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Despite trusting and supportive relationships with HIV care providers, including open dialogue about other substance use, participants had not been asked by their providers about popper use

Psychoactive drugs like cocaine and amphetamines stimulate the effects of neurotransmitters, according to a 2021 article by da Silva et al., published in the journal Current Opinion in Toxicology , titled Neurotoxicity of psychoactive substances: A mechanistic overview . For instance, cocaine increases the availability of the dopamine neurotransmitter and induces symptoms like feelings of pleasure and being rewarded, increased energy, and enhanced arousal, according to a 2015 article by Vivek Verma published in the journal Clinical Psychopharmacology and Neuroscience , titled Classic Studies on the Interaction of Cocaine and the Dopamine Transporter . Another example of drug impact on the brain is observed when psychoactive substances like alcohol reduce the effects of neurotransmitters

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