Adolescents use inhalants more frequently than cocaine or LSD but less frequently than marijuana or alcohol. In the United States, about 10% of adolescents have inhaled solvents. Inhalant use is particularly a problem among children aged 12 and younger. Inhalants are found in many common household products. Thus, children and adolescents can easily obtain them.

The product may be sprayed into a plastic bag and inhaled (bagging, sniffing, or snorting), or a cloth soaked with the product may be placed next to the nose or in the mouth (huffing).

Symptoms

Users rapidly become intoxicated. They may become dizzy, drowsy, and confused. Speech may be slurred. They may have difficulty standing and walking, resulting in an unsteady gait. Users may also become excited—but not because the solvents are stimulants. Later, perceptions and sense of reality may be distorted, resulting in illusions, hallucinations, and delusions. Users experience a euphoric, dreamy high, culminating in a short period of sleep. They may become delirious and confused, with mood swings. Thinking and coordination may be impaired. Intoxication can last anywhere from a few minutes to more than an hour.

Death can occur suddenly, even the first time one of these products is directly inhaled, because breathing becomes very slow and shallow or because heart rhythm is disturbed (called arrhythmia).

Common Products That Contain Solvent Inhalants
Adhesives Airplane glue Rubber cement Polyvinyl chloride cement Aerosols Spray paint Hair spray Solvents and gases Nail polish remover Paint remover Paint thinner Typing correction fluid and thinner Fuel gas Cigarette lighter fluid Gasoline Cleaning agents Dry cleaning fluid Spot remover Degreaser

With chronic use, people become somewhat tolerant of the solvent's effects. People may become psychologically dependent on solvents, with a strong urge to continue using the solvents. But physical dependence does not occur. That is, stopping the drug does not cause unpleasant symptoms (withdrawal).

Chronic use or exposure to solvents (including exposure in the workplace) can severely damage the brain, heart, kidneys, liver, and lungs. In addition, bone marrow may be damaged, impairing red blood cell production and causing anemia.

Treatment

Treating children and adolescents who use inhalants involves evaluating any organ damage. Education and counseling to improve mental health and social skills and to manage sociologic problems may help. Recovery rates from inhalant use are among the poorest for any mood-altering substance. However, most users stop by the end of adolescence.

Abused Inhalants With Medical Uses
Amyl nitrite: This inhalant widens (dilates) the arteries of the heart, allowing more oxygen to reach the heart muscle. Thus, it is used to relieve chest pain caused by coronary artery disease. Amyl nitrite is sold only by prescription. Two closely related drugs, butyl nitrite and isobutyl nitrite, are not used medically. They can be sold legally for commercial purposes related to their use as air-fresheners, but other use is banned. All three of these nitrite drugs briefly lower blood pressure, produce dizziness, and cause flushing, followed by a rapid heartbeat. These effects combined may produce a sense of excitement and euphoria. People also use these drugs because they believe that they enhance sexual pleasure. When used with sildenafilSome Trade Names VIAGRA (used to treat erectile dysfunction), these nitrite drugs may greatly lower blood pressure, which can cause fainting, heart attack, or stroke. Nitrous oxide: This gas (laughing gas) is used as an anesthetic. It is also used as a propellant in cans and dispensers of whipped cream. Nitrous oxide is sometimes abused because it produces a sense of euphoria and a pleasant dreamlike state. Prolonged exposure to nitrous oxide can cause numbness and weakness in the legs and arms, which can be permanent.

Last full review/revision January 2009 by Patrick G. O'Connor, MD, MPH