Inhalants

Source: National Institute on Drug Abuse (NIDA) - http://teens.drugabuse.gov/facts/facts_inhale1.asp

What Are They?
Most inhalants are common household products that, when inhaled, cause a psychoactive (mind-altering) effect. There are literally hundreds of inhalants, including everyday products such as nail polish remover, glue, gasoline, household cleaners, and nitrous oxide ("laughing gas," which can be found in whipped cream dispensers and is often inhaled via a balloon). Inhalants also include fluorinated hydrocarbons found in aerosols such as hairspray, spray paint, and household cleaners.

Although the wide range of chemicals found in different products can have different effects, inhalants generally fall into three categories: solvents, gases, and nitrites.

Solvents include:

• Certain industrial or household products, such as paint thinner, nail polish remover, degreaser, dry-cleaning fluid, gasoline, and glue
• Some art or office supplies, such as correction fluid, felt-tip marker fluid, and electronic contact cleaner [1]

Gases include:

• Some household or commercial products, such as butane lighters, propane tanks, whipped cream dispensers, and refrigerant gases
• Certain household aerosol propellants, such as those found in spray paint, hair spray, deodorant spray, and fabric protector spray.
• Medical anesthetic gases, such as ether, chloroform, halothane, and nitrous oxide [2]

Nitrites include:

• Cyclohexyl nitrite (found in substances marketed as room deodorizers)
• Amyl nitrite (used for medical purposes)
• Butyl nitrite (previously used in perfumes and antifreeze, but now an illegal substance) [1]

What Are the Common Street Names?
Common slang for inhalants includes "laughing gas" (nitrous oxide), "snappers" (amyl nitrite), "poppers" (amyl nitrite and butyl nitrite), "whippets" (fluorinated hydrocarbons, found in whipped cream dispensers), "bold" (nitrites), and "rush" (nitrites).

How Are They Used?
Inhalants can be breathed in through the nose or mouth in a variety of ways: [2]

• "Sniffing" or "snorting" fumes from containers
• Spraying aerosols directly into the nose or mouth
• Sniffing or inhaling fumes from substances sprayed or placed into a plastic or paper bag ("bagging")
• "Huffing" from an inhalant-soaked rag stuffed in the mouth
• Inhaling from balloons filled with nitrous oxide

Because intoxication lasts only a few minutes, abusers frequently try to make the high last longer by continuing to inhale repeatedly over several hours.

How Many Teens Use Them?
National surveys report that more than 22.9 million Americans have abused inhalants at least once in their lives. [3] Abuse of inhalants often starts early. [2] Some young people may use inhalants as an easily accessible substitute for alcohol. [1] One national survey, conducted in 2003-2004, found that 2.5 percent of 4th-graders had used inhalants at least once in the year prior to being surveyed. [4]

According to a NIDA-funded survey of drug use among 8th-, 10th-, and 12th-graders, students in 8th grade regularly report the highest rate of inhalant abuse. [2] Use of inhalants gradually increased from 1976 until 1995 and then steadily declined until recently. The 2004 NIDA survey reported an increase in use among 8th graders. The survey reported that 17.3 percent of 8th-graders, 12.4 percent of 10th-graders, and 11.9 percent of 12th-graders had tried inhalants at least once in their life. [5]

In the United States in 2002, about 40 deaths were associated with inhalant abuse. [6]

What are the Common Effects?
Most of us don't think of spray paint, glue, household cleaners, and the like as drugs because we're used to seeing such products under the kitchen sink, in the bathroom, or on the grocery shelves. Inhalants are easy to get, and children and adolescents are among those most likely to abuse these potentially toxic substances.

Initial Effects
The lungs rapidly absorb inhaled chemicals into the bloodstream, quickly distributing them throughout the brain and body. Within minutes of inhalation, users feel "high." The effects are similar to those produced by alcohol and may include slurred speech, lack of coordination, euphoria, and dizziness. Inhalant users may also experience lightheadedness, hallucinations, and delusions. [2] The high usually lasts only a few minutes.

With repeated inhalations, many users feel less inhibited and less in control. Some may feel drowsy for several hours and experience a lingering headache. [2]

Effects on the Brain
Inhalants often contain more than one chemical. Some chemicals leave the body quickly, but others can stay there a long time, absorbed by fatty tissues in the brain and central nervous system. [7]

One of these fatty tissues is myelin, a protective cover that surrounds many of the body's nerve cells (neurons). Myelin helps nerve fibers carry their messages to and from the brain. Damage to myelin can damage nerve fibers in a way that is clinically similar to the effects of multiple sclerosis. [2]

Long-term inhalant use can break down myelin. When this happens, nerve cells may not be able to transmit messages, resulting in muscle spasms and tremors or even permanent difficulty with basic actions like walking, bending, and talking. [6]

Inhalants also can damage neurons in a part of the brain called the hippocampus by preventing nerve cells from getting enough oxygen. [7] The hippocampus helps control memory, so someone who repeatedly uses inhalants may lose the ability to learn new things or may have a hard time carrying on simple conversations. [7]

Damage from long-term use of inhalants can slow or stop nerve cell activity in some parts of the brain. This might happen in the cerebral cortex, the part of the brain that solves complex problems and plans ahead. If inhalants get into the brain's cerebellum, which controls movement and coordination, they can make someone move slowly or clumsily. [7]

Long-Term Health Effects
Regular abuse of inhalants can result in serious harm to vital organs, including the brain, heart, kidneys, and liver. [2] It can cause heart damage, liver failure, and muscle weakness. [8] The vaporous fumes can change brain chemistry and may be permanently damaging to the brain and spinal cord. [8]

Certain inhalants can also cause the body to produce fewer types of all blood cells, which may result in aplastic anemia (a condition in which the bone marrow is unable to produce blood cells). [8] Frequent long-term use of certain inhalants can cause a permanent change or malfunction of nerves, called polyneuropathy. [8]

Compulsive use and mild withdrawal symptoms can occur with long-term inhalant abuse. Additional symptoms exhibited by long-term abusers include weight loss, muscle weakness, disorientation, inattentiveness, lack of coordination, irritability, impaired vision, and depression. [2] Specific Effects by Type of Inhalant

Depending on the type of inhalant abused, many serious health effects can result. The table below lists a few examples of inhalants and their effects.

Examples of Effects by Type of Inhalant [1]

Butane (found in cigarette lighters and refills) makes the heart extra sensitive to a chemical that carries messages from the central nervous system to the heart. This chemical, noradrenaline, tells the heart to beat faster when someone's in a stressful situation-such as being scared suddenly. [7] If the heart becomes too sensitive to noradrenaline, a normal jolt of it may cause the heart to temporarily lose its rhythm and stop pumping blood through the body. Some inhalant users die this way. [7]

Nitrite abuse can also have specific negative health effects. Unlike most other inhalants, which act directly on the central nervous system, nitrites enlarge blood vessels, allowing more blood to flow through. Inhaled nitrites make the heart beat faster and produce a sensation of heat and excitement that can last for several minutes. Other effects can include dizziness and headaches. While younger teenagers use other inhalants to alter mood, older adolescents and adults inhale nitrites primarily to enhance sexual pleasure and performance. This latter type of nitrite abuse is associated with unsafe sexual practices that greatly increase the risk of contracting and spreading infectious diseases such as HIV and hepatitis. [2]

Lethal Effects
Prolonged sniffing of the highly concentrated chemicals in solvents or aerosol sprays can induce irregular or rapid heart rhythms and can lead to heart failure and death within minutes of a session of prolonged sniffing. [2] This "sudden sniffing death" is particularly associated with the abuse of butane, propane, and chemicals in aerosols. [2]

While high on inhalants, users also can die by choking on their own vomit or by fatal injury from accidents, including car crashes. [2]

References

1. National Institute on Drug Abuse. NIDA InfoFacts: Inhalants (http://www.nida.nih.gov/Infofax
   /inhalants.html). Revised December 2004. Retrieved May 2005.
2. National Institute on Drug Abuse. NIDA Research Report: Inhalant Abuse (http://www.drugabuse.gov
   /researchreports/inhalants/inhalants.html). NIH Publication No. 00-3818. Printed 1994. Reprinted 1996, 1999. Revised March 2005. Bethesda, MD: NIDA, NIH, DHHS. Retrieved May 2005.
3. Substance Abuse and Mental Health Services Administration. Results from the 2002 National Survey on Drug Use and Health: National Findings (http://www.oas.samhsa.gov/nhsda
   /2k2nsduh/Results/2k2Results.htm). Office of Applied Studies, NHSDA Series H-22. DHHS Pub. No. SMA 03-3836. Rockville, MD: SAMHSA, DHHS. Printed 2003. Retrieved November 2005.
4. PRIDE Surveys. PRIDE Questionnaire Report for Grades 4 through 6 (http://www.pridesurveys.com). 2003-04 PRIDE National Summary/Grades 4 thru 6. September 16, 2004. Retrieved June 2005.
5. Johnston, L.D.; O'Malley, P.M.; and Bachman, J.G. Monitoring the Future: National Results on Adolescent Drug Use; Overview of Key Findings (http://monitoringthefuture.org/data
   /03data/pr03t1.pdf) Bethesda, MD: NIDA, NIH, DHHS, 2003. Retrieved January 2004.
6. Substance Abuse and Mental Health Services Administration, Office of Applied Studies (2005). Drug Abuse Warning Network, 2003: Area Profiles of Drug-Related Mortality (http://dawninfo.samhsa.gov/files
   /ME_report_2003_Front.pdf). DAWN Series D-27. DHHS Publication No. (SMA) 05-4023. Rockville, MD: SAMHSA, DHHS. Printed 2005. Retrieved May 2005.
7. National Institute on Drug Abuse. Mind Over Matter: Inhalants (http://teens.drugabuse.gov/mom
   /mom_inha1.asp). Bethesda, MD: NIDA, NIH, DHHS. NIH Pub. No. 03-4038. Printed 1997. Reprinted 1998, 2000, 2003. Retrieved May 2005.
8. National Institute on Drug Abuse. Mind Over Matter: Teaching Guide. Inhalants (http://teens.drugabuse.gov
   /mom/tg_inha1.asp) Bethesda, MD: NIDA, NIH, DHHS. NIH Publication No. 00-3592. Printed 1997, 1998. Revised 2000. Retrieved May 2005.