What the Science Says: April 2020

What the science says is a series of posts highlighting the latest research from scientists at the BC Centre on Substance Use (BCCSU). These recurring posts feature summaries of new publications from the BCCSU’s investigators, as well as links out to companion resources to consult if you’d like to learn more. What the science says is intended to keep the media, the research community and the public informed about evidence coming out of the substance use field.

This month, we take a look at new research on substance use among lesbian, gay, bisexual, transgender, and intersex (LGBTI) young people, and how this population can be best served by harm reduction and health care organizations.


Goodyear, T., Mniszak, C., Jenkins, E., Fast, D., & Knight, R. (2020). “Am I gonna get in trouble for acknowledging my will to be safe?” Identifying the experiences of young sexual minority men and substance use in the context of an opioid overdose crisis. Harm Reduction Journal, 17(23).

This study by researchers affiliated with the BCCSU and the University of British Columbia looked at how gay, bisexual and other men who have sex with men (otherwise referred to as sexual minority men) are responding to the fentanyl-adulterated illicit drug supply, which has led to opioid overdose crises internationally and the declaration of a public health emergency in BC. Through interviews with 50 young (15-30 years of age) cisgender and transgender sexual minority men who use substances and who live in Greater Vancouver, Canada, the researchers found that participants are highly aware of and impacted by the contaminated drug supply, and are increasingly apprehensive of the risk of overdose. At the same time, participants often described how the landscape of harm reduction services was not viewed as accessible or intended “for them,” because of their sexual and gender identities and the contexts in which they use substances (e.g., with sex, recreationally). However, the analysis also found that harm reduction norms and practices were emerging organically through social networks: for instance, many participants sourced their drugs only from “trusted” suppliers within their peer and sexual networks. Taken as a whole, this study highlights the adaptability and resiliency of this population, and also underscores the need for equitable and tailored harm reduction services for young sexual minority men.


Schwartz, C., Fast, D., & Knight, R. (2020). Poppers, queer sex and a Canadian crackdown: Examining the experiences of alkyl nitrite use among young sexual minority men. International Journal of Drug Policy, 77.

This analysis by BCCSU researchers Cameron Schwartz and Drs. Danya Fast and Rod Knight considers the impact of policy and enforcement action around alkyl nitrites on sexual minority men. Alkyl nitrites, or “poppers”, are a substance commonly used during sex by gay, bisexual and other men who have sex with men. When inhaled, poppers cause vasodilation, giving the user a “head rush” while relaxing smooth muscles and facilitating penetration during anal sex.

In 2013, Canada’s national health oversight body, Health Canada, initiated a crackdown on poppers products, ordering them off retailers’ shelves and threatening businesspeople with fines and imprisonment. The study found that many of the 50 young sexual minority men interviewed associated poppers with their identities as gay and queer men, and that they used poppers in order to enhance their enjoyment of sex as well as reduce pain and injury, with some men feeling dependent on poppers for the experience of pleasure. Participants also expressed uncertainty around the health effects of poppers as well as how to safely and comfortably source them in the context of the crackdown. These findings indicate that the current regulatory environment around poppers is restricting access to a safe and regulated supply of poppers – a drug that has documented benefits for young sexual minority men. The authors call on the federal government to bring the voices of sexual minority men to the forefront in revisiting the federal crackdown on these drugs.