In this week’s report, NDEWS highlights observations from biospatial.io detailing the EMS encounters in the US for nonfatal inhalant-related overdoses from 2023 to 2024. Among states with at least 75% coverage, there were 852 nonfatal inhalant-related overdose encounters.

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What are poppers? Poppers is a slang term for alkyl nitrites, a class of inhalants typically sold in small bottles. When inhaled, they produce a brief rush of euphoria, muscle relaxation, and enhanced sensory experiences. 

What was found? Discussion of poppers has remained relatively steady over the past year with a sharp dip around September and October of last year.

How are they being discussed? Reddit discussions of poppers are primarily discussed in sexual contexts, with Reddit users frequently describing them as tools for enhancing sexual experiences. Reddit users often warn about dangerous drug interactions between poppers and erectile dysfunction medications. Commenters note that this potentially lethal combination risks severe drops in blood pressure. Sexual health concerns are featured prominently in these conversations, with Reddit users expressing anxiety about potential disease transmission risks during encounters involving poppers. Many posts describe physical health issues following combined use of poppers with other substances like MDMA, ketamine and psychedelics. Many Reddit users report diminishing effects from repeated popper use. This frequently leads to discussions about substituting with stronger substances or combining poppers with other drugs to achieve desired effects. 

Drug Terms Searched: Poppers, Alkyl nitrites.

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The FDA recently raided Texas-based poppers manufacturer Double Scorpio amid rising concerns over misuse and health risks. Sold under a legal gray area, poppers (alkyl nitrites) are often marketed as cleaners but widely used recreationally. Dr. Palamar, NDEWS Co-Director, noted 18% of nightclub attendees reported past-year use in 2024, with cases of poisoning increasing, especially from mistaken ingestion. A recent study found 8% of store employees incorrectly advised drinking poppers, a potentially fatal mistake. The scope of the FDA’s crackdown remains unclear, but concerns over accessibility and misuse are growing.

Read more here.

More Media Coverage Featuring Quotes From NDEWS Co-Director Dr. Palamar
- FDA crackdown on poppers prompts rush on popular gay party drug - Los Angeles Times

A recently published study in Clinical Toxicology by Olinde et al. described visits to 98 urban retailers during May 2023 in New York City;  86 (88%) stocked alkyl nitrites ("poppers". Among vendors, 48% recommended inhalation, 44% were unsure or refused to answer, and 8% incorrectly advised ingestion. Additionally, 59% of stores also sold energy drinks, with 39% placing poppers near these drinks, increasing the risk of mistaken ingestion. Following these findings, the New York City Department of Health initiated a public health response, including advisories, retailer education, and social media campaigns to prevent further incidents.

Read more here.

Media Coverage:
- FDA reportedly raids manufacturer of poppers, an increasingly popular party drug - NBC News
- Is the FDA cracking down on poppers? And if so, why? - NPR

The FDA has issued a warning about the misuse of nitrous oxide (N₂O), commonly known as laughing gas, following a rise in injuries linked to flavored canisters sold in gas stations, vape shops, and online. Brands such as Cosmic Gas, Galaxy Gas, and MassGass market the product for "culinary use only," but reports indicate increasing recreational misuse, particularly among young people. Inhaling N₂O can cause dangerously low blood pressure, loss of consciousness, and other serious health risks. Poison control centers have reported emergency calls related to its misuse, and some states have introduced age restrictions, though no federal regulations currently limit its sale. The FDA continues to monitor the situation as concerns grow over the accessibility and marketing of these products.

Read more here.

Submit any information concerning new trends in inhalant (poppers, nitrous oxide, etc.) use in your area, here.

Is there any other information NDEWS should know about related to substance use, overdoses (fatal or nonfatal) or other drug-related trends in your area, including trends associated with polysubstance or co-use? 

A recent NIH blog by NIDA Director, Dr. Nora Volkow, advocates for recognizing reduced drug use—not just abstinence—as a valid endpoint in addiction treatment trials. Citing 2022 NSDUH data showing 65% of adults in recovery used substances in the past month, Dr. Volkow highlights growing evidence that reductions in use are linked to improved mental health and functioning. Dr. Volkow points to findings from pooled clinical trials showing that reductions in cocaine, stimulant, and cannabis use (e.g., ≥75% cocaine-negative urine screens or 50% fewer cannabis use days) lead to meaningful clinical gains. While abstinence remains the FDA standard, Dr. Volkow urges adoption of alternative endpoints to encourage treatment development, especially for opioid use disorder, where relapse after abstinence can heighten overdose risk.  

Read more here.

A recent investigative report by Scripps News sheds light on the alarming rise in pediatric fentanyl poisonings across the U.S., drawing from over 110 hours of 911 calls, police bodycam footage, and interviews. The report documents dozens of near-fatal overdoses in children—often under age 5—who were exposed to fentanyl in their homes, typically through accidental ingestion of pills, foils, or drug paraphernalia.

Complementing these findings, a recent analysis led by NDEWS Co-Directors, Drs. Palamar and Cottler, and Dr. Black, an NDEWS affiliate, found a 900% increase in nonfatal fentanyl exposures among U.S. children ages 0–12 between 2015 and 2023, based on poison center data. In parallel, researchers at Rady Children’s Hospital-San Diego reported that over 80% of asymptomatic children tested positive for fentanyl when living in homes where the drug was used or distributed.

Read more here.

For more information regarding pediatric fentanyl exposures, click here.

📅 Date: Tuesday, April 8, 2025

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📅 Date: Thursday, April 10, 2025

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📅 Date: Thursday, April 10, 2025

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📅 Dates: May 29 - May 30, 2025

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📅 Dates: June 2 - 4, 2025

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📅 Date: Friday, June 20, 2025

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If you miss or want to learn more about NDEWS Original Content, you can find our archived content on the NDEWS website:

     • NDEWS Hotspot Alerts using substance-related EMS data
     • NDEWS Rapid Street Reporting (RSR) survey data reports
     • NDEWS Web Monitoring Team Reddit Alerts
     • NDEWS Sentinel Site Reports
     • Previous issues of the NDEWS Weekly Briefings

The Weekly Briefing is a newsletter published each week by the National Drug Early Warning System (NDEWS) Coordinating Center, which is funded by the National Institute on Drug Abuse (U01DA051126) to the University of Florida (MPI: Cottler (contact), Co-Is: Goldberger, Nixon, Striley), New York University (MPI: Palamar), and Florida Atlantic University (Co-I: Barenholtz). Any item may be reproduced provided the source is acknowledged.