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Inhalant Abuse

Scope Of The Problem
About 17 percent of adolescents in this country say that they have sniffed inhalants-usually volatile solvents such as spray paint, glue, or cigarette lighter fluid-at least once in their lives, according to the National Institute on Drug Abuse's Monitoring the Future study, a national survey of 8th, 10th and 12th grade students. In fact, results from a number of surveys suggest that among children under 18, the level of use of inhalants is comparable to that of stimulants and is exceeded only by the level of use of marijuana, alcohol, and cigarettes.
The abuse of inhalants, which includes a broad array of cheap and easily obtainable household products is not viewed traditionally in the same high-risk categories as drugs such as alcohol, cocaine, and heroin. Some people tend to view inhalant "sniffing," "snorting," "bagging" (fumes inhaled from a plastic bag), or "huffing" (inhalant-soaked rag in the mouth) as a kind of childish fad to be equated with youthful experiments with cigarettes.
But inhalant abuse is deadly serious. Sniffing volatile solvents, which includes most inhalants, can cause severe damage to the brain and nervous system. By starving the body of oxygen or forcing the heart to beat more rapidly and erratically, inhalants can kill sniffers, most of whom are adolescents.
Survey data on the prevalence of inhalant abuse is difficult to obtain for a number of reasons, and information that does exist may underemphasize the severity of the situation. No one knows how many adolescents and young people die each year from inhalant abuse, in part because medical examiners often attribute deaths from inhalant abuse to suffocation, suicide, or accidents. What's more, no national system exists for gathering data on the extent of inhalant-related injuries. Although medical journals have described the situation as serious, some researchers warn that doctors and emergency medical personnel are not adequately trained to recognize and report symptoms of inhalant abuse.
Inhalant abuse came to public attention in the 1950's when the news media reported that young people who were seeking a cheap "high" were sniffing glue. The term "glue sniffing" is still widely used, often to include inhalation of a broad range of common products besides glue. With so many substances lumped together as inhalants, research data describing frequency and trends of inhalant abuse are uneven and sometimes contradictory. However, evidence indicates that inhalant abuse is more common among all socioeconomic levels of American youth than is typically recognized by parents and the public. For instance, NIDA's Monitoring the Future survey shows that one in every five 8th graders, or 19.4 percent has used an inhalant in his or her lifetime.
Inhalants are most commonly used by adolescents in their early teens, with usage dropping off as they grow older. For example, while 5.4 percent of 8th graders reported using inhalants within the past 30 days, known as "current" use, only 2.5 percent of seniors reported current use of inhalants.
A major roadblock to recognizing the size of the inhalant problem is the ready availability of products that are inhaled. Inhalants are cheap and can be purchased legally in retail stores in a variety of seemingly harmless products. As a result, adolescents who sniff inhalants to get high don't face the drug procurement obstacles that confront abusers of other drugs.

Types Of Inhalants
Volatile solvents originally were limited to either gases, such as butane or liquids, such as gasoline or paint thinner, that vaporize at room temperature. Since the 1950's, however, the types of products that contain volatile solvents has increased significantly. They now include adhesives, aerosols, cleaning agents, food products and solvents.
Volatile solvents produce a quick form of intoxication-excitation followed by drowsiness, disinhibition, staggering, lightheartedness, and agitation. Because many inhalant products contain more than one volatile solvent, it is difficult to clearly identify in humans the specific chemical responsible for subsequent brain or nerve damage or death.
Some volatile solvents are inhaled by abusers because of the effects produced not by the product's primary ingredient but by propellant gases, like those used in aerosols such as hair spray or spray paint. Other volatile solvents found in aerosol products such as gold and silver spray paint are sniffed not because of the effects from propellant gases but because of the psychoactive effects caused by the specific solvents necessary to suspend these metallic paints in the spray.
Nitrites historically have been used by certain groups, largely gay men, to enhance sexual experience and pleasure. Often called "poppers' or "rush," some nitrite products are sold as room air fresheners. But use of nitrites has fallen off dramatically in recent years. This may be partly because products containing butyl, propyl, and certain other nitrites were banned in 1991, although products using chemical variants of the banned substances are still sold.
Anesthetics are the other major category of inhalants with the principal substance of abuse being nitrous oxide. A colorless, sweet-tasting gas used by doctors and dentists for general anesthesia, nitrous oxide is called "laughing gas" because it often induces a state of giggling and laughter. Recent reports indicate that nitrous oxide is being sold illicitly to teenagers and young adults at outdoor events such as rock concerts and on the street. Nitrous oxide often is sold in large balloons from which the gas is released and inhaled for its mind-altering effects. But nitrous oxide is no laughing matter. Inhaling the gas may deplete the body of oxygen and can result in death; prolonged use can result in peripheral nerve damage.

Chemicals Commonly Found In Inhalants
Adhesives
Airplane glue — toluene, ethyl acetate
PVC cement — trichloroethylene
Rubber cement — hexane, toluene, methyl chloride, acetone
Aerosols
Air fresheners — butane, propane, flourocarbons
Analgesic spray — flourocarbons
Asthma spray — fluorocarbons
Deodorants — butane, propane, flourocarbons
Hair sprays — butane, propane, flourocarbons
Paint sprays — hydrocarbons, toluene
Anesthetics
Gaseous — nitrous oxide
Liquid — halothane, enflurane
Local — ethyl chloride
Cleaning Agents
Degreasers — tetrachloroethylene, trichloroethane, trichloroethylene
Dry cleaning — tetrachloroethylene, trichloroethane
Spot removers — tetrachloroethylene, trichloroethane, trichloroethylene
Food Products
Whipped cream — nitrous oxide
Whippets — nitrous oxide
Solvents
Correction fluid thinners — trichloroethylene, trichloroethane
Fire extinguisher — bromochlorodifluoromethane
Fuel — gas, butane
Lighter — butane, isopropane
Paint remover — toluene, methylene chloride, methanol
Paint thinners — toluene, methylene chloride, methanol
Nail Polish remover — acetone

Dangers Of Inhalant Abuse
Although no central system exists in the United States for reporting deaths and injuries from abusing inhalants, several studies have documented the dangers associated with inhalant abuse. A study by Dr. James C. Garriott, the chief toxicologist in San Antonio and Bexar County, Texas, examined all deaths in the county between 1982 and 1988 that were attributed to inhalant abuse. Most of the 39 inhalant-related deaths involved teenagers, with 21 deaths occurring among people less than 20 years old. Deaths of males outnumbered those of females 34 to 5. Many of the abusers met with a violent death possibly related to but not directly caused by the use of volatile solvents.
As reported in a Texas study, the solvent toluene, a common component of many paints, lacquers, glues, inks, and cleaning fluids, is identified frequently in inhalant abuse deaths and injuries. A 1986 study of 20 chronic abusers of toluene-containing spray paints found that after one month of abstinence from sniffing the paint, 65 percent of the abusers had damage to the nervous system. Such damage can lead to impaired perception, reasoning, and memory, as well as defective muscular coordination and, eventually, dementia.
In England, where national statistics on inhalant deaths are recorded, the largest number of deaths in 1991 resulted from exposure to butane and propane, which are used as fuels or propellants. Many researchers believe that abuse of butane, which is used in cigarette lighters, is on the increase in the United States. NIDA's Dr. Sharp says, "It's hard to tell whether this is a passing fancy or whether some youthful abusers actually like to get dizzy on the butane and propane gases."
A recent report of this particular inhalant problem in the Cincinnati region indicates that butane gas is the cause of enough deaths to foster national concern about the abuse of fuel gases, whether or not it is a passing form of inhalant abuse. Dr. Sharp notes that "sniffers seem to go out of their way to get their favorite product." For instance, in certain parts of the country, "Texas 'shoe-shine' (a shoe-shining spray containing toluene) and silver or gold spray paints are local or current favorites," he says. Since the banishing of fluorocarbons, the most common sniffing death hazards among students in the United States probably are due to butane and propane.

Who's Abusing Inhalants?
One possible reason for the increased use of volatile solvents is that more girls are joining boys in sniffing solvents. The rates of solvent use for males and females have been converging over the past 20 years. Recent studies in New York and Texas report that males are using solvents at only slightly higher rates than females are. Among Native Americans, whose solvent abuse rates are the highest of any ethnic group, lifetime prevalence rates for males and females were nearly identical, according to National Institute on Drug Abuse data.
In fact, inhalant abuse shows episodic patterns, with short-term abuse outbreaks developing in a particular school or region as a specific inhalant practice or product becomes popular in a fashion typical of teenage fads. This episodic pattern can be reflected in survey results and can overstate the magnitude of what is a continually fluctuating level of abuse.
Inhalant abusers typically use other drugs as well. Children as young as 4th graders who begin to use volatile solvents also will start experimenting with other drugs, usually alcohol and marijuana. Adolescent solvent abusers are typically polydrug users and are prone to use whatever is available, although they do show a preference for solvents. However, solvent abuse is often held in low regard by older adolescents, who may consider it unsophisticated, a "kid" habit.
Inhalant abuse is deadly serious. By starving the body of oxygen or forcing the heart to beat more rapidly and erratically, inhalants can kill sniffers, most of whom are adolescents.

For further information on Rimrock Foundation's treatment of inhalant abuse, call Barbara Hansen, Admissions Supervisor at 1-800-227-3953 or 1-406-248-3175, or visit our website at rimrock.org. For more educational information on inhalants, contact the Rimrock Foundation Library at 1-800-227-3953 or 1-406-248-3175.
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