Last opportunity to challenge poppers ban!

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The TGA has published an interim decision on moving nitrite inhalants, also known as amyl or poppers, onto Schedule 9 of the Poisons Standard — a move which would make the sale, possession, use or administration of poppers a criminal offence under controlled substances legislation in Australian states and territories.

These laws are different in each state and territory, making the full exposure to criminal liability a bit difficult to predict. Under the relevant law in the Australian Capital Territory, for example, a person who purchased a poppers product from overseas, held it in their possession, used it themselves and offered it to a sexual partner could be guilty of four separate offences. (See Vic | NSW | ACT laws.)

The interim decision on nitrite inhalants can be viewed here.

Submissions open!

You can make submissions on the interim decision by e-mail until 11 October 2018.

See the instructions on how to respond and my own draft response below

There’s work underway on a public document with key messages and evidence that you can draw on to write your own submissions.

Update 18 Sept – 

 

My own (draft) response

To whom it may concern,

Re: Including a group entry for nitrite inhalants in Schedule 9 of the Poisons Standard

I am a gay man – a member of the community most affected by the proposed changes. I have worked as an educator in HIV prevention since 2004 and as a researcher in the same field since 2013. In addition to undergraduate qualifications in Law and Arts, I hold a Graduate Diploma in Public Health and I am currently a PhD candidate at the ANU School of Regulation and Global Governance.

I have used inhaled nitrites, popularly known as ‘poppers’, on occasion since 2009. The effects of poppers use are extremely short-acting. They play an important role for many gay men in making sexual intercourse less painful, due to their principal effect of relaxing smooth muscle. Indeed, a topical nitrite product, glyceryl trinitrate, is available for the same purpose as a pharmacist-only medication.

In the United Kingdom, the Conservative Party MP Crispin Blunt spoke publicly about the benefits that nitrite inhalants offer gay men, during debate over legislation to ban legal highs. A Home Affairs Select Committee report found the use of poppers was ‘not seen to be capable of having harmful effects sufficient to constitute a societal problem.’[i]

Poppers have been used by gay men for sexual purposes since the 1970s. The medical literature shows a smattering of case reports documenting injuries attributed to poppers use. Only recently have there been reports of retinal injuries subsequent to poppers use. This trend needs to be understood in a regulatory context.

In the EU in 2007 and in Canada in 2013, regulatory action was taken to ban the sale of the chemical formulations commonly included in poppers products. This in turn caused some manufacturers to include different formulations in poppers products. Users have reported the reformulated products often cause an intense headache, ‘blue lips’ and a characteristic chesty cough in the days after use. The Lancet attributes ‘poppers maculopathy’ to the reformulated product.[ii]

This highlights the risk of product substitution posed by any ban. Following the EU and Canadian regulatory action, alternative products have been brought to market. These are packaged in aerosol cans. These are not nitrite inhalants and their mechanism is effectively the same as paint-sniffing. These products would not be captured by the proposed ban, and indeed the proposed ban is highly likely to increase the market for such products.

Poppers have been in use for nearly five decades with very few reports of serious harm, and recent case reports describe a previously undocumented form of harm. This suggests the harm is the result of the reformulated products, which were only adopted due to regulatory action. Banning nitrite inhalants as a class will have a significant impact on the capability of many gay men to achieve sexual pleasure and intimacy without pain and discomfort. In addition, it will expose a historically marginalised, stigmatised and criminalised community to a new vulnerability to criminal prosecution.

A more targeted ban, leaving long-standing formulations legal, would reduce the risks of rare but serious clinical harms, and prevent the import and widespread uptake of copycat products whose risks are substantially unknown.

Yours sincerely,

Daniel Reeders BA LLB (Melb) Grad Dip Pub Hlth (Flin)

[i] Home Affairs Committee, Psychoactive Substances (report), London: Stationery Office, 23 Oct 2015, p. 14 https://publications.parliament.uk/pa/cm201516/cmselect/cmhaff/361/361.pdf

[ii] Gruener, Anna M., Megan A. R. Jeffries, Zine El Housseini, and Laurence Whitefield. “Poppers Maculopathy.” The Lancet 384, no. 9954 (November 1, 2014): 1606. https://doi.org/10.1016/S0140-6736(14)60887-4.

 

Author: Daniel Reeders

I study the cultural dimensions of the social governance of health.

4 thoughts on “Last opportunity to challenge poppers ban!”

  1. Get on it queers, actually make a submission, dont wait for someoneelse to do it and whinge about amyl not being available if these bastards have their way.

  2. Hi,

    I applaud your advocacy Daniel….a timely blog, thank you for your insights. Excellent submission draft.

    There has been a review of the literature on this in 2017 by a Canadian bunch.(1) Whilst i can appreciate the focus on the reformulation, it was a hypothesis and hunch and never a hard evidence based theory.

    Other case reports in the literature have revealed two common themes in the mechanism.(1)
    1. Photic injury secondary to photosensitivity.
    2. Damaged caused by acute changes in ocular perfusion as a result of vasodilation.

    The link below has the literature review and other references about this adverse drug reaction.

    Unfortunately, the TGA has a track record of regulation to basically save us from ourselves (the ‘nanny state’ at it again). Personally, I think a stronger case is to be made regarding the heavy handedness of this, the very few case reports and the overall prevalence of use of this drug. i.e why is the government intervening about this drug which has very few case reports of major problems, yet has substantial wide use over decades?

    This speaks of the broader narrative of policy response to harm from recreational drugs….. criminalisation vs a more sophisticated health promotion / harm minimisation response. For those abusing Amyl enough for it to lead to this issue, they are probably going to be able to access it and abuse it anyway. This begs the question: What is the purpose of such legislation apart from another chance for the government to be in control of LGBTIQ peoples’ private lives and bodies and how we express and experience our sexuality?

    My 2 cents on this whole fiasco…. another predictable and disappointing government response to harm from drugs. What makes this additionally insulting is the institutionalised homophobic undertone dressed up as a perception of government looking after LGBTIQ people’s safety. It is the same over-involvement in the private lives of LGBTIQ people when it isn’t required, needed or asked for…..why aren’t they addressing issues actually important to us?

    1. Hey Deano, thanks for your comment. As you would expect, I have done my own reading. To the best of my knowledge the evidence on poppers maculopathy is confined to case reports and case series. There is one single letter to the editor that claims that poppers maculopathy might actually be photic injury. I didn’t find the behavioural premises of that argument credible, and it certainly isn’t a common theme. There is also speculation that the damage is caused by changes in ocular perfusion, but that’s a systemic effect, so it’s odd that poppers maculopathy repeatedly presents in such a specific form. The public policy questions you raise are important and I would definitely encourage you to express your thoughts in a submission to the TGA.

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