Inhalation of volatile industrial solvents and solvents from aerosol sprays can cause a state of intoxication. Chronic use can result in neuropathies and hepatotoxicity.

Use of volatile solvents (eg, acetates, alcohol, chloroform, ether, aliphatic and aromatic hydrocarbons, chlorinated hydrocarbons, ketones) continues to be an endemic problem among adolescents. Common commercial products (eg, glues and adhesives, paints, cleaning fluids) contain these substances; thus, children and adolescents can easily obtain them. About 10% of adolescents in the US have reportedly inhaled volatile solvents.

Volatile solvents temporarily stimulate the CNS before depressing it. Partial tolerance and psychologic dependence develop with frequent use, but a withdrawal syndrome does not occur.

Symptoms and Signs

Acute symptoms of dizziness, drowsiness, slurred speech, and unsteady gait occur early. Impulsiveness, excitement, and irritability may occur. As effects on the CNS increase, illusions, hallucinations, and delusions develop. Users experience a euphoric, dreamy high, culminating in a short period of sleep. Delirium with confusion, psychomotor clumsiness, emotional lability, and impaired thinking develop. The intoxicated state may last from minutes to > 1 h.

Sudden death can result from respiratory arrest or airway occlusion due to CNS depression or arrhythmias (perhaps due to myocardial sensitization).

Complications of chronic use may result from the effect of the solvent or from other toxic ingredients (eg, lead in gasoline). Carbon tetrachloride may cause a syndrome of hepatic and renal failure. Toluene may cause degeneration of CNS white matter. Injuries to brain, peripheral nerves, liver, kidneys, and bone marrow may result from heavy exposure or hypersensitivity.

Diagnosis

Volatile solvents are not detected by routine drug screens.

Treatment

Treatment of solvent-dependent adolescents is difficult, and relapse is frequent. However, most users stop solvent use by the end of adolescence. Intensive attempts to broadly improve patients' social skills and status in family, school, and society may help. For symptoms and treatment of poisoning with specific solvents, see Table 8: Poisoning: Symptoms and Treatment of Specific Poisons .

Last full review/revision July 2008 by Patrick G. O'Connor, MD, MPH

Content last modified February 2012