Talk:Poppers

NPOV lost with removal of any reference to HIV/AIDS and the elimination of dozens of published research articles from the reference section.

The recent elimination of any reference to poppers being a risk factor in HIV infection is a blatant example of vandalism. Dozens of published research articles, with PMID numbers included, were eliminated from the reference section. Attempts to link the references to the article have been repeatedly sabotaged by tag team tactics, apparently from those who cannot let the controversy even be referenced, let alone published research findings from major AIDS journals. Unfortunate for those who would be interested in the popper/HIV connection and/or controversy. The controversy does exist. It should be referenced. The poppers industry does exist. It's viewpoint should be included but not result in the elimination of information supported by dozens of published research articles. Hankwilson 02:53, 2 May 2007 (UTC)HankwilsonHankwilson 02:53, 2 May 2007 (UTC)

Let's find a way to incorporate information on the poppers/HIV correlation into the article, rather than as an indiscriminate laundry list of links in the reference section. MastCell ^Talk 04:11, 2 May 2007 (UTC)

Hank, an item should not be listed in the References section if it's not directly used as a citation in the main article. Wikipedia isn't meant to list every article on every subject. ...and crying 'vandalism' when it clearly isn't true won't help your credibility in this area. --John T. Folden 05:45, 2 May 2007 (UTC)

How do you add or delete items in the "references section"? I am not able to. It looks like the section is somehow locked or something.196.40.34.129 15:39, 4 May 2007 (UTC)

The references list is generated automatically from citations in the body of the article. So to modify them, you have to find the text where the reference is cited and edit that. To add a reference, just put the text you want footnoted between <ref> and </ref> tags. It will appear, numbered properly, in the references section once you save it. There's more how-to information at Wikipedia:Footnotes - let me know if that doesn't make sense. MastCell ^Talk 15:45, 4 May 2007 (UTC)

In being bold and making some changes to the 'Health Issues' section I'm hoping to avoid abuse by following the guidelines in the "This Topic contains controversial issues" notice at the top of the Discussion page.

I've thoroughly read the discussion-page dialogue and have cited reputable sources supporting the information contained in the edit. Also I'm trying to "carefully describe the reasons" for the edit.

Setting aside the passionate arguments and sometimes heated rhetoric in the discussion-page, the body of data points to a general consensus that inhaling nitrites is not significantly harmful nor is it wide spread through society. [1] </ref [2] [3] [4] [5]

The concern about poppers and a possible relationship to AIDS creates the most rhetoric in this article and underlies passionate exchanges throughout the discussion-page. I hope any debates over the general consensus of thought about poppers can be on a high note and not degenerate to the silliness and personal attacks seen in the past. Munatobe7 20:03, 11 May 2007 (UTC)

You may want to look at Wikipedia's guidelines on reliable sources - many of those you cite would fail that guideline (virusmythpoppersmyth.org, allaboutpoppers.com, for instance). Further, it's not clear to me that there's a medical or scientific consensus that poppers are "not significantly harmful" - in fact, a number of scientific papers cited above target popper use as an area of intervention to improve the health of affected communities. MastCell ^Talk 20:09, 11 May 2007 (UTC)

Rather than looking at apparently biased sites such as virusmythpoppersmyth and so on, or complex scientific papers which most Wikipedia users cannot understand, my preference would be to reference and cite sources that provide information about poppers, but as a general review of drug (ab)use in general. In the UK, the two that come to mind to me are FRANK (drugs), which is a government sponsored drugs awareness programme, and TheSite.org, which is run by a fairly large UK charity, and covers a large variety of information for teenagers and young adults. Merck also seems to fit this criteria. These sorts of sources will inherently be more trustworthy than the sources that focus soley on poppers, as these seem to tend to have either a strong pro- or anti-popper stance. me_and 22:13, 11 May 2007 (UTC)

Sure, I think we should focus on reliable secondary sources like those you mention. In the U.S., there's the National Institute on Drug Abuse, for one (see [6] (slightly out of date), [7], etc). Virusmythpoppersmyth, allaboutpoppers, etc are not encyclopedic sources. MastCell ^Talk 22:34, 11 May 2007 (UTC)

I chose the 'not significantly harmful' text based on the Merck site along with public statements from what appeared to me to be credible sources, including the CPSC and other Government agencies, and researchers here and in Canada.

What makes the allaboutpoppers.com site unreliable? It appears credible at first glance and once inside is full of apparently credible and valuable information. For example, there's the page that contains comments from various credible sources . The Lancet article seems to fit your criteria perfectly, as well. The article about the CPSC is not biased one way or the other.

I don't entirely agree that because a site may focus solely on poppers it is inherently less trustworthy. I think that it would depend on the content and any underlying support for that content. In fact, such a site could actually be more trustworthy if it is grounded in genuine expertise on the subject.

I've noticed disparities in the content of the various general review sites which try to be the know-all on various subjects. Some fit the classic criteria for the admonishment to beware of what you read on the internet.

My effort to add to the article isn't to take a position one way or the other. The article had been sitting idle so I though I'd be bold and add what I felt was an honest assessment of the available credible information.Munatobe7 23:01, 11 May 2007 (UTC)

Sorry, I didn't mean to criticize you; I think boldness is a good attribute here. I was focusing mainly on the sources involved. Allaboutpoppers appears to be a self-published site(?). The fact that it may appear credible at first glance is not necessarily reassuring, rather the opposite. If we want to use the various reliable sources found at the site, we should link them directly. It's quite easy to link the Lancet article directly via PubMed, and I think we can find the other sources to link directly online without going through the filter of a self-published site. MastCell ^Talk 00:09, 12 May 2007 (UTC)

No offense taken MastCell. I appreciate your civil feedback. BTW, would it be better if I removed the edit I did until we come to some agreement on all this? I put it out there thinking it would be worked on almost immediately. I think I may have screwed up anyway since the references don't seem to be working properly now. I must have miscoded it or something.Munatobe7 01:01, 12 May 2007 (UTC)

A site concentrating on poppers is not biased inherently. However having looked at the sources that have come up on this article, I've found sites that focus on poppers or inhalants tend to have a strong bias one way or the other. All About Poppers, for example, has no references to anti-poppers articles that I can see. That doesn't make the content unreliable, but it does mean that when reviewing the site, one has to remember that this bias exists; a problem that is reduced, at least, by using secondary sources. Also, as MastCell points out, all(?) the content on All About Poppers is simply reprinted from elsewhere—better to find a copy of the original source and cite that.

IMO, the content you added was good; there's no need to remove it, it just needs the referencing corrected (I think you missed the > from the opening <ref> tag—you want <ref>citation</ref>). You might also want to consider using citation templates to include more information in the citations, although that's my preference rather than Wikipedia policy. That said, I will admit to being concerned about the "Though no definitive proof exists, caution seems prudent" comment—that's really something for the reader to make their own mind up about (WP:OR, WP:NPOV, and so on). I'll let you correct, not least because it's gone 3am here, and I need to go to bed!

Echoing MastCell, I'm very grateful for other editors on this article! One of the problems this article seems to have suffered is a lack of bold editors (myself included—it's far too easy to take the easy road and try to avoid an argument). Thanks! me_and 02:22, 12 May 2007 (UTC)

Me_and thanks for the comments. I assumed that when you were referring to the suggested correction you meant I might want to rethink "though no definitive proof exists", which is what I removed. You're right, the reader can make up their own mind. Do you think "caution seems prudent" is too much? Or not enough?

I love your citation style, and I tried and tried to do the same thing. But when I couldn't get it to work after several attempts, and my eyes began to glaze over, I decided to throw in the towel and go to bed, too. :-) Munatobe7 04:31, 12 May 2007 (UTC)

I think "caution seems prudent" is to close to advising the reader to use caution when using poppers. I've changed it to "most current secondary sources do not consider the risk large enough to note", which I think achieves broadly the same purpose, but draws a conclusion from cited sources, rather than actually advising the reader.

I've removed a few references that seemed to be duplicating themselves; Harper's Publishes AIDS Denialist (Kim, 2006) has the added advantage of linking to further sources. After the article's references had been cleaned up so beautifully from the sprawling mass that they were before, I'd hate to see them all creep back in.

If you want to try to learn how to use the citation templates, I recommend looking at how I've edited them; for example your reference to Merck simply became <ref name="Merck"/>, as it had already been referenced earlier in the article. More usefully, the reference to the US CPSC became:

 
  {{cite web |                                                 Name of the template
  url=http://www.virusmythpoppersmyth.org/cpsc_report_1983/ |  URL of the source
  title=Briefing Package on Petition HP82-1 |                  Title of the source
  accessdate=2007-05-12 |                                      Date the source was last
                                                                 checked
  last=McNamara |                                              Author name, you can also
  first=A. Moira |                                                use Author= instead of 
                                                                  Last= & First=
  year=1983 |                                                  Date of writing/publication
  month=July |                                                 If the full date is available,
                                                                 use date=[[yyyy-mm-dd]]
  format=Reprint |                                             This could be, for example, 
                                                                 PDF, or similar
  publisher=[[Consumer Product Safety Commission|U.S. Consumer Product Safety Commission]]
                                                               I've wikilinked the publisher
                                                                 so that people can find out
                                                                 more about the source
  }}

I find the easiest way to learn how to use the references system is to play around in the sandbox. The templates are all at WP:CITET, and you seem to have the hang of the <ref> tags now. me_and 13:21, 12 May 2007 (UTC)

The health issues reference to "most current secondary sources" should be changed to "some current secondary sources" to achieve NPOV. The current wording overstates, it is non neutral, and it is dismissive of published concerns by multiple researchers that popper use increases the risk of HIV transmission.

A credible current secondary source which does cite a concern about popper use increasing the risk of HIV transmission is the FDA. See 2006 FDA letter, this articles reference #3,:including this statement:" FDA recognizes that the abuse of amyl nitrite inhalant and other poppers is a serious health issue, particularly for the segment of homosexual male population that continues to use them. There are reports in the literature that associate the use of nitrite inhalants with immunosuppression, increased risk of HIV transmission, and Kaposi's sarcoma."

The current health risks section fails to reference the accumulating published research which finds popper use a significant risk factor increasing HIV transmission and risky sexual behavior. See previous citations with PMID numbers for easy reference.

Again, this is a major health issue for  gays and men who have sex with men, the major consumers of poppers.

Again, there should be a statement that there is a controversy and the divergent positions should be stated for the reader to consider. I will be adding these changes but am noticing for constructive feedback in advanceHankwilson 21:20, 12 May 2007 (UTC)HankwilsonHankwilson 21:20, 12 May 2007 (UTC)

Hank, the author of a letter, even if it's a government employee as is the case with the FDA letter you cite, isn't necessarily a reliable secondary source. The statement about poppers that you reference is based on the letter-writer saying there are 'reports in the literature'. There are also 'reports in the literature' that conflict with his statement.

The massive indiscriminate laundry list of links to both your anti-popper papers and the pro-popper references was mainly listcruft and was finally cleaned up. I hope you're not going to rebuild it. But reading through it I found it hard to understand why you think this is a "major health issue" for gays and men who have sex with men. I also can't find a reliable secondary source to support your statement that gays are "the major consumers of poppers'. Is that an urban myth within the gay community, or fact?

There is already a statement in the 'Health Issues' section of the article that addresses your concerns about divergent positions and controversy. Straightshooter7 17:53, 13 May 2007 (UTC)

The FDA letter is a usable, reliable secondary source. It's not private correspondence; it is stored on the FDA's website and represents an official response to a request on nitrites and therefore an indication of the FDA's thinking on the subject, at least as of the time it was written. Yes, there are reports in the literature stating various things - hence the need for reliable secondary sources (e.g. FDA letter, Merck manual, etc) to parse them. MastCell ^Talk 19:39, 13 May 2007 (UTC)

I disagree, Hank. "Most seconary sources" implies that the majority of secondary sources draw no link between poppers and HIV or related illnesses, although some secondary sources do draw such a link. To me, that seems to be the case; especially if one concentrates on secondary sources designed to be seen by the general public.

On a seperate note, with your permission, Hank, I'd like to edit the formatting of your posts on this board; at times I find it makes this page difficult to read. me_and 22:09, 13 May 2007 (UTC)

I would tend to agree that "most secondary sources" do not draw a link between poppers and HIV or related illnesses, especially sources that are geared toward the general public.

Looking at the studies in that long reference list revealed that there seems to be almost a cottage industry of a few researchers who, going back twenty five years or longer, have performed a number of studies that try to draw such a conclusion, with some of them even having drawn conflicting results sometimes in their own studies.

Some of these studies have been careful to caution the reader about the 'results', while others have used what has been termed ' treacherous' analysis techniques to reach their conclusion about such a connection.

I think it can safely be said that, in general, it seems that science and medicine do not draw any significant link between poppers and HIV/AIDS.

But that is not to say that popper usage should be encouraged. I also feel that it would be useful if more and better-controlled studies were performed on popper usage which might answer some of these open questions.Munatobe7 02:17, 14 May 2007 (UTC)

I disagree about your "it can safely be said...." There are multiple recent published studies in peer reviewed scientific journals which find that popper use is a significant risk factor for HIV infection. The PMID numbers were supplied for verification of said statement. It seems reasonable that several of these published studies should be cited. They are recent studies. They are in peer reviewed scientific journals. They are not home grown cottage industry researchers. They are responding to the AIDS epidemic and conducting research to reduce transmission of HIV. The immunosuppression research spans over 20 years...and continues. Thus, there is disagreement about what can safely be said. A controversy does exist for sure and it should be included.

There is a popper industry and it has a message. There are researchers and they have a message. I support inclusion of both positions with attribution to facilitate analysis. 71.138.80.137 04:28, 14 May 2007 (UTC)Hankwilson71.138.80.137 04:28, 14 May 2007 (UTC)

Hank Wilson:

1) Are you currently or have you ever been a petitioner to the FDA or any other government agency on the subject of poppers or nitrites?

2) Have you ever collaborated with any petitioner to any government agency on poppers or nitrites?

3) Are you an author of any books or publications on poppers or nitrites in addition to 'Death Rush'?

4) Are you currently or have you ever collaborated with any researchers on the subject of poppers or nitrites?

5) Have you ever or are you currently collaborating in any way with any popper sellers or manufacturers?

I don't see the relevance of this. User:Hankwilson is hardly the only single-purpose account active here, nor the only one with a potential conflict of interest. Conflicts of interest on Wikipedia are generally relevant insofar as they lead to disruptive or biased editing (see WP:COI). So far I've seen Hank suggest we include balanced information on poppers attributed to reliable sources, which is hardly disruptive. So let's focus on what sources to use and how to present them instead of going after a contributor who has not been disruptive. MastCell ^Talk 17:53, 14 May 2007 (UTC)

The "Health Issues" section should state that poppers are immunosuppressive reflecting the published articles in peer reviewed scientific publications..

The current wording says "it has been suggested". This should be changed to "Research has demonstrated that poppers are immunosuppressive." It is suggested that the demonstrated immunosuppression is significant increasing susceptibility to HIV infection. Issues of quantity of popper use and frequency of popper use may be considerations effecting the susceptibility to HIV infection.Research is ongoing to understand the significance of the immunosuppression.

To refer to the immunosuppression research is to state reality. The research exists. To judge it,critique its limitations, characterise it, raises points of view issues but these can be included in the context of acknowledging that there is controversy on interpretation of the research.Failure to acknowledge the research is not neutral or objective. Hankwilson 20:33, 15 May 2007 (UTC)HankwilsonHankwilson 20:33, 15 May 2007 (UTC)

I've slightly reworded this section to indicate actual evidence rather than simply a suggestion of it so as to bring the statement in line with the original cited article. I can not mention anything further as it is not included in the current source article. --John T. Folden 00:00, 16 May 2007 (UTC)

allaboutpoppers.com is not a credible source of information. It omits references finding poppers immunosuppressive that have been published in scientific peer reviewed journals.

www.allaboutpoppers.com is a poppers industry website. Google fails to list that website in a google search re: "poppers" for this reason. It does not pass the neutral point of view test and it should not be listed as a credible reference.Can more credible references replace existing references? Hankwilson 20:51, 15 May 2007 (UTC)HankwilsonHankwilson 20:51, 15 May 2007 (UTC)

What references are you talking about? --John T. Folden 00:04, 16 May 2007 (UTC)

I agree that All About Poppers is biased, however, as other users have pointed out, it does have a good collection of sources that can be verified elsewhere. I support changing the citations to reference the original source that All About Poppers uses, but whilst the collection may only consider one side of the argument (so linking to http://www.allaboutpoppers.com/ wouldn't be NPOV), referencing the individual articles seems sensible to me.

Whilst Google does not link to All About Poppers on a search for "poppers", it does link to Flying Pig, and All About Poppers does appear on a search for "alkyl nitrites". In any case, Google's page ranking is not and never has been a criteria for inclusion in Wikipedia. me_and 09:37, 16 May 2007 (UTC)

Hank, I've noticed that you've mentioned in a number of posts that Google does not list All About Poppers in a search on "poppers" as though that's somehow significant. Then, today, you bring it up again saying the reason is because Google claims it is an "industry website" and it does not "pass the neutral point of view test", and that it 'omits references finding poppers are immunosuppressive".

I agree that All About Poppers is biased, but I guess the first thing I wonder is why does that make the site less then credible? It is readily apparent that it's full of credible information, or at least contains links to lots of credible information. And why does Google care anyway? What business is it of Google to police the web and make judgments about websites before it catalogs them? I thought Google sent spiders out that looked at web page content based on the words in the sites and the links to the sites from related-subject sites. I thought this was the criteria it used, not whether it's an 'industry site' or whether or not the site passes some 'neutral point of view test'. ("Neutral" is in the eyes of the beholder.) It should follow, then, that under this criteria your anti-popper sites should also be de-listed.

I can understand, but don't agree with, Google China kowtowing to the Communist government and de-listing sites because the government does not want its citizens seeing certain sites, but this is not China. What right does Google have in de-listing any site in the USA simply because they don't feel it "passes the neutral point of view test" or is an "industry website"? (How do you know, or how does Google know, that this is an 'industry website'?)

My next question is how do you know this is the reason why Google does not list the site? What makes you say that? Google's algorithms and criteria are thought to be more secret then even the Coke formula. How do you know why Google does not list All About Poppers?

When you mention that All About Poppers should not be listed because it's not a 'credible reference', you raise another relevant question. No offense intended, but what makes any of the sites you yourself have referenced any more credible than All About Poppers? I mean, after-all, based on what you've posted in this article over the past year or more along with your history of anti-popper advocacy, it's hard to find anyone out there who is more biased against poppers then you are. I yet to find any sites you've referenced that were anything than other than anti-popper. Yet it's clear there's a wealth of information available that is opposed to your anti-popper viewpoint.

Me-and, what is the link to Flying Pig about? When I went to it I only found a 'paper animation kit' site. I think you're right about Google's page rankings not being a criteria for inclusion in Wikipedia.Msmchaser 21:46, 16 May 2007 (UTC)

I dont know why Google eliminated any listing of www.allaboutpoppers.com. The rationale cited was speculative on my part. Yahoo.com had also eliminated the same listing for a few months but has since reinstated the listing, but at a lower ranked rating. Complaints about popper selling sponsored sites got responses from Google.

A Google search result ranking should not be a credibility criteria. But it is interesting since that popper industry site had been listed as #1 or 2 for about 5 years. And another wiki contributor cited a web program which determined that a popper company owned the www.allaboutpoppers.com site. No surprise since it linked to sites selling poppers and also failed to cite any published research showing that popper use was immunosuppressive or risk factors for risky sex and/or HIV infection.

Primary sources are generally preferable to secondary sources. Citing Simon Sheppard as the reference about poppers being immunosuppressive is less credible than citing the original publication and including its PMID, PubMed identification number, the latter for easy verification. The original Dax research on immunosuppression PMID 1685501 was not dismissive of the importance of the immunosuppression. All exposures to HIV do not result in infection. However, if the immune system is suppressed susceptibility to infection, to HIV and other infections is increased. The Dax study found natural killer cells the immune system component most suppressed. And natural killer cells are a prime defense mechanism against infections. The fact of the immunosuppression should not be minimized, or dismissed, but should be emphasized in the context of the HIV epidemic. This importance to gay men and men who have sex with men cannot be understated.

Hank: In looking at the Dax study you reference, which was also one of the studies in the laundry list of references that used to be in this article, the results were not compelling evidence for a major effect of nitrite inhalation on the immune system.

If you do a search for "Dax" on this page you'll see where the Dax study was flawed due to various problems. I wouldn't agree that just because it was published in a peer reviewed scientific research journal that it therefore necessarily has "very high credibility". I think Peter Duesberg's theories on poppers causing AIDS and KS were similarly published in peer reviewed scientific research journals as well, and he has very little credibility in the area. I'm not sure what you mean when you say it "should be emphasized in the context of the HIV epidemic". What exactly should be emphasized? Where? In the main article somewhere? How would you see it being worded? Munatobe7 23:54, 17 May 2007 (UTC)

The references I have cited have very high credibility because they are from published peer reviewed scientific research journals...and I also cited the PMID numbers to faciliate easy verification. Others may have cited anti popper websites. I have no connection with www.virusmyth....etc. I cited the www.iabuse.org in reference to concern about youth using poppers but don't recommend it as a reference listing.

In regards to controversial issues, facts, interpretations, it seems that multiple references are preferable to one reference. When there are differing positions cite credible positions from multiple sides. Neutral point of view can apply to each fact, but seems more important to the apply to the article as a whole, and that referencing controversies is reflective of reality and a reference point in time. Some controversies will be settled overtime, but they still might be referenced for historical perspective. Hankwilson 06:30, 17 May 2007 (UTC)HankwilsonHankwilson 06:30, 17 May 2007 (UTC)

One correction: according to Wikipedia:Reliable sources, secondary sources are actually preferred, if (and this is the big "if") they are reliable secondary sources according to the criteria set forth there. In other words, FDA, CDC, Merck manual, etc are reliable secondary sources. Allaboutpoppers.com and virusmythpoppers.com are not. Primary sources are also useful, and we should include a number of them, but the problem is that when there's conflicting data (as there is here), we need to avoid synthesizing it ourselves (see WP:SYN) and saying "These studies clearly indicate that poppers are (or are not) immunosuppressive." Relying solely on primary sources also leaves us open to selective citation, since there are conflicting studies out there. Instead, we should rely on syntheses published by reliable secondary sources. Does that make sense? MastCell ^Talk 15:59, 17 May 2007 (UTC)

My job's keeping me hopping and I've missed a couple of days here. Things move fast!

Yes, it makes sense.

I agree that we need to avoid synthesizing the data ourselves, but I was surprised to see the edit that claims research is still "contradictory as to whether there is a causative link between popper use and HIV...". Is this theory still being debated by credible researchers? My general sense is that it was long ago resolved that HIV, not poppers, causes AIDS. In following links found at All About Poppers I note that several apparently notable researchers have written on this. Stephen J. O'Brien addressed the theory some time ago, as did Stanley B. Prusiner, and Christine Weber who talks about the history of science being littered with disagreements over opposing hypotheses in her research titled "The Art of Scientific Scrutiny: Investigating the Poppers-AIDS Hypothesis".

IMHO the statement "It was previously believed that any link was due to poppers having a causative link with KS" is outdated and not accurate, and may lead the reader to believe poppers have a 'causative link with KS". Is there a credible researcher today who still claims poppers cause KS? On the same links page I found the poppers/KS theory addressed by Christine Weber, among others, who pointed out that not surprisingly, correlation is easily confused with fact.

I'm sensitive to your caution that we not synthesize conflicting data but is there any credible conflicting data that purports to claim that poppers cause AIDS or KS? How should we best handle this? Munatobe7 21:11, 17 May 2007 (UTC)

After I hung up the phone on that last post I stumbled on this article by an AIDS activist (it may take me forever to get through all the links on the All About Poppers site!) which clarifies a bit the argument over the poppers/KS/AIDS theory. The author, Paul Varnell, peppers his article with some gems, but this one is particularly interesting: "The government's own expert on poppers, Harry Haverkos, has been working on the notion of a poppers-KS link for nearly seven years and still cannot confirm such a link; he always talks in terms of "potential" and "could be" and then calls for more epidemiological and laboratory studies. That's pretty much what he was saying years ago." Haverkos authored a number of the studies that were in that huge laundry list of references that used to be posted in this article. Munatobe7 21:25, 17 May 2007 (UTC)

That's how scientists and researchers tend to talk. Are you suggesting this calls his published findings into question? MastCell ^Talk 00:24, 18 May 2007 (UTC)

Sorry for the confusion. I don't know if I'd call his findings into question because I haven't read them. But I'd caution against using his findings as a basis to make definitive statements that poppers cause AIDS or KS which seems to have been what was done in the past in this article. I guess the point I was trying to make, clumsily so, was that I further agree with your earlier caution that we have to be careful not to allow ourselves to fall into the trap of synthesizing conflicting research results, or even studies with questionable results, as a basis for authoritative claims, one way or the other. So how do we handle the current implication in the article's health section that poppers cause KS? Munatobe7 00:47, 18 May 2007 (UTC)

That's the point I was trying to make earlier, albeit far better expressed. I'd forgotted that WP:SYN existed... Thanks MastCell! me_and 07:30, 20 May 2007 (UTC)

Poppers are immunosuppressive. Demonstrated multiple times and reported in peer reviewed scienific journals.

There are multiple published research studies demonstrating that poppers are immunosuppressive.Do a PUB MED search re: "nitrite inhalants" and you will get many, if not most of those studies. The import of the immunosuppression is still to be determined and is admittedly controversial. A popper industry does exist and consumption will be effected if the research and its implications is known. Nonetheless,the finding and its potential implications in the HIV/AIDS epidemic compel its inclusion in any article about poppers. There is no suggestion. The suggestions are that it is not significant, is significant, or the studies had limitations. Those critiquing the published research showing immunosuppression have questionable credibility, and the existence of an "analysis" does not dismiss the findings. Seems reasonable to critique the critiquer. NIDA,CDC,FDA, vs ? what is the popper industry position? does it ever surface on this site? ever responsible for eliminating references to published research?

The researchers finding immunosuppression are funded by National Institute of Drug Abuse and/ Centers for Disease Control. The publication in peer reviewed scientific journals does not guarantee credibility, however, the total weight of the multiple researchers finding immunosuppression, the funding sources and peer review processes of both funders and journals should outweigh a dismissive position by the poppers industry reps.

The Dax, 1991 study was a human study, not a mice study, so I give it special importance. Suppression of natural killer cell function is very significant in the context of HIV/AIDS epidemic. The simple message is that poppers are immunosuppressive making popper users more susceptible to infections, including HIv infections. The epidemiologal research finds that popper use is correlated with HIV infection. There are both biological(immunosuppression increasing susceptibility to infection) and behavioral impacts(disinhibition and increase in risky sex) of popper use. And there may be a compound effect with both the biological and the behavioral factors both operating to explain the correlation with HIV infections in gays.

The tone of noting the demonstrated immunosuppression should not be dismissive. Indeed, while the immune system itself recovers after a few days, the damage is permanent to the individual if HIV infection has occurred. We need to note the demonstrated immunosuppression, qualify the limitations, and put it in a serious context....potentially increasing susceptibility to HIV infection...

The popper industry position should be included. Its reality. Its a position which is actively promoted despite the mounting scientific research. not surprising, though harmful to the gay community. How many PMID published studies, re: immunosuppression and risk factor for HIV infection are needed? Refer to ARCHIVE #2, topic 20 for a dozen important studies.

Citing 2 decade old positions about the harmlessness of poppers does not negate the aggregate of the research and especially the recent findings re: immunosuppression and correlation with HIV infection. The dismissive analysis of the research is longstanding...but the research findings continue to surface. Too bad we don't have an objective article for those folks trying to evaluate the safety of using poppers. The focus on poppers has changed overtime and the article might include how perspective has changed overtime. Intially suspected of causing AIDS, then when HIV was discovered considered a possible promotion factor/co factor. Initially thought of causing KS, then when KS virus was discovered, considered a possible promotion factor/co factor in KS infection and KS development.

KS: Having the KS virus does not evolve to KS in most cases. Being exposed to the KS virus which is in saliva does always result in infection. There is still a KS mystery. There is a cofactor or cofactors operating which results in development of KS. Poppers are immunosuppressive. Transplant patients given immunosuppressive drugs to ward off transplant organ rejection develop KS. The KS goes away when the immunosuppressive drugs are stopped. This is an obvious clue how popper use might be related to KS. There are dose variations in amount of poppers used, number of inhalations, frequency of use, etc...

Hankwilson 01:04, 19 May 2007 (UTC)HankwilsonHankwilson 01:04, 19 May 2007 (UTC)

Just a comment on this statement of yours "Indeed, while the immune system itself recovers after a few days, the damage is permanent to the individual if HIV infection has occurred.":

Poppers don't cause HIV. Obviously, IF they lower the immune system response then the individual may be more susceptible to any number of illnesses. However, the one thing this article does not need is alarmist statements. In other words, saying there is evidence that popper use contributes to an increased risk for contraction of the HIV virus is perfectly fine BUT we have to be careful about drawing a line because the "permanent damage" is not caused by Poppers, it's caused by HIV (which has it's own article for elaboration in that regard). --John T. Folden 02:25, 19 May 2007 (UTC)

A researcher friend at UCLA referred me to the UC Berkeley "San Francisco AIDS Oral History Series" for information about the history of AIDS and poppers.

At first I just did a quick search for 'poppers' and 'nitrites'. But then I found myself unable to stop reading so I went back to the beginning. It's an utterly fascinating walk through the history of the epidemic taken from oral interviews with the doctors and researches who were suddenly thrust into the middle of the crisis when it began.

Of the immune system theory being discussed here, Dr. Andrew Moss said that people "who knew what they were talking about" didn't seriously believe it and suggested it was an "ideologically-maintained hypotheses" that some people wanted to believe. He says that poppers were a "micro-hypothesis" and accounted for "a tiny bit" of what was going on -- "maybe". "People decide for their own ideological or personal reasons that immune overload is what causes AIDS, although it's overwhelmingly clear that it's not, and it was from a very early point."

I hesitate to quote much more from the UC site because it has a prominent notice about permissions to quote, but a search for 'poppers' finds that they were early on in the epidemic dismissed as being causative of AIDS or KS and that there doesn't seem to be much to the immune system theory either. I was surprised. Munatobe7 19:53, 20 May 2007 (UTC)

The point of poppers being immunosuppressive is the resulting increase in susceptibility to HIV infection, and other infections. A simple concept which does not negate that HIV causes AIDS.And the "poppers are immunosuppressive" point is not part of the immune system theory. Importantly, all exposures to HIV do not result in infection. The immune system can fight off initial exposure. Thus the importance of the hosts immune system and immune response. There are a variety of factors which impact whether an exposure results in infection or not, host defense/immune system response is one.

The first speaker at the last International AIDS conference in Toronto,speaking from the main stage to thousands of attendees referenced two co factors involved in the continuing HIV/AIDS epidemic among men who have sex with men. Those two cofactors were crystal methamphetamine and poppers.There was a slide projection which summarized his points.

The articles that I have cited come from credible researchers funded through peer review driven processes published in peer reviewed publications. The findings seem worthy of inclusion in an article that is supposed to incorporate multiple view points.Hankwilson 21:02, 20 May 2007 (UTC)HankwilsonHankwilson 21:02, 20 May 2007 (UTC)

No matter what level of immune suppression being alleged, the Dax study that was referenced presented no evidence that poppers are immunosuppressive to any significant degree or that they result in an "increase in susceptibility to HIV infection, and other infections".

Jumping to the International AIDS Conferences, it's a well documented and accepted fact that merely speaking at an International AIDS Conference and having a slide projection doesn't prove a theory is true or not. Remember Durban 2000. It was so bad that over 5,000 scientists and doctors from around the world signed a petition that said enough is enough after the conference was taken over by a minority of anti-HIV proponents who had convinced the president of South Africa that AIDS is not caused by HIV, but instead by drugs, including poppers.

Considering that many if not most of the cited articles formerly in the references section here were based on invalid or flawed research with some having conflicting findings themselves, which of those findings are worthy of inclusion in this article? Msmchaser 22:16, 20 May 2007 (UTC)

To the methamphetamine and poppers comment above, a large study titled "Associations Between Substance Use and Sexual Risk Among Very Young Men Who Have Sex With Men" which was published last April (Sexually Transmitted Diseases:Volume 33(4)April 2006pp 265-271) showed that among the drugs examined, amphetamine use was most strongly associated with insertive UAI (unprotected anal intercourse/no condom -- the most dangerous kind of sex).

Other drugs associated with an increased risk of insertive UAI included cocaine, poppers, and ecstasy. In multivariate analysis, the association for an increased risk of insertive UAI was maintained for amphetamines and cocaine, whereas the effect of ecstasy and poppers was no longer statistically significant.

An important aspect of this study is that it was done in very young men, ages 15-22, a critical demographic in the current AIDS crisis. Munatobe7 22:59, 20 May 2007 (UTC)

Comments removed

[Personal attacks removed]

Single-purpose accounts

I've noticed a proliferation of single-purpose accounts used solely to edit this article, or even solely to make comments on this talk page. I'll assume, for now, that these are all genuine new users, but please be sure that no one is violating the prohibitions on abuse of multiple accounts which are set forth at the page on sockpuppetry; note also that the creation of new accounts by multiple users specifically to participate in and influence a disputed issue is against policy. MastCell ^Talk 19:58, 19 May 2007 (UTC)

NPOV Questionable with Hank Wilson controlling this article

One of the most prolific posters in the poppers article is the person named Hank Wilson, who is well known as an aggressive anti-popper person. As an AIDS researcher myself (unwilling to post using my name) I am familiar with Wilson and his associates John Lauritsen, Peter Duesberg, Harry Haverkos and others as well as with their many theories over the years about poppers being the cause of AIDS, KS, and a myriad of other maladies.

This article must be careful if it is to achieve NPOV. Many if not most of Wilson's references have been not only flawed but sometimes duplicates and have even presented conflicting results which he himself has then interpreted as negative toward poppers. Some of his postings have put a negative spin on poppers no matter what the actual article he references may have said about poppers, good or bad.

A typical tactic of Wilson and his associates is changing the subject, as he did when he was not able to present a credible argument earlier in this discussion page about immune system issues; he abruptly switched the subject to the International AIDS Conference and some unsubstantiated claim about a presenter who had a "slide projection".

The article should be watched for potential sabotage. 65.199.96.2 20:45, 31 May 2007 (UTC)

Chemistry section

I'm tempted to remove or completely rewrite the Chemistry section, but I'd like to see if there's a consensus here. IMO, there should only be a very brief overview here, with {{main}} at the top linking to Alkyl nitrites. Does anyone have any other opinions? me_and 11:32, 2 June 2007 (UTC)

I would vote to clean up the Chemistry section, too, or maybe even remove it altogether.

A valid question is whether the Chemistry section is really needed or not. The numerous links from the Poppers article to Alkyl Nitrites and other nitrites articles take the reader directly to very comprehensive articles on these various compounds.

I could see removing the Chemistry section, but also could see a clean up. Munatobe7 15:06, 4 June 2007 (UTC)

I've rewritten it using text from Alkyl nitrites. As always, improvements are always welcome. me_and 12:57, 5 June 2007 (UTC)

I like the Chemistry rewrite. Well done. Munatobe7 18:09, 5 June 2007 (UTC)

Thanks :D me_and 19:31, 6 June 2007 (UTC)

Award nomination

The article is looking pretty good these days.

Does it make sense to nominate it for some kind of notice or award from Wikipedia? (It might be a good idea to try to find a better photo then the one that's on the main page right now.) Munatobe7 18:09, 5 June 2007 (UTC)

Do you mean something like WP:GOOD, perhaps? I think WP:FA would be a bit ambitious, at least at present.

I think there's still some work to be done before that, though: a consensus of some form would have to be reached first on the Health Issues section, to allow the NPOV warning to be removed, and personally I'd like to see the Popular Culture and the Media section tidied up or removed as well—at the moment it's little more than a dumping ground of trivia.

I've just had a look through Wikimedia Commons, and the only alternatives to the present image are Image:Poppers bottle.jpg and Image:Poppers.jpg. A better image might be a cropped version of the present one—zooming in on two of the bottles, for example. I presently have neither the time nor the software to do that, however. me_and 19:31, 6 June 2007 (UTC)

Rambling attack used as reference source?

Should a rambling attack on poppers as the cause of AIDS and KS, given at a gay symposium 8 years ago, be included as a credible source in this article (see "added quote from cited source" by Meand 7 June 2007)? If so, shouldn't a reasoned response to it also be included in the article?

Just asking....... Nospinhere 18:10, 7 June 2007 (UTC)

I agree that it isn't a very good source; indeed a consensus was reached a while ago to try to avoid citing VirusMythPoppersMyth.org, VirusMyth.net, AllAboutPoppers.com and the suchlike—I completly forgot about it. Admittedly this talk page is rather ugly, but if you look under section 3 of this talk page, for the paragraph beginning "One correction: according to Wikipedia:Reliable sources…" it is there.

As such, I've removed all those citations, and replaced them where necessary (the one you picked up on, I've replaced with an article from the San Fransisco Chronicle). As such, I've just removed the citation you've added as well. Of course, the cosensus can change, and indeed the consensus was reached when the article was a lot less stable, so it may be worth discussing it. (Although I am personally in favour of attempting to avoid these sites still.)

Please don't take this as discouraging you from editing this article—bold editors are always much appreciated! me_and 00:10, 8 June 2007 (UTC)

Article says that popper damage to the immune system goes away after a few days. What if the use is relatively constant - more than every few days. How long does it take to kill the immune system . Once dead or damaged does the immune system regenerate. How many days/months/years/etc of constant use ( or often enough so the immune system can't recover ) does it take to ruin the immune system ? Is this distinquishable from AIDS? 159.105.80.141 15:45, 11 June 2007 (UTC)

By my understanding, the immune system does regenerate, and it is distinguishable from AIDS as AIDS, according to Wikipedia "is a collection of symptoms and infections resulting from the specific damage to the immune system caused by the human immunodeficiency virus (HIV) in humans". My understanding, however, is entirely irrelevent; particularly on articles such as this, it is the understanding of verifiable, reliable sources that are relevent. me_and 19:16, 11 June 2007 (UTC)

Meand is correct, the understanding any of us may have about the science is irrelevant. There are conflicting opinions by credible researchers and there are a number of places you can read more about all this. Some of the main HIV/AIDS researchers have suggested that the immune system issues that have been raised seemingly have been based on flawed studies, or on studies that appear to have been done by people with potentially personal agendas or who "invested their career in" a theory and for whom it was "very difficult to let their pet hypothesis go."

It seems unlikely that typical inhalation of these products can cause any significant harm to the human immune system. I have no idea about people actually 'killing' their immune system, or if that's even possible -- but surly not with poppers. Killing ones immune system is out of the range of the scope of this article and you'd have to research the immune system itself for that information.

I'm not sure exactly what you mean by "ruin the immune system", but my reading of the available literature on poppers indicates there's no substantial concern with them relative to harming the immune system and for certain it doesn't look like you can 'ruin' your immune system with them.

It also appears that the FDA, which controls medicines in the USA, found poppers essentially harmless as well. In April of 1984 Mark Novitch, who was head of the FDA at the time and a President Reagan appointee whom I'd venture to guess was not inclined to support the misuse of products by homosexuals to enhance sexual activity  :-), wrote a letter to the White House which said "...there is very little evidence of acute toxicity related to use of butyl nitrite." “...relative to lifetime use by homosexuals, although some groups contend that the possibility exists that repeated use among homosexuals may produce adverse effects, there is virtually no direct evidence to support that." Munatobe7 13:13, 12 June 2007 (UTC)

Citation (19) says damage that can be undone. I suspect there has not been much study beyond what this citation mentions. Wiki - Poppers cites this so I assumed that poppers are immune system unfriendly on a one time basis - just guessed that continued use might be unwise. Should the citation stay - the sentence?159.105.80.141 17:59, 13 June 2007 (UTC)

Yes, it should. There's nothing scientifically incorrect about it as far as I'm aware and seems applicable to the majority of users. --John T. Folden 20:29, 13 June 2007 (UTC)

I'm unclear on what's being suggested. I would caution that basing statements in the article on phrases such as "I suspect", or "I assumed" , or I "..just guessed" is not a good idea.

What sentence are you suggesting be used and where in the article is it proposed to be used? (BTW, what is "citation (19)"?) Munatobe7 20:52, 13 June 2007 (UTC)

He's suggesting that the source and sentence concerning damage to the immune system (poppers may weaken the immune system, however any damage is undone in a few days.[20]) be removed on the basis of his random speculation. --John T. Folden 21:19, 13 June 2007 (UTC)

Seems reasonable to me. Thanks for explaining. Not sure why I couldn't grasp it myself. A brain-fart maybe? Munatobe7 02:31, 14 June 2007 (UTC)

I don't know about Reagan and poppers but a quick check of the internet says that poppers are illegal and dangerous as hell. You are basically sniffing gas - their legal use is as video head cleaners. Amyl nitrate is totally illegal, if your pharmacy carries it then call the cops. I believe amyl nitrate is the poison of choice - the head cleaner stuff is weaker. I suspect that in 1984 Mr Novitch wasn't totally up on this stuff - check out the web for yourself on this one but it didn't seem safe to me - once maybe but who does anything fun once.159.105.80.141 18:11, 13 June 2007 (UTC)If you type i "poppers immune'" the second thing I got from 1999 - post Novitch - was a study showing 300% increase in cancer etc - other sites get better.159.105.80.141 18:12, 13 June 2007 (UTC)

In an encyclopedia the goal is to present credible and supported evidence, not guesswork and personal bias or assumptions based on news articles

Although none of what you've just posted is accurate or even makes any sense, it's acceptable for the Discussion page, but would not fly on the main article page. It's a perfect example of what had been going on in this article. Munatobe7 18:27, 13 June 2007 (UTC)

I have no dog i the fight over those who want to take poppers going their own way - but for those who are looking for some good (as in correct ) information I suggest you look up poppers and immune system on the internet. AIDS.org is quite at odds with much of this article. Reagan's time is some years back and his expertise in the immune system probably was cursory at best - I have seen nowhere but wiki that seems to think that poppers are safe and nondamaging. Maybe you have some links as to their mild effects.? 159.105.80.141 19:48, 13 June 2007 (UTC)

I checked out the above links - the one about pet hypthoses was interesting ( the guy certainly had a pet theory himself if appeared - HIV or nothing ( too bad that not all AIDS patients seem to have HIV, but he tried). The other study was very old.159.105.80.141 19:57, 13 June 2007 (UTC)

Sorry for the confusion about President Reagan. It was not suggested that he knew anything about poppers, as I doubt he did. (But, hey, who knows... maybe he and Nancy got down with them once in a while after-all. :0) ) Rather, it was under his conservative administration that poppers were very closely scrutinized, studied and investigated by the Consumer Products Safety Commission, the FDA and other agencies.

Like any subject, looking to the internet for information on poppers means being careful. For example, you're going to get lots of sites that claim they cause AIDS, when we know that is not true. Most, btw, appear to spring from the theory that HIV is not the cause of AIDS which you described as "too bad, but he tried", an apparent reference to Peter Duesberg, Hank Wilson, Ian Young and John Lauritsen. These men all seem to have personal agendas and there's no doubting that they have a 'dog in this fight'. You probably saw their many sites when you searched on 'poppers'.

You asked for "links as to their mild effects". I'm not aware of any such links, but there are sites with credible information supporting the position that poppers do not cause AIDS or any of it's infections.

The goal in this article is to move it toward NPOV. Munatobe7 21:45, 13 June 2007 (UTC)

I didn't delve into their catalogs but it appears that some of the sites minimizing the effects of poppers also sell them - they truely put their(your) money where their mouth is. This whole story seems to have hit an emotional nerve - not amiable to much science ( like telling my brother that drinking is causing his liver to die ).159.105.80.141 12:18, 14 June 2007 (UTC)

Merge?

Is there any reason for maintaining this as separate from the Alkyl nitrite article? This is the only drug article I know of that does this, everything from ecstasy to Dextromethorphan to methamphetamine is covered in a single unified article that documents both pharmacology and sociology. The split was done a ways back, but it might be time to reconsider and try merging the two. Night Gyr (talk/Oy) 01:37, 12 June 2007 (UTC)

Merge. By my understanding, the original split was to reduce vandalism on Alkyl nitrite. Since this article is much more stable than it has been in the past, I should think that much less of a risk. I'm not even convinced that displacing vandalism in that way is such a good reason for the split in the first place. I've added the merge template to this article and to Alkyl nitrate; hopefully that should garner some other opinions. me_and 11:22, 12 June 2007 (UTC)

Reducing vandalism appears to be one reason, but it may also be due to the fact that only one alkyl nitrite is a drug -- amyl nitrite. The others are used in a range of ways including, of course, nitrite-based room odorizers (often misused as poppers). Munatobe7 13:14, 12 June 2007 (UTC)

Cyclohexyl nitrite is used as a drug too, and as you say yourself the others are used as poppers. Night Gyr (talk/Oy) 15:36, 12 June 2007 (UTC)

A compound is only a 'drug' if the FDA or similar agency has jurisdiction over it. Otherwise it's classified as a consumer product. For example a common correction fluid such as Wite-Out®, which is misused as an inhalant (a drug use), is not a drug. It is a consumer product. Inhaling it is a misuse and is contrary to labeling instructions (another FDA criteria).

It's the same thing with poppers. Remember that poppers is a street name, not a product name. Various alkyl nitrites (including apparently cyclohexyl nitrite) are used for various applications including as the primary ingredients in nitrite-based room odorants, video head cleaners, or leather cleaners. People can and do misuse these nitrite-based products contrary to labeling instructions, but they are not drugs per-say. (Just as Wite-Out® is not a drug per-say.)

A manufacturer has to promote and sell the product for a drug use, with labeling instructions and package inserts that promote a drug use, otherwise it is a consumer product. So poppers technically are not drugs. Except, of course, amyl nitrite, which is an approved drug.

I think the past effort to separate the alkyl nitrites article from the poppers article is because poppers are just one of many uses for alkyl nitrites and someone wanted to keep them separate for simplicity and better organization. Munatobe7 17:06, 12 June 2007 (UTC)

That's quite a legalistic way to look at it. Nitrous oxide is also used for many purposes, some drug, some not, and they're all covered in one article (with a summary-style section linking to an extended article on automotive use). There's no reason to break up the usages of a single class of substances so much so that the main article doesn't even mention its applications. Night Gyr (talk/Oy) 18:52, 12 June 2007 (UTC)

Night Gyr, the nitrous oxide article is a very well done article. Thanks for bringing it up here. The poppers article could do with a bit more polish. Munatobe7 20:06, 12 June 2007 (UTC)

• Oppose merge: Avert vandalism, articles have very different scope and it is not unusual to have pages non-chemistry / chemistry for a substance for example vanilla / vanillin asperin / Salicylic acid V8rik 19:27, 12 June 2007 (UTC)
  • Avoiding vandalism is not a justification for editorial decisions, if it was we wouldn't have an article on Jesus or George W. Bush. As for your examples, each of those pairs talks about different substances. Vanilla is a plant, a food, a marketed commodity, vanillin is a single substance that contributes to its flavor. Aspirin (acetylsalicylic acid) has a large article that covers all aspects of the substance as does salicylic acid, the two are separate because they're different substances. Night Gyr (talk/Oy) 19:48, 12 June 2007 (UTC)

• Oppose merge: It looks like there was a major discussion about this last year over in the alkyl nitrite article. Both sides raise interesting points. I think I favor keeping the articles separate but with links to each other. Munatobe7 19:59, 12 June 2007 (UTC)
  • Most of the opposition was based on the confusion between Nitrates and nitrites. Night Gyr (talk/Oy) 20:04, 12 June 2007 (UTC)
    • There was a brief mention of that, but generally it was for other reasons. Munatobe7 20:28, 12 June 2007 (UTC)

• Merge The material on the drug should be kept together unless the article becomes huge. --Peter cohen 21:36, 12 June 2007 (UTC)

• Oppose merge: I think previous discussions on this are still valid and there's no overriding reason for reversing that consensus now. Keeping the articles separate but cross link if/when needed. --John T. Folden 04:00, 13 June 2007 (UTC)
  • What previous consensus? That one was only a handful of people and just sort of died off, there wasn't really a firm consensus. Night Gyr (talk/Oy) 04:12, 13 June 2007 (UTC)

• Oppose merge: ecstasy, Dextromethorphan, methamphetamine, and nitrous oxide are not analogous examples because they are specific drugs. Alkyl nitrite is a functional group, a much more general concept. Note for precedent that we have separate articles for the alcohol functional group, for ethanol, and for alcoholic beverages. (Not to mention Effects of alcohol on the body and Alcohol fuel.) --Itub 06:07, 13 June 2007 (UTC)

• Oppose. Alkyl nitrites are a functional group. Poppers are a cultural thing. So these seem to be distinct. It seems that well-intentioned editors who dont know chemistry often to wish to morph or merge chemical articles into some other topic that is more understandable but where the chemical content is compromised, all with the best intentions as in this case. WE provides chemistry a rare public forum to present itself without being redescribed in a social context. It is a very precious and very powerful aspect.--Smokefoot 23:43, 13 June 2007 (UTC)

• Good point. "Poppers" are a cultural phenomenon and a subject that's better kept in a separate article from the chemistry aspects of the actual contents of these products. Munatobe7 02:38, 14 June 2007 (UTC)

Oppose:: Poppers refers to the recreational use of nitrite inhalants. The term "alkyl nitrites" is technical and will be unfamiliar to many people.Hankwilson 05:05, 14 June 2007 (UTC)HankWilsonHankwilson 05:05, 14 June 2007 (UTC)

That HIV/AIDS argument

Having recently discovered this article and the arguments here, I did a search on MEDLINE and found this [8] of which "Controlled clinical trials to examine this potential correlation have not been conducted, and the use of nitrites simply may be a marker for other high-risk behaviors such as unprotected sex." is the key sentence. I'd be interested to hear from anyone who can access the full text of the article. But, taking the abstract on face value, this indicates that there is no reliable evidence of a link between the aggravation of HIV infection and the action of poppers on the human body. Given that MEDLINE shows no more recent publication on this link, a NPOV requires stating that there is njo concrete evidence that supports the claims of such a link. --Peter cohen 21:32, 12 June 2007 (UTC)

Peter, you'll find a significant degree of support for your statements here. But there are a couple of people posting in this article who could be reasonably described as having potentially personal agendas and for whom it's seemingly impossible to let go of their pet hypothesis, which has made it painfully difficult to stabilize the article. Munatobe7 23:48, 12 June 2007 (UTC)

I'm curious about your change in the Health Issues section today where you inserted ".. appears to be a statistical correlation between popper use and these problems", meaning AIDS, HIV and KS.

What is the statistical correlation between poppers and HIV or AIDS? It seems there is no causal relationship between them.

KS is a separate issue, but even then, the literature seems clear that there is no causal relationship between poppers and KS, but that it appears that some portion of the poppers-using population is prone toward higher risk behaviors.

Would you be comfortable with a slight re-wording that separates the issues of HIV/AIDS and KS as they relate to poppers? Munatobe7 21:16, 13 June 2007 (UTC)

You're right. Returning to the abstract of the review, it only mentions only Karposi's. I'll change it. --Peter cohen 21:24, 13 June 2007 (UTC)

Health Issues (The Dead Horse Sandbox)

Isobutyl nitrite was nominated by the Consumer Products Saftety Commission to the National Toxicology Program for toxicology and carcinogenicity studies because of its possible contribution to the high incidence of Kaposi's Sarcoma among gay AIDS patients and because of the lack of available data on the potential carcinogenicity of isobutyl nitrite. The 1996 assessment concluded that there was clear evidence of carcinogenic activity of isobutyl nitrite. See PubMed PMID:12594527. This is a significant risk that should be included in the health risks section. Hankwilson 22:17, 12 June 2007 (UTC)HankwilsonHankwilson 22:17, 12 June 2007 (UTC)

Hank, are you aware that by shouting that there is "Clear evidence of carcinogenic activity of isobutyl nitrite reported by National Toxicological Program..." you are posting a terribly misleading header for a new section?

A quick scan of this study shows that it apparently suffers from the same flaws as many of the others you've posted here, and even in spite of that, there's no significant harm demonstrated to humans at all.

I don't agree with your statement that "This is a significant risk that should be included in the health risks section." It's just not a true statement. Munatobe7 22:50, 12 June 2007 (UTC)

This article seems to be a rodent study not a human one. It would be interesting to see a meta-analysis of human studies or at least a systematic review on this subject. See, for example, "Risk of Kaposi's sarcoma and sexual practices associated with faecal contact in homosexual or bisexual mens with AIDS". Valerie Beral, Diana Bull, Sarah Darby, Ian Weller, Chris Carne, Mick Beecham and Harold Jaffe. The Lancet v339.n8794 (March 14, 1992): pp632(4). Beral et al. found no evidence in their own data and two of these authors were involved in a reanalysis (reference [7] in the following) of Haverkos et al 1985 (reference [11]). It obviously predates your reference

• Our findings do not support the notion that Kaposi's sarcoma is due to the use of the sexual stimulants known as poppers.[11] 57 of the 87 subjects who were included in the original study implicating poppers[11] had been interviewed for the CDC's case-control study of patients with AIDS diagnosed in 1981.[4] Reanalysis of the data from these 57 subjects shows that the men with Kaposi's sarcoma practised insertive rimming significantly more often than did men with other opportunistic infections and that there was no significant association with frequency of use and poppers.[7] --Peter cohen 23:18, 12 June 2007 (UTC)

This NIDA sponsored research by Dax EM et al, (Pubmed PMID #: 2902516) found popper inhalation by humans to be immunosuppressive. This is a significant risk factor that should be included in the health risks section. The study demonstrated that natural killer cell function was significantly suppressed. It took 4 days for the immune system to recover and then the immune system stayed stimulated which is hazardous if a user had been exposed to HIV.HIV replication is dependent on a stimulated immune system.

The article should cite the original research instead of a health columnist. "4 days" should replace "a few days". And there needs to be an inclusion that the immune system stayed stimulated. Portraying a "return to normal" is inaccurate.

The interpretation of the research findings can include multiple perspectives but the findings of immunosuppression should be included. NPOV would allow for the research limitations and variable interpretations to be included. NPOV would not allow omission of this important research finding. Hankwilson 22:36, 12 June 2007 (UTC)HankwilsonHankwilson 22:36, 12 June 2007 (UTC)

Hank, this study was discussed at length a few weeks ago. Why are you again putting it up here?

If the work presented in this paper is accurate, the overshoot in immune activity could easily be interpreted as evidence for nitrite use causing an increase in immune function.

The study used only eight HIV- male volunteers, and the investigators found that amyl nitrite inhalation caused an initial suppression in immune function that was followed by an overshoot seven days after cessation of drug. The study had a low sample number and was not repeated.

As you have already been reminded, the results were also contradictory to results obtained by other research groups.

This study simply does not provide any credible support for any significant damage to the immune system, and it obviously does not warrant your creating a new section with such an alarmist and misleading heading.

You should stop doing this as it could fall within the definition of vandalism, which could get you banned.Munatobe7 23:24, 12 June 2007 (UTC)

With those few numbers I would certainly hope that it would only be used as part of a meta-analysis.

The link has been demonstrated multiple times in published epidemiological research. Whether the link is causal or correlational is unknown. NPOV allows inclusion of the published research findings and conclusions. NPOV allows qualification that whether the link is causal or correlational is unknown. Hankwilson 22:44, 12 June 2007 (UTC)HankwilsonHankwilson 22:44, 12 June 2007 (UTC)

Well the Beral et al. article I cited above suggests that the link can be correlational. That the sort of people who take poppers also behave in other ways that are high risk. Cna you give more details of the Drumright meta review? --Peter cohen 23:32, 12 June 2007 (UTC)

Hank, even if you're correct that "dozens of published research studies have found a significant link between popper use and risky sex and/or HIV infection" (a review of the literature does not support such a statement), there are "dozens" more which have contradicted such studies.

As was pointed out earlier, some of the studies you reference even demonstrated contradictory results within themselves.

As a result you cannot draw a conclusion of harm -- certainly not any significant harm.

The poppers article has stabilized and this has been made clear. NPOV means just that: neutral point of view. Munatobe7 23:38, 12 June 2007 (UTC)

Hank, in your absence the poppers article had finally become stable. But now that you've resurfaced using your familiar tactics again, the discussion page has suddenly exploded with multiple new sections containing alarmist section titles.

Instead of starting up a shouting match again, would you be willing to allow a more civil discussion to take place around your suggestions that poppers are inherently dangerous. Would you be willing to calm down and take a more measured approach to making your case by presenting credible support for your statements rather than shouting at us with headlines atop ever more new sections? Munatobe7 23:14, 12 June 2007 (UTC)

It is tempting to add a new heading titled "TIRED OLD PISSING MATCH" to this page. Does no one, especially Hank Wilson, read the guidelines at the top of this page?

Within five blocks of my NYC home, there are at least 20 establishments that sell poppers. Thousands of bottles. If people were really getting ill, or worse, dying from the use of these products, wouldn't it be in the news?

Of course risky sex leads to HIV infection. If one is to indict popper use in that equation, then why not include lube, air, even incandescent light to the list, since they are likely present during risky sex also? The PRESENCE of poppers does not prove their CAUSE of risky behavior or HIV infection. One has only to look at the numbers (how many people use poppers vs. the rate of infection) to see the absurdity of such a claim. The idea that poppers cause risky sexual behavior is fantasical, neither factual nor scientific, as is the idea that sniffing this chemical suddenly causes someone to lose control of their ability to govern their behavior. Where are there people claiming, "I wouldn't be HIV-positive if I hadn't used poppers?"

What is truly unfortunate about this ongoing spitting match is that: 1) People seeking unbiased information on poppers are likely to be misled, or just turned off, by the overwhelming repetition and bias in these postings, and 2) People won't know who/what to trust for information when truly dangerous substances (such as crystal meth) merit warning bells (see the late Peter Jenning's courageous and informative ABC News special on Ecstasy, and how the government's mishandling/misinformation about that drug has lead to a lack of governmental credibility regarding actual drug hazards).

Please, for the sake of truth and in the name of civility, LET THIS END. All sides have stated their cases. There is clearly nothing more factual to add to the discussion. Quit trying to get the last word. Let THIS be the last word, and trust readers discern for themselves the truth about poppers.

This NIDA sponsored research by Dax EM et al, (Pubmed PMID #: 2902516) found popper inhalation by humans temporarily boosted the immune system. This is a significant factor that should be included in the health risks section.

The study demonstrated that the human immune system was temporarily boosted with a spike in function proving that improving the immune system is a positive side effect of poppers.

The interpretation of the research findings can include multiple perspectives but the findings of an immune system boost should be included. NPOV would allow for the research limitations and variable interpretations to be included. NPOV would not allow omission of this important research finding. Scientistdoc 03:35, 13 June 2007 (UTC)

People, let's not make a new heading on this page every time someone sneezes, okay? If you'd like to suggest improvement to a particular area of the article then making a clean heading for "Health Issues", for example, rather than sensationalist comments. --John T. Folden 04:09, 13 June 2007 (UTC)

The sole human study to date on popper use concludes: "The results showed that exposure to amyl nitrite can induce changes in immune function even after short exposure to moderate doses. Several tests of immune function showed an "overshoot" over basal activity at 7 days following nitrite inhalation after an initial immunosuppression. A possible interpretation of the results would be that nitrites cause a cycling of immune activity between suppressed and nonspecific stimulated levels. This situation might result in a period of immunosuppression followed by a proliferative period in which virus-containing cells propagate in the presence of a nondirected immunosresponse."

While the National Toxicology Programm(NTP) demonstrated toxicity and carcinogenicity in rats and mice, NIDA's Dax study PMID assessed immunological effects of popper inhalation by humans. Natural killer cell activity showed an initial significant decrease, then returned to baseline levels by day 4 post-inhalation. The Dax human research (1988 PMID 2902516 and 1991 PMID 1685501) is worthy of noting because its a human inhalation study and compliments the findings of most of the animal inhalation studies: poppers effect the immune system. Admittedly, there are limitations of the research and whether the findings are negated is controversial.The controvery could be articulated with the goal of letting readers decide.

The Dax findings should be relayed to readers to foster an informed choice. Alternative perspectives should be included. Seems this multiple perspective inclusion fits in with NPOV .

The article should reference the demonstrated finding: inhalation of poppers by humans resulted in an initial immunosuppression effecting natural killer cell activity taking 4 days to recover to baseline followed by a 7 day cycle of immune stimulation.

Seems we have agreement that more research is needed. Prevalence of use warrants more research. Correlation with risky sex and HIV infection warrant more research. Hankwilson 06:53, 13 June 2007 (UTC)HankwilsonHankwilson 06:53, 13 June 2007 (UTC)

I'll play in the sandbox for just a second.

Wilson you sound like a broken record. Do you even read this page before you post? There is nothing to your comment that it "seems we have agreement that more research is needed." Where in the discussion has that even been discussed?

For the love of god people, especially Hank Wilson, please stop beating this dead horse. Poppers do NOT cause AIDS. Poppers do NOT cause KS. Poppers do NOT significantly impair the immune system.

They may not be totally harmless but what is? CNN ran a story two days ago about a woman who used too much of a body lotion, so much so it rose to a toxic level. Just a few months ago an athlete in California died from drinking so much WATER it became toxic.

Anything can be toxic at some level and poppers are no different. But there is no evidence that poppers are toxic or otherwise harmful at anything near the levels used by people exposed to those tiny bottles. For god's sake, they've been around for hundreds of years and no one has gotten hurt by inhaling them. Scientistdoc 16:31, 13 June 2007 (UTC)

The second of the Dax articles 1991 PMID 1685501 does have an abstract I can find online. It looks suspiciously like the source for which the Simon Sheppard article (Speaking of Poppers. Sex Talk p. 2. Gay.com. Retrieved on 16 March 2007. “There is evidence that using poppers does lower immune function, though the damage is undone in at most a few days.”) is cited and I'm inclined to replace that citation with Dax. AFAIC for scientific claims it is better to site the original source rather than a lay exposition.--Peter cohen 22:27, 13 June 2007 (UTC)

I agree that using the actual study could possibly be a better idea then a lay exposition. But Meand had suggested that Wikipedia prefers secondary sources (I think that's what he called them). Also we need to be mindful that some of the studies that were earlier used in the old references section were either flawed due to protocol problems or reached conflicting results.

On another matter, there is data discussed here that would indicate the statement on methemoglobinemia may be inaccurate.

A study in a nitrite bottling plant exposed men to high concentrations over long periods of time, with no resulting problems. The study is said to confirm that there is no significant potential toxicity due to methemoglobinemia from alkyl nitrite inhalation. Munatobe7 03:01, 14 June 2007 (UTC)

The nitrite bottling plant study was paid for by a company headed by Joseph Miller, the owner of Great Lakes Products, producers of RUSH and self proclaimed "world's largest nitrite odorant company." The conductors of the study should disclose that their funding source had a Joseph Miller connection. The dose exposures of the workers could be very different from recreational popper users, who are intentionally inhaling concentrated doses of fumes. Also, there is a continuum of use among popper users from a few hits(inhalations) to dozens. Users at the highest end of the continuum would be at risk for methemoglobinemia. There are numerous emergency room reports in the journals reporting such cases.Hankwilson 05:18, 14 June 2007 (UTC)HankwilsonHankwilson 05:18, 14 June 2007 (UTC)

On Primary v secondary sources: a well executed systematic review from a peer-reviewed journal is a secondary source that is preferable to the articles it reviews reporting the findings of individual research projects, the primary sources. So the review from Pharmacology looks to be the best source referenced in the article. Whilst one-off research articles have their limitations especially if they are epidemological studies or rodent studies rather than human random-control studies. It's a pity that no one has yet said they have access to the whole Pharmacoloy article and not just the abstract.

Less formal secondary sources, for example information sheets, depend on the understanding of those who put them together. I would respect a sheet produced by Drugscope because I know they have an extensive library of primary sources and, certainly when they were the ISDD, referenced the original sources. I would be wary of an unreferenced information sheet whose pedigree I did not know. Similarly I would be wary of newspaper reports as journalists often don't understand the subtleties of scientific reports. Then you come to secondary sources with an agenda which have been identified on both sides of a debate and I certainly would rather trust a peer-reviewed primary source than a biasded secondary source.--Peter cohen 09:27, 14 June 2007 (UTC)

From the Journal of Neuroimmune Pharmacology (2006) 1: 317-322. Abstract: Because inhalant nitrites were thought to be rapidly cleared from the body, the lay literature has somewhat downplayed their toxicity. However, scientific reports have documented their immunosuppressive effects in animals, and epidemiological studies have implicated their use with the development of Kaposi's sarcoma (KS) in humans. Because inhalant nitrites are exogenous nitric oxide donors, we hypothesized that these substances of abuse might exert part of their toxicological effects through this biochemical product, which has been shown to alter gene regulation and angiogenesis. In a series of studies, we showed that acute and chronic in vivo exposure to isobutyl nitrite produced significant tissue-dependent alterations in the expression of a number of cancer-and angiogenesis-related genes in mice. In particular, hepatic mRNA and protein expression of vascular endothelial growth factor (VEGF) was significantly stimulated. The in vivo growth rate of a subcutaneous VEGF-responsive tumor was also shown to be accerlerated by inhalant nitrite exposure. Because the development of KS is extensively linked to VEGF and its receptors, the purported link between inhalant nitrites and KS may be explained mechanistically, at least in part, through the stimulation of VEGF expression by these inhalants.

You can find this article online by doing a Google search: "Journal of Neuroimmune Pharmacology" . The article's reference list is extensive and indicates multiple published research studies. The article takes issue with Andrew Weil's dismissal of poppers having any hazards.

The Ho-Leun Fung research group is funded by National Institutes of Drug Abuse to study immunospressive effects of poppers. The work builds on the previously NIDA funded work by the Soderberg group which demonstrated that poppers were immunosuppressive.

Some have discounted the immunosuppression findings. It has been demonstrated that poppers are immunosuppressive and this hazard of popper use should be included in a credible section on the health risks of poppers. The nuances of dosing, quantity, frequency of use, degrees of hazard should be included also.

This discussion overtime has illustrated that the perspective on poppers remains controversial. I support inclusion of the various perspectives on poppers and the research to date to facilitate a NPOV. Hankwilson 05:48, 14 June 2007 (UTC)HankwilsonHankwilson 05:48, 14 June 2007 (UTC)

I think the article is worth a mention, but there are some factors that prevent me from taking it as definitive. It is invited and therfore presumably not peer-reviewed; it is by authors whose own research forms an important part of the literature that they are reviewing, it concerns largely animal studies. However, their observations that the apparent lack of harm from poppers mentioned in earlier literature was contributed to by a lack of methods to research any harm makes sense. --Peter cohen 09:52, 14 June 2007 (UTC)

I tend to disagree that the article may be worth a mention. The individuals who are 'invited' have their own agendas based on an already existing bias toward nitrites and a desire to bolster their previous published or even unpublished work. The subject work has also been shown to be flawed. And, the results of animal studies cannot be extrapolated to the human organ.

Hank, it's not particularly significant that people like Fung got their funding from NIDA. Lots of sloppy work comes out of research done by folks who were great grant writers able to get government grants. It happens all the time. In fact, the Fung studies have already been shown to have been flawed.

For example Fung and Keibasa, in their 2000 work in Biochem and Biophysic. Res. Comm, 275:335, exposed rats to excessive amounts of nitrites for hours -- nothing like human exposure. Their somewhat sloppy work could actually lead one to say that inhaling nitrites could actually depress tumoricidal activity. They certainly did not prove any harm comes from inhaling nitrites.

You continually bring up "the Soderberg group" as support for your theories that poppers are immunosuppressive. But aside from the fact that he appeared to have once be a prolific grant writer himself when he was working together with you in the 1980's, it has been shown that all of Soderberg's studies on nitrites were seriously flawed. The fact that you worked closely with him, even providing the compounds he used in his studies (whatever it was you gave him), shows that the two of you are clearly biased against poppers and have your own personal agendas in this article.

Your statement that Soderberg's previous work demonstrated that poppers were immunosuppressive is simply untrue. This has been pointed out ad nauseam over the past several months yet you continue to disregard it.

I would tend to disagree with your statement that this discussion has 'illustrated that the perspective on poppers remains controversial. Every-time a consensus is arrived at and a NPOV has been established, you have restarted the discussion and arguments all over again.

Since you discovered how to create new sections in the Discussion page you have continually opened new sections with either alarmist or misleading titles. You were asked not to do that two days ago yet you did it again today. In discussion after discussion here we have been unable to find any credible support for your statements that poppers are significantly immunosuppressive in humans. And in a NPOV consensus article, both claims have been described. What more is it that you want in the article on this matter? Munatobe7 14:23, 14 June 2007 (UTC)

the complete article is available online. www.springerlink.com/content/vp5555853053?sortorder=asc&p_o=10

for the article "Effects of inhalant nitrites on VEGF expression: a feasible link to Kaposi's sarcoma." by Ho-Leung Fung and Donah C. Tran in Journal of Neuroimmune Pharmacology (2006) 1:317-322.

As for the bottling plant study, just a head's up of who sponsored the study. The cigarette/tobacco industry have hired guns including "experts" with credentials.

As for the ad hominen attack on Hank Wilson, Wilson stopped working with Lauritsen when Lauritsen became an AIDS denialist and an a leader/spokesman in the AIDS denialist movement.The book DeathRush was written prior to AIDS denialism. Wilson is a longtime AIDS activist open about his being a person with AIDS. Wilson is a long term AIDS survivor.Wilson is an AIDS educator and debunks AIDS denialism.

As for the critique of the Soderberg, Fung, and other NIDA researchers methodology, there has been no consensus that the research is flawed.There has been a core of debunkers of the research,difficult to tell how many and if they are paid by the poppers industry, but their credentials are questionable and unpublished. It's common practice for researchers to fine tune their research overtime and modify protocols to mitigate limitations. The body of research produced, taken as a whole, supports the claim that poppers are immunosuppressive. Not a suggestion, but a demonstrated finding of the published research.

As for working with Soderberg, Wilson provided one bottle of RUSH to enable Soderberg to do some preliminary analysis. This was in the early 90's when people were dying predictably and the life saving treatments had not been discovered. There was a sense of urgency about proceeding with the research. Soderberg subsequently accessed his own supply of poppers for subsequent work.

I would advise anyone new to this discussion to review the archives and examine who supports acknowledging the controversies and who resorts to ad hominem attacks, and who predictably deletes information.

the poppers industry is alive and marketing as if there was no federal ban. Their perspective surfaces in this discussion regularly and predictably. Beware. Hankwilson 15:24, 14 June 2007 (UTC)HankwilsonHankwilson 15:24, 14 June 2007 (UTC)