Corkery John Martin, Copeland Caroline S, Ream Stephen, Streete Peter, Schifano Fabrizio
Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, Hertfordshire AL10 9AB, UK.
Institute of Pharmaceutical Science, King's College London, London SE1 9NH, UK.
J Clin Med. 2025 Jan 10;14(2):427. doi: 10.3390/jcm14020427.
Alkyl nitrites are a class of inhalant, commonly known as 'poppers'. Although having medical uses, some other effects include a 'rush', 'high', 'euphoria', or feeling of excitement. This has led to their recreational use, in different scenarios, since the mid-1960s. Adverse effects include tachycardia, migraine headaches, fainting and dizziness, and ventricular fibrillation. Death can occur from the inhalation or ingestion of nitrites. As part of its updated advice to the United Kingdom (UK) Government, the Advisory Council on the Misuse of Drugs considered popper-related mortality, seeking an accurate estimate of deaths. Data from a range of sources, including specialist mortality databases, were collated and analysed in terms of the key characteristics of decedents and fatal incidents, including the use mode. The chemical names of the nitrites were used in searches. At least forty-two deaths occurred during 1987-2018; two were female. The mean age at death was 44 (range of 20-75) years. Most were White. Most fatalities occurred in England. The specific nitrites mentioned (N = thirty-two) were isobutyl (fourteen); amyl (seven); isopropyl (six); alkyl (three); and butyl (two). The mode of use was only known in 23/42 cases. The product was definitely swallowed in five cases, and very likely in a further one. Four additional cases were identified from the literature and media searches. The lack of a current systematic identification of relevant deaths and shortcomings in historical specialist mortality databases have severely limited what could be established with certainty about these cases. The same criticisms also apply to inhalant mortality data more generally. Nevertheless, the information presented here allows for some conclusions to be drawn and inform UK policy development.
亚硝酸烷基酯是一类吸入剂，通常被称为“Poppers”。尽管有医疗用途，但其他一些影响包括“冲动感”“兴奋感”“欣快感”或兴奋情绪。自20世纪60年代中期以来，这导致它们在不同场景下被用于娱乐。不良反应包括心动过速、偏头痛、昏厥和头晕，以及心室颤动。吸入或摄入亚硝酸盐可能导致死亡。作为向英国政府提供的最新建议的一部分，药物滥用咨询委员会考虑了与Poppers相关的死亡率，力求准确估计死亡人数。对包括专业死亡率数据库在内的一系列来源的数据，按照死者和致命事件的关键特征（包括使用方式）进行了整理和分析。搜索时使用了亚硝酸盐的化学名称。1987年至2018年期间至少发生了42起死亡事件；其中两起为女性。死亡时的平均年龄为44岁（范围为20至75岁）。大多数为白人。大多数死亡事件发生在英格兰。提及的具体亚硝酸盐（N = 32）为异丁基（14种）；戊基（7种）；异丙基（6种）；烷基（3种）；丁基（2种）。仅在23/42的案例中知道使用方式。在5个案例中产品肯定被吞服，在另外1个案例中很可能被吞服。通过文献和媒体搜索又发现了4个案例。目前缺乏对相关死亡事件的系统识别以及历史专业死亡率数据库存在的缺陷，严重限制了对这些案例能够确定的情况。同样的批评也普遍适用于吸入剂死亡率数据。尽管如此，此处提供的信息仍能得出一些结论，并为英国的政策制定提供参考。
