Inhalants abuse
Inhalant abuse refers to the repeated inhalation of chemical fumes from common household products, resulting in a temporary high similar to alcohol intoxication. This practice involves substances like glues, aerosol sprays, and solvents, which are easily accessible and often inexpensive. Users, primarily preteens and young adolescents, may develop a tolerance, necessitating increased consumption to achieve the desired effects. The initial euphoric experience is quickly followed by dangerous side effects, including drowsiness, agitation, and in severe cases, respiratory failure or cardiac arrest, even after a single use. Long-term inhalant abuse can lead to irreversible damage to vital organs such as the brain, liver, and kidneys.
Identification of inhalant abuse is typically based on behavioral and physical changes in individuals, as standard drug tests do not detect these substances. Treatment often involves community-based approaches focusing on behavioral modification and addressing underlying issues. Prevention efforts emphasize educating children and adults about the risks associated with inhalants and monitoring their use in homes and schools. Despite being a significant health concern, inhalant abuse remains underrepresented compared to other substance use issues.
Inhalants abuse
ALSO KNOWN AS: Bagging; chroming; dusting; glading; huffing; sniffing; snorting
DEFINITION: Inhalant abuse is the repeated inhalation of fumes, vapors, or gases from common household and commercial products despite evident negative effects.
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. Over one thousand inhalant products can be purchased at a relatively low cost and, for the most part, without legal restrictions on purchase or use. State laws within the United States (US) 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 estimated in 2022 that about 3.6 percent of all eighth graders had some experience with abusing inhalants, and that 10 percent of abusers were younger than age eighteen years when their inhalant abuse began. Other organizations put the incidence of inhalant abuse even higher and suggest the figure is comparable to initial marijuana use among the same age. The relative ease of obtaining inhalants makes the issue increasingly dire.
Symptoms
The initial, brief high experienced with inhalant 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. Pulmonary dysfunction, hearing loss, and brain damage may also occur. 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 can also 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, 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 inhalant 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 issues at home, which can be resolved or redirected. One should focus on the serious health risks of inhalant 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 concurrent physical or psychological problems. An initial step is a medical examination to determine if inhalant 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 inhalant 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. Inhalant 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. They should be prepared to discuss the dangers of inhalant 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 to minimize the risk of abuse. 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. Although the underrepresentation of inhalant abuse as a serious substance abuse issue continues, the death of public figures, such as Aaron Carter's drowning in 2022 related to chronic inhalant abuse, has brought increased attention to the issue.
Bibliography
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Nguyen, Jacqueline, Casey O’Brien, and Salena Schapp. "Adolescent Inhalant Use Prevention, Assessment, and Treatment: A Literature Synthesis." International Journal of Drug Policy, vol. 31, 2016, pp. 15–24.
"What are Inhalants?" National Institute on Drug Abuse, 2022, nida.nih.gov/publications/research-reports/inhalants/what-are-inhalants. Accessed 24 Aug. 2024.
"What is the Scope of Inhalant Use in the United States?" National Institute on Drug Abuse, 2022, nida.nih.gov/publications/research-reports/inhalants/what-scope-inhalant-abuse. Accessed 24 Aug. 2024.
Wright, George. "Aaron Carter Accidentally Drowned after Taking Drugs." BBC, 18 Apr. 2023, www.bbc.com/news/world-us-canada-65319830. Accessed 24 Aug. 2024.