Amyl Nitrite: Usage trends

Last modified: Thursday, 25. December 2008 - 5:28 am

 

The use of amyl nitrite as a prescription drug for angina pectoris has dropped considerably from a few decades ago and since the early 1960s has been prescribed rarely in the United States. Because a prescription is required to obtain amyl nitrite in the United States, two variants of the drug, butyl nitrate and isobutyl nitrate, became popular in the 1970s. After falling out of favor in the 1980s and 1990s, there again appears to be a slight surge in the drugs’ usage. The primary users today are teenagers and young adults who attend raves and all-night dance parties. Poppers are often used in conjunction with other so-called rave or club drugs, such as 3, 4-methylenedioxymethampheta-mine (MDMA or ecstasy), ketamine, 2C-B, and gamma hydroxybutyrate (GHB).

Scope and severity

There are few studies or research data that tracks the scope and severity of amyl nitrite usage, particularly among adults. It is usually lumped in the general category of inhalants. However, it is generally believed the problem is not as severe as with other, more readily available inhalants, such as solvents, aerosol propellants, and aliphatic nitrites, such as cyclohexyl nitrite.

Inhalant abuse is found in both urban and rural areas of the United States and Canada. Research indicates social and economic rather than racial and cultural factors in general impact the rate of inhalant abuse. Poverty, physical or mental abuse as a child, poor grades in school, and dropping out of school are all associated with increased inhalant abuse. At particularly high risk are Native American youths who live on reservations where poverty and school dropout rates are high.

According to Alcoholism & Addiction Magazine, researchers have put together a “user profile” of inhalant abusers. Almost all of the profile indicators relate to social and economic conditions. The profile of a typical inhalant abuser is: poor academic achievement in junior high or middle school, no father living at home, poor coping skills, insecurity and low self-esteem, low I.Q., depression, an alcoholic living in the home, family problems, and low family income.

Age, ethnic, and gender trends

Amyl nitrite abuse can be found in all ethnic groups, age levels, and genders. However, the predominance seems to be among older adolescents, white, from families with low to average incomes, male, and those who frequent dance clubs and raves. Most abusers use amyl nitrite in combination with other drugs.

The University of Michigan has conducted the Monitoring the Future (MTF) study, sponsored by the National Institute on Drug Abuse (NIDA), each year since 1991. It tracks drug use among students in the eighth, tenth, and twelfth grades. While inhalant use has been tracked for all three grade levels, amyl nitrite use has been tracked only for twelfth grade students.

In 1991, 1.6% of the nation’s high school seniors reported using amyl nitrite at least once during their lifetime. For the next five years, the survey found the rate relatively consistent, between 1.5% and 1.8%. In 1997, the rate rose to 2% and jumped to 2.7% the following year. It dropped to 1.7% in 1999 and plunged to less than 1% in 2000, the lowest level in 10 years. But in 2001, the rate jumped again, to 1.9%, a 1.1% increase over the previous year. It was the largest percentage increase between 2000 and 2001 of any of the 20 drugs or drug groups tracked by the study (which includes alcohol and tobacco), with the exception of steroids, which showed a 1.2% increase among twelfth-graders.

Researchers involved in the study were unsure what caused the increase. The only other drugs that showed usage gains among twelfth-graders between 2000 and 2001 were marijuana and hashish (0.2%), hallucinogens other than LSD (0.1%), PCP (0.2%), MDMA or ecstasy (0.7%), amphetamines (0.6%), tranquilizers (0.4%), and Rohypnol (0.3%). Since most of the increases were in the so-called club drugs, it is likely that amyl nitrite is being used in conjunction with these drugs.

Amyl nitrite was not tracked among eighth- and tenth-graders in the MTF study, but was included in the general category of inhalants. Data from national and state surveys have found that inhalant abuse is most commonly found in junior and senior high school students, reaching a peak in seventh through ninth grades. In the MTF survey, about 20% of eighth grade students said they have sniffed inhalants. This compared to about 16% of tenth-graders and 15% of high school seniors.

One obvious question then is how can fewer tenth and twelfth grade students than eighth grade students report they have ever used inhalants? There are two possible answers, according to NIDA. First, older students may not remember their earlier use of inhalants. Second, and more troubling to researchers, is that many eighth grade inhalant abusers may have dropped out of school before they reached the twelfth grade.

Gender differences in inhalant abuse have been identified at different age levels, according to NIDA studies. One study showed inhalant abuse is higher for boys than girls in the fourth through sixth grades, occurs at similar rates in the seventh through ninth grades when overall use is highest, and is higher for boys in the tenth through twelfth grades. The National Household Survey on Drug Abuse (NHSDA) among Americans found that in 1998, the use of inhalants among 12- to 17-year-olds was evenly divided among boys and girls. The same study found that among 18- to 25-year-olds, the rate of inhalant abuse was twice as high among males compared to females. This suggest the long-term use of inhalants is much more common among males.

Inhalant abuse among eighth, tenth, and twelfth grade students gradually declined between 1996 and 1999, according to MTF surveys. However, the rates are still higher than they were in the late 1980s, according NHSDA data. Usage seems to vary from state to state. Few states track the use of amyl nitrite among students. One that does is Maryland, which reports one of the lowest rates of inhalant abuse among students.

In the rural state of West Virginia, 28.4% of high school students reported they had used an inhalant to get high in 1997, according to the Office of National Drug Control Policy (ONDCP). Among female students, the rate was 26.4% and among males, 30.6%. In neighboring Kentucky, the rate was 18.2% for 1999. In Ohio, which has both large urban and rural areas, 17.1% of high school students said they had used an inhalant, according to a 1999 ONDCP report. In Texas, a 1996 survey found that 20% of seventh and eighth grade students had used an inhalant to get high at least once.

In Britain, the trend is taking amyl nitrite into the general youth and adolescent population. A 2000 survey of 16-year-olds in northwest England found that more than 20% said they have used inhalants at least once. The number of Canadian youths between 12 and 17 years of age who have tried inhalants is between 3% and 5%, according to the Canadian Medical Association (CMA). However, the percentage is much higher among certain impoverished populations, such as the Inuit and Aboriginal communities, where the CMA stated the problem is widespread and epidemic.

 

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