Last opportunity to challenge poppers ban!

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 – 

• here’s my item-by-item breakdown of the TGA’s interim reasons for the ban.
• we do not have to write anything this comprehensive but this application by New Nicotine Australia for re-scheduling of non-smoked nicotine (e.g. vapin) offers a really good introduction to the way the TGA works. Takehome: IT’S TECHNICAL AF. (Thanks Ash Blackwell from Unharm and SSDP for passing this on.)

 

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.