What is inhalants abuse?

Causes

Inhalation of fumes, vapors, or gases leads to the rapid onset of a high that resembles alcohol intoxication. The chemicals in the inhalants are quickly absorbed from the lungs into the bloodstream and from there to the brain and other organs. The initial high lasts for only a few minutes, so most abusers inhale repeatedly over time to maintain a sustained high. Repeated use builds up tolerance, leading to the need for higher and more frequent dosing.

Risk Factors

Inhalant products, such as glues, nail polish removers, hairsprays, felt-tip markers, lighter fluids, and spray paints, are readily available in the home and the community. More than one thousand products containing inhalants can be obtained at a low cost and, for the most part, without legal restrictions on purchase or use. US state laws prohibiting the sale of products containing certain inhalants to minors are difficult to enforce. Legal consequences for abusing the few restricted inhalants are minimal.

Most first-time abusers are preteens or young adolescents who begin by experimenting with friends. Among the youngest users, girls are about as likely as boys to try inhalers. In contrast, among young adults, abuse is twice as common among men as among women. The National Institute on Drug Abuse estimates that about 15 percent of all eighth graders have had some experience with abusing inhalants and that 70 percent of abusers were younger than age eighteen years when their inhalants abuse began.

Symptoms

The initial, brief high experienced with inhalants abuse is followed by drowsiness, lightheadedness, and agitation. Short-term adverse effects that can develop include headache, numbness and muscle weakness, nausea, and abdominal pain. Hearing loss and visual disturbances, even hallucinations, may occur.

Long-term use may result in weight loss, disorientation, incoordination, irritability, depression, and irreversible damage to the brain, heart, kidneys, liver, and other organs. Even a first-time user is at risk of death. The abuser can develop a rapid and erratic heartbeat, which can lead to cardiac arrest and death. Abuse also can reduce the body’s oxygen level, leading to suffocation.

Screening and Diagnosis

Changes in an abuser’s appearance and behavior are the primary indicators of abuse. An abuser may have red or runny eyes and nose, spots or sores around the mouth, paint or other products on the face, lips, nose, or fingers, or unusual breath odor or the odor of chemicals on clothing. The abuser may have slurred speech and appear to be dazed or drunk.

Behavioral changes include increased anxiety, excitability, and irritability. The abuser may become belligerent, even violent, with swings between extreme agitation and lethargy. Speech may be slurred. Disciplinary problems or truancy may develop. Extracurricular activities may be dropped in favor of socializing with friends or staying home. The abuser may develop a new set of friends or become a loner. Conflict with siblings and parents may increase.

No test, such as urinalysis, will detect inhalants abuse. The user has to be confronted and admit to the problem.

Treatment and Therapy

For most abusers, treatment is community-based and focuses on behavioral changes. One should listen to what an abuser has to say and remain calm and nonjudgmental. This may provide clues to underlying problems, such as peer pressure or problems at home, which can be resolved or redirected. One should focus on the serious health risks of inhalants abuse, not on such behavior being “bad,” and should redirect an abuser to constructive, safe, and healthy activities.

A frequent or relapsing abuser will require professional help to identify and address underlying causes for the abuse and any concomitant physical or psychological problems. An initial step is a medical examination to determine if inhalants abuse has caused organ damage. Neurologic, psychological, and cognitive assessments should be part of the initial examination. Family stability, structure, and dynamics may contribute to the abuser’s behavior. An effort should be made to obtain constructive participation in treatment by the abuser’s family.

Few treatment centers address inhalants abuse. Detoxification may take up to thirty or forty days because inhaled chemicals stored in fatty tissue take a long time to break down and be flushed from the body.

During withdrawal, the abuser may experience headaches, nausea, excessive sweating and chills, tremors, muscle cramps, hallucinations, and even delirium. Relapse is common among heavy abusers, especially if underlying behavioral problems are not addressed.

Prevention

Children should be informed about the dangers of experimenting with inhalants, preferably before they try them. Inhalants abuse can be the gateway to further substance abuse. Parents, teachers, and other adults involved with children and young adolescents should know and be on guard for warning signs, including behavior changes, and should be prepared to discuss the dangers of inhalants abuse with the young person.

Parents should be aware of what inhalant products are in the home and how they can be used and stored so the risk of abuse is minimized. Similarly, school personnel should assess the use and storage of inhalant products in schools. Programs such as the Alliance for Consumer Education Inhalant Abuse Prevention Program can help parents, teachers, school administrators, and community leaders.

Bibliography

Abadinsky, Howard. Drug Use and Abuse: A Comprehensive Introduction. 7th ed. Belmont, CA: Wadsworth, 2011. Focuses on what drugs are abused, how they are abused, and how abuse is treated. Inhalants abuse is covered in chapter 6.

Julien, Robert M. A Primer of Drug Actions. 11th ed. New York: Worth, 2008. A concise, nontechnical guide to the mechanisms of action, side effects, uses, and abuses of psychoactive drugs. Chapter 4 is on inhalants.

Kuhn, Cynthia, Scott Swartwelder, and Wilkie Wilson. Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy. 3rd ed. New York: W. W. Norton, 2008. Contains an informative, easy-to-read section on the risks involved in inhalants abuse.

Lowinson, Joyce W., et al., eds. Substance Abuse: A Comprehensive Textbook. 4th ed. Philadelphia: Lippincott, 2005. A comprehensive textbook on substance abuse. Chapter 20 covers inhalants abuse.