Inhalants Addiction and Treatment

How Are Inhalants Used?

Inhalants can be breathed in through the nose or the mouth in a variety of ways, such as:

• "Sniffing" or "snorting" fumes from containers;
• Spraying aerosols directly into the nose or mouth;
• "Bagging"-sniffing or inhaling fumes from substances sprayed or deposited inside a plastic or paper bag;
• "Huffing" from an inhalant-soaked rag stuffed in the mouth; and
• Inhaling from balloons filled with nitrous oxide.

Inhaled chemicals are rapidly absorbed through the lungs into the bloodstream and quickly distributed to the brain and other organs. Within seconds of inhalation, the user experiences intoxication along with other effects similar to those produced by alcohol. Alcohol-like effects may include slurred speech, an inability to coordinate movements, euphoria, and dizziness. In addition, users may experience lightheadedness, hallucinations, and delusions.

Because intoxication lasts only a few minutes, abusers frequently seek to prolong the high by continuing to inhale repeatedly over the course of several hours, a very dangerous practice. With successive inhalations, abusers can suffer loss of consciousness and death. At the least, they will feel less inhibited and less in control. After heavy use of inhalants, abusers may feel drowsy for several hours and experience a lingering headache.

A strong need to continue using inhalants has been reported among many individuals, particularly those who abuse inhalants for prolonged periods over many days. Compulsive use and a mild withdrawal syndrome can occur with long-term inhalant abuse. Additional symptoms exhibited by long-term inhalant abusers include weight loss, muscle weakness, disorientation, inattentiveness, lack of coordination, irritability, and depression.

Health Hazards

Although they differ in makeup, nearly all abused inhalants produce short-term effects similar to anesthetics, which act to slow down the body’s functions. When inhaled in sufficient concentrations, inhalants can cause intoxication, usually lasting only a few minutes.

However, sometimes users extend this effect for several hours by breathing in inhalants repeatedly. Initially, users may feel slightly stimulated. Repeated inhalations make them feel less inhibited and less in control. If use continues, users can lose consciousness.

Sniffing highly concentrated amounts of the chemicals in solvents or aerosol sprays can directly induce heart failure and death within minutes of a session of repeated inhalations. This syndrome, known as "sudden sniffing death," can result from a single session of inhalant use by an otherwise healthy young person. Sudden sniffing death is particularly associated with the abuse of butane, propane, and chemicals in aerosols.

High concentrations of inhalants also can cause death from suffocation by displacing oxygen in the lungs and then in the central nervous system so that breathing ceases. Deliberately inhaling from a paper or plastic bag or in a closed area greatly increases the chances of suffocation. Even when using aerosols or volatile products for their legitimate purposes (i.e., painting, cleaning), it is wise to do so in a well-ventilated room or outdoors.

Chronic abuse of solvents can cause severe, long-term damage to the brain, the liver, and the kidneys.

Harmful irreversible effects that may be caused by abuse of specific solvents include:

• Hearing loss—toluene (spray paints, glues, dewaxers) and trichloroethylene (dry-cleaning chemicals, correction fluids)
• Peripheral neuropathies, or limb spasms—hexane (glues, gasoline) and nitrous oxide (whipped cream dispensers, gas cylinders)
• Central nervous system or brain damage—toluene (spray paints, glues, dewaxers)
• Bone marrow damage—benzene (gasoline)

Serious but potentially reversible effects include:

• Liver and kidney damage—toluene-containing substances and chlorinated hydrocarbons (correction fluids, dry-cleaning fluids)
• Blood oxygen depletion—aliphatic nitrites (known on the street as poppers, bold, and rush) and methylene chloride (varnish removers, paint thinners)

Inhalant abuse also can cause death by:

• Asphyxiation - from repeated inhalations, which lead to high concentrations of inhaled fumes displacing the available oxygen in the lungs;
• Suffocation - from blocking air from entering the lungs when inhaling fumes from a plastic bag placed over the head;
• Convulsions or seizures - caused by abnormal electrical discharges in the brain;
• Coma - the brain shuts down all but the most vital functions;
• Choking - from inhalation of vomit after inhalant use; or
• Fatal injury - from accidents, including motor vehicle fatalities, suffered while intoxicated.

Abuse of inhalants during pregnancy also may place infants and children at increased risk of developmental harm. Animal studies designed to simulate human patterns of inhalant abuse suggest that prenatal exposure to toluene or trichlorethylene (TCE) can result in reduced birth weights, occasional skeletal abnormalities, and delayed neurobehavioral development. A number of case reports note abnormalities in newborns of mothers who chronically abuse solvents, and there is evidence of subsequent developmental impairment in some of these children. However, no well- controlled, prospective study of the effects of prenatal exposure to inhalants in humans has been conducted, and it is not possible to link prenatal exposure to a specific chemical to a specific birth defect or developmental problem.

What Are The Special Risks For Nitrite Abusers?

Nitrites are abused mainly by older adolescents and adults. Typically, individuals who abuse nitrites are seeking to enhance sexual function and pleasure. Research shows that abuse of these drugs in this context is associated with unsafe sexual practices that greatly increase the risk of contracting and spreading such infectious diseases as HIV/AIDS and hepatitis.

Animal research raises the possibility that there may be a link between abuse of nitrite inhalants and the development and progression of infectious diseases and tumors. The research indicates that inhaling nitrites depletes many cells in the immune system and impairs immune system mechanisms that fight infectious diseases. A recent study found that even a relatively small number of exposures to butyl nitrite can produce dramatic increases in tumor incidence and growth rates in animals.

Where Can I Get Further Scientific Information About Inhalant Abuse?

To learn more about inhalants and other drugs of abuse, contact the National Clearinghouse for Alcohol and Drug Information (NCADI) at 1-800-729-6686. Information specialists are available to help you locate information and resources.

Fact sheets, including InfoFacts, on the health effects of inhalants, other drugs of abuse, and other drug abuse topics are available on the NIDA Web site (www.drugabuse.gov), and can be ordered free of charge in English and Spanish from the National Clearinghouse for Alcohol and Drug Information (NCADI) at www.health.org.

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