Inhalants Solvent abuse is defined as a deliberate inhalation of an easily vaporized organic substance to achieve a distortion of consciousness (Ste ffle 1996). Any product containing a volatile substance can be used; those containing large portions are preferred. There are hundreds of chemicals, sold in thousands of products. The one thing they all have in common is that they all replace oxygen in the brain. Inhalants are classified into three categories (solvents and gases, anesthetics and nitrites); they have horrible short and long term effects on the user and are potentially deadly. Most users are young males.
People have inhaled drugs throughout recorded history. In ancient times, people in Greece would sit over fires burning laurel leaves and inhale the smoke. In Biblical Palestine and ancient Egypt, ointments and perfumes were inhaled freely to enhance religious worship. People in the Mediterranean, 2, 500 years ago, and hundreds of years ago in Africa, marijuana leaves and flowers were thrown into fires and the smoke was then inhaled (Glowa 1986). In 1776, nitrous oxide (N 2 O) was discovered by Sir Joseph Priestly and synthesized later that year by Sir Humphry Davy. In 1799, Davy observed the drug s ability to reduce pain and suggested it be used during surgery.
It was tested forty-five years later. Dentist Horace Wells was the first person in the United States to use nitrous oxide in surgery. He later died from complications from his own inhalant abuse (Glowa 1986). In 1831, chloroform was discovered simultaneously in the United States and in Germany.
Within that same year, the first accounts of chloroform abuse were reported in the U. S. In Scotland, 1847, Dr James Y. Simpson introduced chloroform usage as an anesthetic in surgery and childbirth (Glowa 1986). In the late 1800 s, ether was often used as a medicinal agent and some patients began to drink it as if it were a liqueur. Othe solvent abuse was reported in the mid 1800 s, most resulting from prescribed treatments that turned into addiction (Glowa 1986).
As more volatile substances were produced, people realized that inhaling these agents produced behavioral effects. In the late 1940 s, one of the earliest accounts of solvent abuse was an outbreak of gasoline sniffing on the east coast of the United States. The first reported case of glue sniffing was in Great Britain. Afterwards, various aerosols, gases, propellants and refrigerants also found their way into becoming abused. By the 1960 s, people began filling plastic bags with nitrous oxide and passing them to friends as party activities (Glowa 1986). More recently, amyl nitrite and butyl nitrate have become popular in certain circles for their muscle relaxant effect.
Almost all solvents and gases are made from petroleum and natural gas. They have an enormous number of industrial, commercial and household uses. Because they are easily attainable (they are found in almost every home), solvents and gases are the most often abused. Included in this category are adhesives (glue, rubber cement), aerosols (spray paint, hair spray, air fresheners), solvents (nail polish remover, correction fluid, lighter fluid) and cleaners (dry cleaning fluid, de greasers). Sadly, they cause the most damage to the liver and other organs. Of the anesthetics, nitrous oxide (N 2 O) is the most often abused.
N 2 O is a colorless, almost odorless gas that when inhaled produces a loss in sensitivity to pain. It produces light-headedness, euphoria and a tingling sensation. Overuse of N 2 O can produce auditory changes, sweating, crying, excessive dreaming or nausea. Dentists use N 2 O on a regular basis because of its effective reduction in sensitivity to pain and it wears off quickly, allowing their patients to drive home alone.
N 2 O tanks are often obtained form medical supply companies under false pretenses. It is also used in pressurized cans of whipped cream, in cartridges (also known as whippets). Nitrites are the least abused of the three classes of inhalants, mostly because they are more difficult to obtain. Butyl nitrite is used in room odorizes, and Amyl nitrite is used to help cardiac patients with angina. Nitrites also cause the least amount of damage to the liver. Solvent abuse is found predominately among male adolescents ages 12-16 although it may be found in females and the later teens and into adulthood.
The average age of first use is age twelve (Stapleton 2000). The large majority of these users do so only occasionally, as an experimental phase, or because of pressure from friends who abuse them. Most of these kids abuse solvents out of boredom or for a cheap escape from their realities. Most abused solvents are found within the user s home, so they provide an easily attainable, no-cost escape (Stapleton 2000) and they are easily concealable. The amazing statistic is that almost 20 % of all teens have used inhalants at least once within their lifetime (Scheller 2000) and it is usually one of the first substances abused. Juveniles often make the mistake in thinking that because inhalants are easily obtained that they are safer than street drugs, when the reality is that most of them are more dangerous.
The user s goal while inhaling is to find a way to concentrate the vapor of the chemical to obtain a greater high. Adhesives and similar products are usually sprayed or poured into a small plastic bag. The open end is then placed over the nose and mouth and the air within is recreated. The warmth inside the plastic bag increases the vaporization. Other inhalant abusers use a rag or the sleeve of their shirts soaked in the solution. They then either place the cloth over their mouth and nose or they put the cloth in a plastic bag to concentrate the vapors.
Liquids can be placed in a bottle or sniffed directly from the container the product was purchased in, but since the chemical cannot be re breathed or concentrated in this fashion, this method is uncommon. Some gaseous substances (e. g. butane from lighters) can be sprayed directly into mouth or the user while they inhale.
Occasional and experimental users usually abuse inhalants in groups, such as, at parties where they may pass the plastic bag or share their inhalants with friends. Usually only chronic abusers use alone. Most abusers prefer using one substance or product because of taste, odor, similar affect it produces, availibily or cost. Most outgrow the habit of inhaling by late teens, but some continue or move on to more adult drugs such as marijuana, cocaine or heroine. Absorption begins in the lungs.
From there the substance enters the blood stream and is circulated by the heart. It then enters various organs. Most inhalants are fat soluble, so they are absorbed into the central nervous system quickly. If the chemical is completely metabolized, it is excreted trough the kidneys into the urine. It is exhaled if not completely metabolized. The way in which many chemicals are absorbed, distributed and eliminated is understood; we know very little about how inhalants produce their behavioral effects.
Regular use has been shown to build a tolerance to similar chemicals. Psychological dependence is fairly common and Physical dependence occurs in some chronic users. Short-term effects appear within seconds and can last for hours depending on the user s experience. An experienced user can prolong their high up to twelve hours. Inhalants give its user a euphoric feeling and may include light-headedness, exhilaration and vivid fantasies.
Nausea, drooling, sneezing, coughing, muscular incoordination, slow reflexes and sensitivity to light may occur. Symptoms of inhalant abuse are similar to the effects of depressants, such as alcohol. They deaden inhibitions, some users lose touch with their surroundings, and some lose self-control, have violent behavior or become unconscious. Repeated use over a short period of time may lead to a loss of control, hallucinations or seizures. Frequently, feelings of powerfulness lead to reckless and bizarre behavior (dangerous driving, trying to fly, etc). Death occurs from sudden sniffing death syndrome (following strenuous exercise or undue stress after deep, repeated inhalation causes heart failure) or by suffocation (occurs after user falls asleep/ unconscious with plastic bag over nose and mouth).
The long-term effects of inhalant abuse are seen after repeated use over a lengthy period of time. Physical effects may include: pallor, excessive thirst, weight loss, nosebleeds, bloodshot eyes, and sores on nose or in mouth. Some chemicals interfere with the formation of blood cells in the bone marrow, which affects the immune system (including the possibility of massive hemolysis). Brain cells are the first to be damaged, so there is the possibility of perma nt brain damage.
Inhalants tend to remain in the muscles of the heart longer, which could lead to the risk of cardiac arrhythmia or other heart conditions. They also impair liver and kidney function (which may return to normal if user stops abusing) and can lead to permanent damage, which is compounded by the use of alcohol. There is also a possibility of hearing loss. Long-term behavior effects include: short term memory loss, mental confusion, fatigue, depression, irritability, hostility and paranoia. There is also the possibility of severely impaired mental function, lack of motor coordination and tremors. It is difficult to establish a direct link between abuse of a particular inhalant and the resulting medical complications because of several variables including 1.
Many products contain a variety of chemicals. 2. Many users vary the product the abuse, mostly due to availability. 3.
Many abusers also abuse other types of drugs. Little is known about inhalant abuse and its effect on pregnant women and their unborn babies. Some animal research suggests that exposure to certain solvents may increase the risk of birth defects. Possible effects may include physical malformation, functional impairment, decreased body weight, size and IQ, and the possible termination of pregnancy.
Some inhalants have shown to cause damage to reproductive cells and may prevent conception and pregnancy. Treatment for inhalant abusers is complex, expensive, time consuming, and hard to find. Most teen users will continue to abuse inhalants after (and sometimes during) their treatments. Detoxification can take 30-40 days (Stapleton 2000), and most outpatient treatments are ineffective due to the east access to the products. Most researchers agree that the most successful programs are those that are inpatient, lasting longer than 40 days and include close supervision during the time of detoxification. Most treatment programs focus on teaching clients to take responsibility for themselves and others.
By using group and individual talk therapies, the programs focus on resolving the client s personal problems that lead to abusing inhalants as a form of self-medication. The client is then slowly reentered into society with continued therapy, then focusing on social and family problems. Treatment is considered complete when the client: 1. reaches self-set goals 2. Is reestablished within family / society 3. Is drug free 4.
is attending work / school 5. Is socially responsible and able to cope with daily stress (Mason 1979) Because of these products are so readily available, preventing access to them is an extremely difficult task. Professions agree that the best prevention is education aimed at young children (Stapleton 2000), since the largest age group of users are ages 12-16. They also feel that physicians should question young patients with sores around their mouths and noses or with any other signs of solvent abuse.
The signs (or symptoms) of inhalant abuse may include: 1. A collection of chemicals (glues, paints, air fresheners). 2. Chemical breath 3.
Constant sniffles, without other cold symptoms. 4. Drunken or dazed appearance lasting less than an hour. 5.
Chemical soaked rags, clothes, bags, etc. 6. Missing household chemicals or cleaners. 7. Sores around or in mouth or nose. 8.
Trouble in school. 9. Unusual irritability or hostility. 10. Other drug paraphernalia (Scheller 2000). According to the United States Consumer Products Safety Commission, more Than a thousand different products can be abused.
Most drugs are controlled by the Drug Enforcement Administration, however most inhalants are not listed on any of the five drug schedules. Regulating these products has also been found to be difficult. Placing a warning label on such products may encourage abuse. In most states, anyone can purchase products containing volatile substances, and only a few states have laws prohibiting possession and usage of such products. Of the three categories of inhalants, solvents and gases are the most often abused And are the most harmful to the individual using them; nitrites are the least often abused (because of availability) and are by far the least harmful to an individual. Inhalants produce a euphoric feeling, similar to that of a depressant or alcohol.
With repeated use the abuser may lose control their behavior, become violent, or even die due to complications. After repeated use over a lengthy period of time, the user risks the chance of liver and heart damage, brain damage, damage to their immune system and other medical complications. Occasional users (usually males ages 12-16) most often abuse in groups, and most outgrow this behavior by their late teens. Most parents are unaware of the danger or existence of this problem, which is why it has been called the silent epidemic.
Sources Used Glowa, J. (1986). Inhalants: The toxic fumes. New York, Chelsea House. Hanson, G. & Venture lli, P.
(2000). Drugs and society (6 th ed. ). Boston: Jones and Bartlett. Mason, T. (1979).
Inhalant use and treatment. Rockville, Maryland: U. S. Department of Health, Education, and Welfare. Scheller, M. (September, 2000).
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American Medical News 43. (14) p 32. Stef fee, C. (September 1996).
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