"INHALANTS"

Inhalants are breathable chemical vapors that produce psychoactive (mind-altering) effects. Although people are exposed to volatile solvents and other inhalants in the home and in the workplace, many do not think of inhalable substances as 'drugs' because most of them were never meant to be used in that way.

Young people are likely to abuse inhalants, in part because inhalants are readily available and inexpensive. Sometimes children unintentionally misuse inhalant products that are found in household products. Parents should see that these substances are monitored closely so that they are not inhaled by young children.

Inhalants fall into the following categories:

• Solvents
  • industrial or household solvents or solvent-containing products, including paint thinners or solvents, degreasers (dry-cleaning fluids), gasoline, and glues
  • art or office supply solvents, including correction fluids, felt-tip-marker fluid, and electronic contact cleaners
• Gases
  • gases used in household or commer cial products, including butane lighters and propane tanks, whipping cream aerosols or dispensers (whippets), and refrigerant gases
  • household aerosol propellants and as sociated solvents in items such as spray paints, hair or deodorant sprays, and fabric protector sprays
  • medical anesthetic gases, such as ether, chloroform, halothane, and nitrous oxide (laughing gas)
• Nitrites
  • aliphatic nitrites, including cyclohexyl nitrite, which is available to the general public; amyl nitrite, which is available only by prescription; and butyl nitrite, which is now an illegal substance.

Health Hazards

Although different in makeup, nearly all abused inhalants produce 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 can last only a few minutes or several hours if inhalants are taken repeatedly. Initially, users may feel slightly stimulated; with successive inhalations, they may feel less inhibited and less in control; finally, a user can lose consciousness.

Sniffing highly concentrated amounts of the chemicals in solvents or aerosol sprays can directly induce heart failure and death. This is especially common from the abuse of fluorocarbons and butane-type gases. High concentrations of inhalants also cause death from suffocation by displacing oxygen in the lungs and then in the central nervous system so that breathing ceases. Other irreversible effects caused by inhaling specific solvents are as follows:

• 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).

Serious but potentially reversible effects include:

• 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).

Death from inhalants usually is caused by a very high concentration of fumes. 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.

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.

Extent of Use

Initial use of inhalants often starts early. Some young people may use inhalants as a cheap, accessible substitute for alcohol. Research suggests that chronic or long-term inhalant abusers are among the most difficult to treat and they may experience multiple psychological and social problems.

Monitoring the Future Study (MTF)*

NIDA's national survey of drug use among high school students provides estimates of the percentage of seniors using inhalants since 1976. The annual rate of inhalant use among seniors steadily rose from 3.0 percent in 1976 to a peak of 8.0 percent in 1995. In 1997, 6.7 percent of seniors reported past year inhalant use.

The MTF also includes 8th- and 10th-graders, providing estimates of drug use among a younger population. In 1997, 21.0 percent of 8th-graders and 18.3 percent of 10th-graders had used inhalants at least once in their lives; 11.8 percent of 8th-graders and 8.7 percent of 10th-graders had used inhalants in the past year.

The perceived harmfulness of inhalants varies among high school students. In 1997, almost 40.1 percent of 8th-graders and 47.5 percent of 10th-graders said there is great risk in trying inhalants once or twice; 68.7 percent of 8th-graders and 74.5 percent of 10th-graders saw great risk in taking inhalants regularly.

National Household Survey on Drug Abuse (NHSDA)**  Data from the National Household Survey on Drug Abuse show that in 1996, 5.9 percent of adolescents (1.3 million) reported use of inhalants at least once in their lifetimes, and 4 per cent (900,000) reported using inhalants in the past year.

* MTF is an annual survey on drug use and related attitudes of America's adolescents that began in 1975. The survey is conducted by the University of Michigan's Institute for Social Research and is funded by NIDA. Copies of the latest survey are available from the National Clearinghouse for Alcohol and Drug Information at 1-800-729-6686.

** NHSDA is an annual survey conducted by the Substance Abuse and Mental Health Services Administration. Copies of the latest survey are available from the National Clearinghouse for Alcohol and Drug Information at 1-800-729-6686.