It’s not unusual for the packaging of one product to resemble that of another, potentially leading to mix-ups. But the U.S. Food and Drug Administration (FDA) has warned people who drink energy shots to make sure they’re not accidentally chugging a bottle of poppers — or they might end up sick or dead. 

“Don’t be fooled. These poppers, often purchased online or in novelty stores, are unapproved products and should not be inhaled or ingested, regardless of how they are packaged, labelled or displayed,” the FDA notes in its online warning shared in recent social media posts.

But those who work in LGBTQ sexual health say the FDA’s warning that people are confusing poppers with energy shots, with sometimes dire consequences, may actually be doing more of a disservice. 

Such messaging “borders on inflammatory” and may contribute to the “the stigmatization of the product [and] the stigmatization of the person who’s using poppers,” said Rod Knight, an associate professor at the at Université de Montréal’s School of Public Health, who has also conducted research on poppers.

Poppers are a chemical substance that belongs to a class of drugs known as alkyl nitrates. When they’re inhaled as vapour, from a small liquid-filled bottle wrapped in a colourful plastic label, the user can almost instantly get the short-lasting, light-headed sensation of a head rush, Knight explained.

He explained they also relax the sphincter muscle of the anus, making receptive anal sex more comfortable for some people. Poppers have been popular among gay, bisexual and other men who have sex with men for decades. 

Knight acknowledges that there are sometimes side effects, which may include nausea, headaches, reduced blood pressure — alkyl nitrates are vasodilators, meaning they open blood vessels — and even vision issues. But he suggested such side effects “can be remedied through change of usage patterns.”

According to the FDA’s website, they are usually purchased in sex shops or online — often labelled as other products such as leather cleaner or deodorizers — even though the agency recommends against using them. Alkyl nitrates as poppers are unauthorized in Canada and Health Canada has cracked down on the sale of them since 2013, though they’re not necessarily illegal to purchase, possess or consume.

Does the FDA claim pass the sniff test? 

Energy shots are flavoured beverages containing some amount of caffeine, and vitamins or other natural substances that purportedly boost your energy, like ginseng or ginkgo biloba. They’re sold in small bottles with colourful plastic labels. They’re commonly found at convenience stores, supermarkets or bought online.

If by some chance you had both products side-by-side and didn’t realize your mistake by the time you peeled off the plastic and cracked open the bottle, the distinct smell of poppers should be a red flag, explained Adam Awad, the communications manager for the Gay Men’s Sexual Health Alliance in Toronto.

“If you’re about to drink a 5-Hour Energy drink [a popular energy shot brand] and it smells like nail polish remover, you know, maybe you should ask yourself some questions before touching it to your lips,” he said.

Awad said he isn’t aware of any cases of people dying from a poppers-related mishap like the FDA described — a claim the agency previously made in 2021 — but he said he “would be very keen to see any evidence that they’ve got or reports on the actual number of cases.” 

CBC News reached out to the FDA for data on injuries or death related to the accidental oral ingestion of poppers and an explanation for the social media warning, but did not receive a response.

In 2012, however, the agency stated that it was investigating 13 deaths and 33 hospitalizations related to the consumption of 5-Hour Energy drinks. 

But if serious or fatal mix-ups with poppers and energy shots are happening, it would certainly be a dangerous situation, said Knight. He said he’s curious to know in what context such a serious mistake might have happened and whether there were other contributing factors to these incidents. 

There is also a flip side to poppers, Knight said, that health agencies like the FDA and Health Canada do not mention in their cautionary messaging.

“This drug is being used by gay and queer men for very therapeutic reasons,” Knight said. “[Poppers] can prevent muscle spasm and injury during receptive anal intercourse.” 

Should Canada ease its restrictions on poppers?

Health Canada states alkyl nitrites can only be used when prescribed by a doctor, but there are currently no approved products sold as poppers. In a statement to CBC News, the agency said “there have been no submissions filed by any company [or] manufacturers for authorization of a popper product.”

Knight said it would be difficult and unlikely for many producers to go through the clinical trials and regulatory processes needed to get approval for prescription use and, even if that did happen, it would only create other barriers to accessing the drug.

“This drug is not really well known among a lot of clinicians, except for those who specialize in sexual health,” he said. 

He said the current restriction has done little to prevent people from acquiring poppers one way or another, whether it’s ordering them online, buying them over the border in the U.S. or procuring them by some other means. 

He noted a survey from the Community-Based Research Centre that showed only a slight drop in the percentage of people using poppers, after the ban on sales, and had little effect on regular use.

“If this was a drug that was being used among, for example, straight guys at a rate of 30 per cent of straight guys across Canada, there would be a very different approach to how the drug would be treated,” he said.

He believes the restriction has done more harm than good, pushing poppers into a form of “illicit market,” making it unclear what ingredients they may contain because manufacturers aren’t “incentivized” to label their products with accurate health information. 

There is also the possibility poppers may be packaged in a way that resembles other products in order to “disguise them” because of the restriction, added Awad, potentially setting up that very mixup scenario.

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Mosquitoes. 

They’re thirsty bloodsuckers that annoy those who cross into nature, feasting on their salty life source while leaving behind red, itchy bumps.

And this year across Canada, it seems the pesky insects are worse than ever.

Those who’ve wondered about an increase in mosquitoes may be right, according to Laura Ferguson, assistant professor of biology at Acadia University in Nova Scotia.

“It’s definitely been a trend to some extent that people are noticing anecdotally,” she told CTVNews.ca in an interview on Friday. “New Brunswick, in particular, over the last couple of years, has noticed big bursts in mosquito populations, especially in this mid- to late spring.”

Why mosquitoes may be worse than normal in some areas has more than one answer.

WHY MOSQUITOES ARE SO BAD THIS YEAR

Ferguson works with a team to study mosquitoes, understand the different species and track their abundance across North America.

“It’s for a few different reasons why we’re seeing more mosquitoes than we may have at least in the past couple of decades or so,” she said.

The first contributing reason is that there are more species of mosquitoes than in years past.

Different species travel with human goods across the world. They then breed in their new homes, creating populations of specific types of mosquitoes where they’d never existed before.

“Here in Nova Scotia for instance, we didn’t have a (species) a couple of decades ago — it came over from Japan in tire, we think — and it’s just exploded across the province and you can find it anywhere now,” Ferguson said.

Additionally, Ferguson said, warmer winters caused by climate change allow mosquitoes that would die off in the winter to survive and continue reproducing.

Along with being able to survive the milder weather, some types of mosquitoes are able to reproducer faster in warm temperatures because of the type of insect they are. Ferguson says mosquitoes are ectotherms, meaning their regulation of body temperature depends on external sources like the sun.

Precipitation also plays a factor in how well mosquitoes can survive, because they lay eggs in stagnant water.

Ferguson said if it’s a particularly dry spring there may be fewer mosquitoes around, depending on the species. Others lay eggs in the fall, so there would only be a large drop in mosquitoes if the previous year was dry.

Another theory that needs more research, Ferguson said, is the waning effects of the chemical Dichlorodiphenyltrichloroethane (DDT), which was used in the past to control insects in crops, but was phased out in the 1970s due to its harm on other species.

Despite this, the chemical can still be found in water and is circulating in ecosystems. 

“Those kinds of holdover effects from these really persistent insecticides may have also suppressed mosquito populations for a few decades,” she said. “And now we’re experiencing a bit of this rebound of these populations as these insecticides and their effects start to wear away in the environment.”

WHAT CAN BE DONE ABOUT MOSQUITOES? 

Unfortunately, all these factors lead to an increase in mosquitoes, a problem without fast solutions.

“I think for the most part, what we need to do is just figure out the ways to protect ourselves from contact with mosquitoes because they are a part of the ecosystem,” Ferguson said.

“On a regular basis it’s going to be things like hanging out in a screened porch instead of right outside, making sure that you dump standing water anywhere in your yard.”

Using repellents like DEET and some natural oils can help when out in the woods, Ferguson said.

“Wear light colours, long sleeves, those kinds of things to reduce the area of your body that’s exposed to potential bites,” Ferguson said. “That kind of thing is sort of our best bet of that trying to sort of prevent our contact with them as much as possible.”

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China’s defence minister defended sailing a warship across the path of an American destroyer and Canadian frigate transiting the Taiwan Strait, telling a gathering of some of the world’s top defence officials in Singapore on Sunday that such so-called “freedom of navigation” patrols are a provocation to China.

In his first international public address since becoming defence minister in March, Gen. Li Shangfu told the Shangri-La Dialogue that China doesn’t have any problems with “innocent passage” but that “we must prevent attempts that try to use those freedom of navigation [patrols], that innocent passage, to exercise hegemony of navigation.”

U.S. Defence Secretary Lloyd Austin told the same forum Saturday that Washington would not “flinch in the face of bullying or coercion” from China and would continue regularly sailing through and flying over the Taiwan Strait and the South China Sea to emphasize they are international waters, countering Beijing’s sweeping territorial claims.

Canadian Defence Minister Anita Anand said Canada would continue to sail where international law allows, including the strait, and that “actors in this region must engage responsibly.”

Concerns accident could lead to escalation

On Saturday, a U.S. guided-missile destroyer and a Canadian frigate (HMCS Montréal) were intercepted by a Chinese warship as they transited the strait between the self-governed island of Taiwan, which China claims as its own territory, and mainland China.

The Chinese vessel overtook the American ship and then veered across its bow at a distance of about 140 metres in an “unsafe manner,” according to the U.S. Indo-Pacific Command.

Additionally, the U.S. has said a Chinese J-16 fighter jet late last month “performed an unnecessarily aggressive manoeuvre” while intercepting a U.S. Air Force reconnaissance aircraft over the South China Sea, flying directly in front of the plane’s nose.

Those and previous incidents have raised concerns of a possible accident occurring that could lead to an escalation between the two nations at a time when tensions are already high.

Li suggested the U.S. and its allies had created the danger, and should instead focus on taking “good care of your own territorial airspace and waters.”

“The best way is for the countries, especially the naval vessels and fighter jets of countries, not to do closing actions around other countries’ territories,” he said through an interpreter. “What’s the point of going there? In China we always say, ‘Mind your own business.”‘

In a wide-ranging speech, Li reiterated many of Beijing’s well-known positions, including its claim on Taiwan, calling it “the core of our core interests.”

‘Meddling in China’s internal affairs’

He accused the U.S. and others of “meddling in China’s internal affairs” by providing Taiwan with defence support and training, and conducting high-level diplomatic visits.

“China stays committed to the path of peaceful development, but we will never hesitate to defend our legitimate rights and interests, let alone sacrifice the nation’s core interests,” he said.

“As the lyrics of a well-known Chinese song go: ‘When friends visit us, we welcome them with fine wine. When jackals or wolves come, we will face them with shotguns.”‘

In his speech the previous day, Austin broadly outlined the U.S. vision for a “free, open, and secure Indo-Pacific within a world of rules and rights.”

In the pursuit of such, Austin said the U.S. was stepping up planning, co-ordination and training with “friends from the East China Sea to the South China Sea to the Indian Ocean” with shared goals “to deter aggression and to deepen the rules and norms that promote prosperity and prevent conflict.”

Li scoffed at the notion, saying “some country takes a selective approach to rules and international laws.”

“It likes forcing its own rules on others,” he said. “Its so-called ‘rules-based international order’ never tells you what the rules are and who made these rules.”

By contrast, he said, “we practise multilateralism and pursue win-win co-operation.”

Li is under American sanctions that are part of a broad package of measures against Russia — but predate its invasion of Ukraine — that were imposed in 2018 over Li’s involvement in China’s purchase of combat aircraft and anti-aircraft missiles from Moscow.

The sanctions, which broadly prevent Li from doing business in the United States, do not prevent him from holding official talks, American defence officials have said.

Still, he refused Austin’s invitation to talk on the sidelines of the conference, though the two did shake hands before sitting down at opposite sides of the same table together as the forum opened Friday.

Handshake no substitute for engagement, U.S. says

Austin said that was not enough.

“A cordial handshake over dinner is no substitute for a substantive engagement,” Austin said.

The U.S. has noted that since 2021 — well before Li became defence minister — China has declined or failed to respond to more than a dozen requests from the U.S. Defence Department to talk with senior leaders, as well as multiple requests for standing dialogues and working-level engagements.

Li said “China is open to communications between our two countries and also between our two militaries,” but without mentioning the sanctions, said exchanges had to be “based on mutual respect.”

“That is a very fundamental principle,” he said. “If we do not even have mutual respect, than our communications will not be productive.”

He said he recognized that any “severe conflict or confrontation between China and the U.S. will be an unbearable disaster for the world,” and that the two countries need to find ways to improve relations, saying they were “at a record low.”

“History has proven time and again that both China and the United States will benefit from co-operation and lose from confrontation,” he said.

“China seeks to develop a new type of major-country relationship with the United States. As for the U.S. side, it needs to act with sincerity, match its words with deeds, and take concrete actions together with China to stabilize the relations and prevent further deterioration,” Li said.

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