee to Monitor Poppers), to Peter Frisch of The Advocate, Joseph
F. Miller, President of Great Lakes Products, Inc., urged The Advocate
to publicize his press release, which claimed that CDC studies had
exonerated poppers from any connection to AIDS. Miller was fully
confident in the power of his advertising dollars:
“As the largest advertiser in the Gay press we
intend to use the extensive ad space we purchase each month as the
vehicle for sending a message of good health and wellness through
nutrition and exercise to the North American Gay communitites [sic].”
Advocate then ran full-page advertisements for the Great Lakes brands
of poppers; the series was called, “Blueprint for Health”. The
Advocate's health expert, Nathan Fain, whose credentials consisted of
journalism experience covering the theater, wrote that poppers had been
exonerated by a CDC study. Fain criticized researchers who warned about
the dangers of poppers, attacked the New York Native for printing
anti-popper editorials and news items, and ridiculed the City of San
Francisco for banning poppers sales to minors and requiring warning
signs to be posted at point of sale.
For more information on Miller's activities, see the section, “The Poppers Industry and its Influence”.
5. Evans, Arthur. “Poppers: An Ugly Side of Gay Business”. Coming Up! November 1981.
W. Jay Freezer died of complications due to AIDS on 27 March
1985. Freezer was not the first poppers manufacturer to die from
AIDS. He was preceded by the New Yorker known as “Poppers
7. See entry under Nickerson.
8. See entry under Nickerson.
Now known as the “Human Immunodeficiency Virus”: HIV-1.
The infra-human primates did become “infected”, since
their bodies formed antibodies to what is now called HIV-1. However,
none developed “AIDS”. As of now, the Spring of 1992,
they are still healthy.
This devastating argument against the AIDS-from-shared-needles
hypothesis became even stronger after this passage was written. A
1988 CDC study, of health care workers who had been stuck with
hypodermic needles that had been used in AIDS patients, found that
out of 1428 workers who had thus been accidentally inoculated with
the plasma of AIDS patients, only four (0.3%) seroconverted (i.e.,
developed HIV antibodies), and none developed AIDS! Not a single case
of AIDS from a needle-stick injury has ever been demonstrated.
(Centers for Disease Control, “Update: Acquired
Immunodeficiency Syndrome and Human Immunodeficiency Virus
Infection Among Health-Care Workers”, Morbidity
Mortality Weekly Report, 22 April 1988 [vol. 37, No. 15], pp. 229
Although the AIDS Establishment claims that techniques for detecting
the virus have improved greatly since 1986, the fact remains that in
a substantial number of AIDS patients neither HIV-1 itself nor HIV-1
antibodies can be detected, even using the most sensitive
At the time this passage was written, the CDC reported AIDS
statistics by using a “hierarchical presentation”. Data
on “AIDS cases by Patient Characteristics” were reported
by listing the largest category (homosexual men) first, after which a
patient was included in a subsequent risk group only if he had not
already been counted. A gay man who used IV drugs was a homosexual,
but not an IV-drug user.
tables showed 17% of
AIDS cases as being IV-drug users, with no indication that these 17%
were only the exclusively heterosexual IV-drug users. They
concealed the substantial overlap group: gay men who were also IV
drug users. In fact, anywhere from 26% to 34% of the total AIDS cases
were IV-drug users.
effect of the CDC's
statistical trickery was to underreport IV-drug users as an AIDS risk
group by at least 50%; the effect was to construe AIDS as a venereal
disease, rather than a drug-induced condition.
New Footnote. Joseph Miller committed suicide on 25 August 2010.
Hank Wilson, a long-time gay activist in San Francisco, founded the
Committee to Monitor Poppers in the fall of 1981. Since then, Wilson
and the Committee have assembled a formidable collection of medical and
other literature on the nitrite inhalants, have corresponded with
researchers and public officials internationally, and have played a
leading role in sounding the tocsin on the dangers of poppers. Wilson
was a founder of the Gay Teachers Coalition, a founder of the Harvey
Milk Gay and Lesbian Democratic Club, a founder of the Butterfly
Brigade (a gay self-defence group), and a founder of Community United
John Lauritsen received his A.B. degree from Harvard (Department of
Social Relations), and has twenty years of experience as a market
research executive and analyst. Lauritsen is co-author of The
Early Homosexual Rights Movement (1864-1935) and has edited the John
Addington Symonds anthology, Male Love: A Problem in Greek Ethics and
Other Writings. His most recent books are described in the Pagan Press Booklist.
I write books and am
proprietor of Pagan Press, a small book publisher. Each of our books
is unique and well produced. Please check out the Pagan Press BOOKLIST — John Lauritsen