Inhalants - Questions and Answers
What are inhalants?
Inhalants are breathable chemical vapors that produce psychoactive (mind-altering) effects. A variety of products
commonplace in the home and in the workplace contain substances that can be inhaled. Many people do not think of these
products, such as spray paint, glues, and cleaning fluids, as drugs because they were never meant to be used to achieve an
intoxicating effect. Yet, young children and adolescents can easily obtain them and are among those most likely to abuse
these extremely toxic substances. Parents should monitor household products closely to prevent accidental inhalation by
very young children. Inhalants fall into the following categories: Solvents, Gases and Nitrites
What do they look like?
Examples of products kids abuse to get high include model airplane glue, nail polish remover, cleaning fluids, hair spray,
gasoline, the propellant in aerosol whipped cream, spray paint, fabric protector, air conditioner fluid (freon), cooking spray
and correction fluid.
How are they used?
These products are sniffed, snorted, bagged (fumes inhaled from a plastic bag), or "huffed" (inhalant-soaked rag, sock, or
roll of toilet paper in the mouth) to achieve a high. Inhalants are also sniffed directly from the container.
What are their short-term effects?
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, dizziness, confusion and delirium.
Nausea and vomiting are other common side effects. The physical damage inhalants cause in the short term includes:
• Drowsiness
• Lack of energy
• Risk-taking behavior
• Lightheadedness
• Agitation
• Belligerence (hostility)
• Lack of concern about surroundings or life
• Poor judgment
• Inability to function in school, work, or social situations
• Slurred speech
• Poor reflexes
• Muscle weakness
• Headache
• Poor coordination
• Loss of sensations
• Confusion and delirium
• Nausea and vomiting
• Unconsciousness
• Sudden death
What are their long-term effects?
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. The physical damage inhalants cause in the long term includes:
• Compulsive use
• Withdrawal
• Unwanted weight loss
• Muscle weakness
• Disorientation
• Inability to concentrate
• Poor coordination
• Irregular or rapid heart rate
• Irritability
• Depression
• Impaired thinking ability
• Dementia (lost contact with reality)
• Lost sense of touch
• Deafness
• Blindness
• Reproductive complications
• Bone marrow injury
• Heart damage
• Lung damage
• Liver damage, including cirrhosis
• Kidney damage
• Damaged nerve cells
• Brain shrinkage
After heavy use of inhalants, abusers may feel drowsy for several hours and experience a lingering headache. Because
intoxication lasts only a few minutes, abusers frequently seek to prolong their high by continuing to inhale repeatedly over
the course of several hours. By doing this, abusers can suffer loss of consciousness and death.
What the health hazards of inhalant use?
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 via the nose or mouth into the lungs in sufficient concentrations, inhalants can
cause intoxicating effects. Intoxication usually lasts only a few minutes. However, sometimes users extend this effect for
several hours by breathing in inhalants repeatedly. Initially, users may feel slightly stimulated. Successive 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 prolonged use. 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 an attached 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.
What are some of the irreversible effects caused by inhaling specific solvents?
• Hearing loss - toluene (paint sprays, glues, dewaxers) and trichloroethylene (cleaning fluids, correction fluids)
• Peripheral neuropathies or limb spasms - hexane (glues, gasoline) and nitrous oxide (whipping cream, gas cylinders)
• Central nervous system or brain damage - toluene (paint sprays, glues, dewaxers)
• Bone marrow damage - benzene (gasoline).
Amyl and butyl nitrites have been associated with Kaposi's sarcoma (KS), the most common cancer reported among AIDS
patients. Early studies of KS showed that many people with KS had used volatile nitrites. Researchers are continuing to
explore the hypothesis of nitrites as a factor contributing to the development of KS in HIV-infected people.
What are some of the serious but potentially reversible effects?
• Liver and kidney damage - toluene-containing substances and chlorinated hydrocarbons (correction fluids, dry-cleaning
fluids)
• Blood oxygen depletion - organic nitrites (poppers, bold, and rush) and methylene chloride (varnish removers, paint
thinners).
What is Sudden Sniffing Death Syndrome?
Sudden Sniffing Death Syndrome (SSDS) is the most common killer of inhalant abusers. A victim may be trying inhalants for
the first time, or may have tried them any number of times in the past. In fact, 22% of inhalant abusers who died of SSDS
had no history of previous inhalant abuse. SSDS occurs when an abuser is surprised or startled while sniffing or huffing.
Often, this occurs when a parent or other authority figure finds the person inhaling. An especially exciting or frightening
hallucination could also trigger SSDS. When the abuser is surprised or startled, he has a sudden surge of the hormone
epinephrine. Epinephrine is also called adrenaline. Epinephrine aids in regulating the functions of the body that are beyond a
person’s conscious control, like heart rate. When a person is highly stimulated (by fear or challenge, for example,) extra
amounts of epinephrine are released into the bloodstream to prepare the body for energetic action. Epinephrine increases
blood pressure, heart rate, and cardiac output. The presence of the chemical inhalants in the body makes the heart muscle
more sensitive to epinephrine. When the surge of epinephrine reaches the heart, the heart suffers an arrhythmia (irregular
heart beat). This massive arrhythmia kills the user in seconds.
What effect to inhalants have on the central nervous system?
Many of the chemicals found in commonly abused inhalants cause severe and permanent brain and nerve cell damage.
Brain scans of inhalant abusers show dramatic shrinkage in the overall size of the brain. Abusers also lose "white matter" in
the brain, which is responsible for conducting nerve impulses throughout the body. The white matter is destroyed because
each cell is encased in myelin, a lipid or fat, and many commonly used inhalants are lipid-solvents; that is, their purpose is to
break down lipids. Chronic inhalant abusers suffer massive central nervous system damage, which results in dementia (lost
contact with reality) and loss of cerebellum function. The cerebellum is the portion of the brain that coordinates movements
of the voluntary muscles. Abusers lose the ability to think, reason, learn, and remember. Their gait (way of walking)
becomes abnormal and they lose coordination.
What are some signs of inhalant abuse?
If you suspect someone you know may have a problem with inhalants, approach the person calmly. Find a quiet time when
the person seems to be sober. Be honest and straightforward, but not accusatory. Your goal in this situation would be to get
the person into treatment, not to express your own disappointment or anger. If you are worried about inhalant abuse in
someone you care about, here are some signs to look for:
• Paint or stains on body or clothing
• Spots or sores around the mouth
• Red or runny nose
• Watery, red eyes
• Chemical breath odor
• Drunk, dazed or dizzy appearance
• Drowsiness or unconsciousness
• Nausea, loss of appetite
• Anxiety, excitability, irritability
• Inability to concentrate
• Substance odor on breath and clothes
• Poor muscle control
• Change in sleep patterns
• Prefers group activity to being alone
• Reduced attendance in school
• Lower grades
• Bags or rags containing dried solvents at home or in locker at school
• Discarded containers of various sprays or gases
• Small bottles labeled "incense" (users of butyl nitrite)
What do I do if I know someone is using inhalants?
If you discover someone sniffing of huffing inhalants, try not to surprise him or her. Keep an eye on the situation for a few
moments so that you do not catch the person "in the act." Remember, one of the main triggers for Sudden Sniffing Death
Syndrome is a surprise, such as being caught using. Here are some important steps to follow when you are with someone
who you believe is under the influence of inhalants.
• Remain calm and do not panic. Panic could cause irrational or violent behavior on the user’s part, or could possibly cause
SSDS.
• If the person is unconscious or not breathing, call for help. CPR should be administered until help arrives.
• If the person is conscious, keep him or her calm and in a well-ventilated room.
• Excitement or stimulation can cause hallucinations or violence.
• Talk with other persons present or check the area for clues to what was used.
• Once the person is recovered, seek professional help for abuser: school nurse, counselor, physician, or other health care
worker.