Poppers are small bottles of liquid alkyl nitrites, inhaled for a rush that lasts a minute or two and for the way they relax smooth muscle. PnP, short for party and play, is a mostly North American term for sex combined with drugs, usually crystal methamphetamine. Chemsex is the British and European name for the same thing, involving crystal meth, GHB or GBL, and mephedrone.
The three terms get used together, and the risks are very different. Poppers are the most common and, for most occasional users, the least dangerous. Chemsex carries much more serious risks, including overdose and dependence. I am a psychotherapist, and nothing here replaces medical advice. A GP, a local drug service or a sexual health clinic can give confidential advice, and many sexual health clinics in larger cities have staff who specialise in chemsex.
What poppers are
Poppers are a group of chemicals called alkyl nitrites: amyl, butyl, isobutyl, isopropyl and pentyl nitrite. Amyl nitrite was prescribed for angina from the 1860s, because it widens blood vessels. The name comes from the glass capsules it was once sold in, which made a popping sound when crushed.
Inhaled, poppers dilate blood vessels quickly. The effect is a rush of warmth and lightheadedness, a faster heartbeat and a drop in blood pressure, and it fades within a couple of minutes. They also relax smooth muscle, including the muscles around the anus, which is the main reason they became part of gay men’s sexual culture in the 1970s. They are sold in small bottles labelled as room odouriser, leather cleaner or nail varnish remover, which allows them to be sold without being marketed for human use.
Many gay men use poppers occasionally for years without obvious harm, and most never move on to anything else. They are still a drug, with specific risks worth knowing.
The risks of poppers
The most serious risk is the combination with erection drugs. Sildenafil (Viagra), tadalafil (Cialis) and similar medicines also lower blood pressure, and taken with poppers they can cause a sudden, severe drop that can lead to fainting, heart attack or stroke. The same applies to nitrate medicines prescribed for heart conditions.
Other risks:
- Swallowing poppers can be fatal. It causes methaemoglobinaemia, in which the blood cannot carry oxygen properly. If someone swallows poppers, call emergency services.
- Skin and eyes: the liquid burns skin, and splashes in the eye need rinsing and medical attention.
- Vision: regular use has been linked to poppers maculopathy, damage to the centre of the retina causing blurred central vision. A review of reported cases found it often improves after stopping, though not always completely. Isopropyl nitrite has been linked to more cases since isobutyl nitrite was restricted in the EU.
- Health conditions: people with heart problems, low blood pressure, glaucoma or anaemia face higher risks.
On the law: in the UK poppers have never been controlled under the Misuse of Drugs Act 1971. Their status under the Psychoactive Substances Act 2016 has been argued over in the courts, and the Advisory Council on the Misuse of Drugs has recommended formally exempting them. Possession for personal use is not an offence. Laws in other countries differ and change, so check where you live.
PnP and chemsex: one practice, two names
PnP and chemsex describe the same thing: sex, often with several partners and over many hours, under the influence of drugs taken to sustain arousal and lower inhibition. PnP is the term used in North America and on apps there. Chemsex is the term used in the UK and Europe, and it entered public health language through The Chemsex Study, research led by Adam Bourne at the London School of Hygiene and Tropical Medicine in 2014.
The drugs most associated with it are:
- Crystal methamphetamine (tina, T, ice): a stimulant that produces intense arousal and energy for hours, sometimes smoked or injected.
- GHB and GBL (G, gina): depressants that produce euphoria and disinhibition at low doses and unconsciousness at slightly higher ones.
- Mephedrone (meph, M-Kat): a stimulant with a shorter effect, more common in the UK and Europe.
Slamming means injecting, usually crystal meth. On apps, words such as PnP or chems, or a capitalised T, usually signal that someone is looking for it. Poppers, alcohol and erection drugs often appear alongside these drugs, but they are not counted as chemsex drugs by themselves.
Wondering about your own use?
I work with gay men to help make sense of experiences like these. You don’t need to have it all figured out before we talk.
Explore working with meWhy some gay men use drugs for sex
Most chemsex has little to do with the drugs themselves. In the research and in my own work, the reasons men give are consistent. Drugs make sex feel easier for men who find it hard sober: men carrying shame about sex, men anxious about their bodies or performance, and men who struggle to feel close to anyone without something lowering the guard first. Drugs also produce a feeling of intense connection with strangers, which can be powerful for men who feel lonely or unwanted.
The drugs work, for a while, on problems that have nothing to do with drugs.
That is why chemsex is so closely tied to shame, anxiety during sex and loneliness. The drugs work, for a while, on problems that have nothing to do with drugs. When they stop working, or start causing harm, the original problem is still there, usually bigger.
Apps make it easier to find. Many men describe their chemsex use rising and falling with how much time they spend on hookup apps, which I wrote about in Grindr and compulsive use. Safety on the apps themselves is covered in Grindr and Sniffies.
The specific risks of chemsex
GHB and GBL carry the most immediate danger. The gap between a dose that feels good and a dose that causes unconsciousness is small, and it narrows further with alcohol or other depressants. In Bourne’s follow-up interviews, a majority of men described overdoses, mostly on G. Men who use it are commonly advised to measure doses precisely, leave long gaps between them and never mix it with alcohol. Someone who cannot be woken needs an ambulance, placed on their side, never left alone to sleep it off.
Crystal meth carries a high risk of dependence. Comedowns can bring days of low mood, and heavy use can cause paranoia and psychosis. Injecting adds the risks of infection and blood-borne viruses.
There are sexual health risks, because long sessions with several partners make condoms less likely and drugs make it harder to keep track. PrEP and regular testing reduce HIV risk significantly. PEP is available from sexual health clinics and A&E within 72 hours of a possible exposure. There are also consent risks: men who are high, or unconscious on G, cannot consent, and some men describe sex during chemsex they did not agree to.
When it stops being a choice
Many men use drugs around sex occasionally and stop without difficulty. For others, use slowly takes over. The signs are fairly consistent: sex that no longer feels possible without drugs, sessions longer or more frequent than intended, missed work, money problems, frightening experiences, comedowns that last days, and a world that has shrunk to sessions and recovering from them.
If you recognise that, support exists. Many sexual health clinics run chemsex services, and a GP or local drug service can arrange support too. Therapy is useful alongside that practical help, for the shame, anxiety or loneliness the drugs were managing. I describe how I work with it in chemsex and gay men.
Questions about this topic
What are poppers in the gay community?
Poppers are small bottles of liquid alkyl nitrites that are inhaled for a brief head rush and muscle relaxation. They have been part of gay men’s sexual culture since the 1970s, mainly because they relax the muscles around the anus and make receptive anal sex easier.
Are poppers dangerous?
For most occasional users the short-term effects pass within minutes, but the risks are real. Combined with erection drugs such as sildenafil or tadalafil they can cause a dangerous drop in blood pressure. Swallowing them can kill. Heavy use has been linked to damage to the centre of the retina, known as poppers maculopathy.
What does PnP mean?
PnP stands for party and play, a term used mainly in North America for sex combined with drugs, most often crystal methamphetamine. It describes the same practice that is usually called chemsex in the UK and Europe.
What drugs are used in chemsex?
Mainly crystal methamphetamine, GHB or GBL, and mephedrone, often in combination and sometimes over many hours or days. Poppers, alcohol and erection drugs are often present too, though they are not usually counted as chemsex drugs on their own.
Are poppers legal in the UK?
Poppers have never been controlled under the Misuse of Drugs Act 1971. Their position under the Psychoactive Substances Act 2016 has been disputed, and the government’s drug advisers have recommended formally exempting them. Possession for personal use is not an offence, and the law elsewhere varies by country.
How do I know if chemsex has become a problem?
Warning signs include sex no longer feeling possible or enjoyable without drugs, sessions lasting longer or happening more often than you intend, missed work or commitments, frightening experiences such as losing consciousness, and comedowns that leave you low for days.