The National Institute on Drug Abuse (NIDA) designates the term inhalant to signify substances that are used to achieve psychoactive effects by inhaling them, but this is not their primary use.
This includes substances like solvents, aerosols, gases, and many other household products that can be purchased relatively easily. Figures regarding the use of inhalants indicate that:
- Over two-thirds of inhalant abuse occurs in people under the age of 18.
- Inhalants are breathed into the mouth or nose, and this is accomplished in a number of different ways.
- The psychoactive effects or the “high” achieved from use of inhalants is very short-lived; however, individuals who abuse these substances typically inhale them repeatedly to extend this experience.
- The use of inhalants peaked in the 1990s.
- The use of inhalant, such as volatile solvents, is more commonly observed in younger individuals, most often between the ages of 12 to 15. Older individuals who abuse inhalants may tend to use nitrous oxide or nitrates.
According to the book Pharmacology and Treatment of Substance Abuse: Evidence and Outcome-Based Perspectives, volatile solvents compromise a number of varied and different types of products. These include:
- Adhesive products, such as glue, cement, etc.
- Common household products that are used in aerosol cans, such as spray paint, air freshener, deodorant, different cleaners, etc.
- Cleaning products like degreasers, dry cleaning fluid, and spot removers
- Food products, such as whipped cream, vegetable cooking spray, and other food products in aerosol cans
- Other solvents, such as paint thinner, cleaning fluid, lighter fluid, gasoline, nail polish remover, etc.
The more common classification of inhalants is used by NIDA. It breaks them into four categories:
- Volatile solvents: These are liquids that vaporize at room temperature. They include household and industrial products, such as paint remover, paint thinner, degreasers, gasoline, and lighter fluid, and office supply or art products that include felt-tip marker fluid, glue, correction fluid, and electronic contact cleaners.
- Aerosol products: These are sprays (in cans) containing solvents or propellants.
- Gases: These are found in medical anesthetics or household products (e.g., butane lighters, propane, whipped cream aerosols, etc.).
- Nitrites: These include video head cleaner, leather cleaner, and others.
The definition of these groupings therefore varies depending on the source. Nonetheless, the manners in which these substances are abused include:
- Sniffing them directly from their containers
- Sniffing or inhaling the substance after it has been sprayed into a plastic or paper bag (bagging) or other flexible containers, such as balloons
- Inhaling or sniffing substances that are sprayed inside soda cans
- Inhaling the substance after it has been saturated in cloth or clothing
- Inhaling directly from an aerosol can (e.g., spraying the substance into the mouth or nose)
- Inhaling vapors that are produced as a result of heating the substance
Effects of Abusing Volatile Solvents
NIDA reports that the effects of abusing volatile solvents include hypoxia or reduced oxygen delivery to the tissues as well as symptoms similar to intoxication from alcohol, such as lightheadedness, giddiness, and a loss of inhibitions
More intense use is associated with significant changes in an individual’s thinking and personality that may be related to changes in the person’s central nervous system, particularly the brain. These include the development of aggression, belligerence, issues with reasoning, impaired judgment, apathy, and psychotic behaviors (e.g., the development of hallucinations, delusions, or both).
The long-term effects of inhaling volatile solvents are often listed as consisting of both psychological and neurological symptoms that may reflect significant damage to the brain. General long-term effects of inhaling volatile solvents include:
- Muscle weakness
- Loss of coordination
- Weight loss
- Poor impulse control
- Slurred speech
- Issues with attention
- Issues with memory
- Chronic depression
- Mood swings
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Other long-term effects include:
- Lung damage as a result of inhaling these potentially toxic substances
- Liver and kidney damage associated with the person’s system having to metabolize and cleanse the system of these substances
- Cardiovascular changes, including the potential for heart attack or stroke
- In pregnant women, the risk of having children with low birth weights and/or with symptoms that resemble fetal alcohol syndrome
- With long-term use, the risk of Parkinsonian, which is a syndrome that appears similar to Parkinson’s disease but is not formally diagnosable as Parkinson’s disease
- Inhaling certain substances can lead to carbon monoxide poisoning.
- A syndrome known as sudden sniffing death syndrome, associated with heart failure
- Cardiac arrest or anoxia (a complete lack of oxygen) that can lead to death in some individuals
- The development of physical dependence
Signs That Someone May Be Abusing Volatile Solvents
Since the majority of individuals who abuse volatile solvents are adolescents, it is important that parents educate themselves regarding specific signs and symptoms that may be indicative of this type of substance abuse. Some of the signs include:
- Paint stains or other stains on the clothing of the person or on their skin
- Unusual chemical smells on the person’s clothing or on their breath
- The appearance of being intoxicated, such as displaying poor coordination, poor balance, staggering gate, poor impulse control, slurred speech, etc., which is not accompanied by a smell of alcohol
- Noticing numerous sores or spots around the person’s mouth or nose
- The person consistently displays a runny nose, red eyes, or discharge coming from the eyes
- Finding rags that have been soaked in chemicals, empty spray cans, or other empty spray containers
- Becoming unusually excitable, irritable, or even belligerent at times
- Displaying periods of nausea, vomiting, or appetite loss that have no logical explanation
- Displaying signs of physical dependence
A study published in 2011 that utilized a very large source of data from the National Epidemiological Survey on Alcoholism and Related Conditions reported that approximately 50 percent of individuals who met the formal diagnostic criteria for inhalant abuse or addiction also reported experiencing three or more formal withdrawal symptoms once they stopped using these substances. The most common symptoms reported were:
- Mood swings, depression, and/or anxiety
- Hallucinations and/or delusions
- Gastrointestinal symptoms, including nausea, vomiting, and stomach pain
- Other general physical symptoms, including profuse sweating, fever, chills, and headaches
These symptoms are not believed to be potentially physically dangerous or fatal. However, anytime a person undergoes a formal withdrawal syndrome, they may be at risk for harm due to accidents, poor judgment, and even self-harm due to potential suicidality.
Approaching a Loved One about Inhalant Abuse
If someone is suspected of abusing volatile solvents, the individual’s parents or loved ones should attempt to discuss the situation with the individual due to the potential for severe effects as a result of using these substances and the potential long-term effects that are associated with damage to the brain, heart, lungs, and other organs. Some considerations regarding approaching a loved one who is suspected of abusing volatile solvents are outlined below.
- Do not express anger or display severe panic. Try to discuss the issue with the person in a very calm and reserved manner.
- If the person is under the influence of the substance or suspected to be under the influence of the substance, the best thing to do is not to excite them. Individuals may have very volatile mood swings when under the influence of these substances. Instead, try to keep environmental stimulation to a minimum so the individual can remain calm.
- If the person is suspected of being under the influence of these substances, attempt to keep them in a well-ventilated area and learn what substance the person was using. You can ask the individual in question, any companions that the person had at the time, or look for physical evidence of the specific volatile substance of abuse.
- If the individual is extremely sedated or appears in any type of distress, including potential unconsciousness, get professional emergency medical attention as soon as possible.
- Never try to have a logical discussion with an intoxicated person regarding their substance abuse. Instead, wait for the individual to sober up.
- Once the individual is capable of discussing the issue, try to find out what types of substances they were using, when they use them, and why they think they use them. Discuss the reasons why these substances are dangerous.
- In discussing the need for treatment with a suspected substance abuser, it is always useful to get assistance from mental health professionals.
Treating Volatile Solvent Abuse
The treatment parameters for individuals who abuse volatile solvents are not well defined. Most often, the standard protocols for substance use disorder treatment are followed. Nonetheless, this group appears to have a relatively high rate of relapse. There may be the need for these individuals to undergo relatively long periods of withdrawal management despite documentation that the symptoms that occur during the withdrawal process do not appear to be severe.
- Clients should initially undergo a very thorough mental health and physical examination to identify any co-occurring issues that contribute to the individual’s current presentation.
- Individuals will be placed in a formal withdrawal management program that is directed under the supervision of an addiction medicine physician or psychiatrist. This can be an inpatient or outpatient program, depending on the specific case.
- While in the withdrawal management program, individuals should also begin to participate in formal substance use disorder treatment. It is particularly important to get individuals involved in some form of a cognitive-behavioral substance use disorder treatment program. This can include individual therapy, group therapy, a combination of individual and group therapy, and other treatments for any co-occurring disorders that are appropriate. Medically assisted treatments should also be utilized for specific conditions (e.g., depression, personality disorders, etc.).
- Adolescents with substance use disorders often benefit from family therapy. Getting the child’s family involved in the therapeutic process has a number of advantages, including addressing issues with the family, relationships between the person and other family members, and getting the individual close support.
- Adolescents also can benefit from social support groups that have members with whom they can identify. These can include 12-Step groups, community health groups, and other types of social support resources.
- Any other interventions that are designated as useful as a result of the initial assessment should also be implemented. These can include tutoring for school, vocational rehabilitation training, psychoeducation programs, and other forms of specific types of therapy.
The abuse of volatile solvents occurs mostly in younger individuals and carries significant physical and psychological risks. Individuals who chronically abused volatile solvents are at risk to develop a number of seriously debilitating conditions, including cardiovascular problems and formal neurological damage. Because use of these drugs often occurs in adolescents, parents should have a general understanding of the signs and symptoms of abuse of these substances. Any individual who abuses these substances requires formal substance use disorder treatment and long-term relapse prevention.