Inhalants
What Is It?
Solvents, aerosols, and gases found in household products such as spray paints, markers, glues, and cleaning fluids; also prescription nitrites. According to NIH, even a single session of inhalant use "can disrupt heart rhythms and lower oxygen levels", which can lead to death. "Regular abuse can result in serious harm to the brain, heart, kidneys, and liver."
Alternative Names
Huffing, sniffing glue, poppers, amyl
Legality
Even though many inhalants are legal, there have been legal actions taken in some jurisdictions to limit access by minors. While solvent glue is normally a legal product, a Scottish court ruled that supplying glue to children is illegal if the store knows the children intend to inhale the glue. In the US, thirty-eight of 50 states have enacted laws making various inhalants unavailable to those under the age of 18 or making inhalant use illegal.
Common Forms
Paint thinners or removers, degreasers, dry-cleaning fluids, gasoline, lighter fluids, correction fluids, permanent markers, electronics cleaners and freeze sprays, glue, spray paint, hair or deodorant sprays, fabric protector sprays, aerosol computer cleaning products, vegetable oil sprays, butane lighters, propane tanks, whipped cream aerosol containers, refrigerant gases, ether, chloroform, halothane, nitrous oxide, prescription nitrites.
Common Ways Taken
Inhalants are a broad range of household and industrial chemicals whose volatile vapors or pressurized gases can be concentrated and breathed in via the nose or mouth to produce intoxication, in a manner not intended by the manufacturer. They are inhaled at room temperature through volatilization (in the case of gasoline or acetone) or from a pressurized container (e.g., nitrous oxide or butane), and do not include drugs that are sniffed after burning or heating.
Short Term Effects
Confusion; nausea; slurred speech; lack of coordination; euphoria; dizziness; drowsiness; disinhibition, lightheadedness, hallucinations/delusions; headaches; sudden sniffing death due to heart failure (from butane, propane, and other chemicals in aerosols); death from asphyxiation, suffocation, convulsions or seizures, coma, or choking.
Nitrites: enlarged blood vessels, enhanced sexual pleasure, increased heart rate, brief sensation of heat and excitement, dizziness, headache.
LongTerm Effects
Liver and kidney damage; bone marrow damage; limb spasms due to nerve damage; brain damage from lack of oxygen that can cause problems with thinking, movement, vision, and hearing.
Nitrites: increased risk of pneumonia.
Other Health-related Issues
Pregnancy: low birth weight, bone problems, delayed behavioral development due to brain problems, altered metabolism and body composition.
When Combined With Alcohol
Unknown .
Withdrawal Symptoms
Nausea, tremors, irritability, problems sleeping, and mood changes.
Additional Information
It is also possible to classify inhalants by the effect they have on the body. Some solvents act as depressants, causing users to feel relaxed or drowsy while others act as stimulants. All commonly abused inhalants act as asphyxiant gases, although a common myth is that their primary effects are only due to oxygen deprivation. In reality, the majority of abused inhalants still exhibit psychoactive effects, although oxygen deprivation does add to the notable effects. Nitrous oxide can be categorized as a dissociative drug, as it can cause visual and auditory hallucinations. Other agents may have more direct effects at receptors, as inhalants exhibit a variety of mechanisms of action. The mechanisms of action of many non-medical inhalants have not been well elucidated. Anesthetic gases used for surgery, such as nitrous oxide or enflurane, are believed to induce anesthesia primarily by acting as NMDA receptor antagonists, open-channel blockers that bind to the inside of the calcium channels on the outer surface of the neuron, and provide high levels of NMDA receptor blockade for a short period of time.
This makes inhaled anesthetic gases different from other NMDA antagonists, such as ketamine, which bind to a regulatory site on the NMDA-sensitive calcium transporter complex and provide slightly lower levels of NMDA blockade, but for a longer and much more predictable duration. This makes a deeper level of anesthesia achievable more easily using anesthetic gases but can also make them more dangerous than other drugs used for this purpose.
Statistics on deaths caused by heavy inhalant use are difficult to determine. It may be severely under-reported because death is often attributed to a discrete event such as a stroke or a heart attack, even if the event happened because of inhalant use.
Regardless of which inhalant is used, inhaling vapors or gases can lead to injury or death. One major risk is hypoxia (lack of oxygen), which can occur due to inhaling fumes from a plastic bag, or from using proper inhalation mask equipment (e.g., a medical mask for nitrous oxide) but not adding oxygen or room air. Another danger is freezing the throat. When a gas that was stored under high pressure is released, it cools abruptly and can cause frostbite if it is inhaled directly from the container. This can occur, for example, with inhaling nitrous oxide. When nitrous oxide is used as an automotive power adder, its cooling effect is used to make the fuel-air charge denser. In a person, this effect is potentially lethal. Many inhalants are volatile organic chemicals and can catch fire or explode, especially when combined with smoking. As with many other drugs, users may also injure themselves due to loss of coordination or impaired judgment, especially if they attempt to operate machinery.
Solvents have many potential risks in common, including pneumonia, cardiac failure or arrest, and aspiration of vomit. The inhaling of some solvents can cause hearing loss, limb spasms, and damage to the central nervous system and brain. Serious but potentially reversible effects include liver and kidney damage and blood-oxygen depletion. Death from inhalants is generally caused by a very high concentration of fumes. Deliberately inhaling solvents from an attached paper or plastic bag or in a closed area greatly increases the chances of suffocation. Brain damage is typically seen with chronic long-term use as opposed to short-term exposure. Parkinsonism (see: Signs and symptoms of Parkinson's disease) has been associated with huffing.
The middle container is cooking spray, a household product, which is used as an inhalant.
Female inhalant users who are pregnant may have adverse effects on the fetus, and the baby may be smaller when it is born and may need additional health care (similar to those seen with alcohol – fetal alcohol syndrome). There is some evidence of birth defects and disabilities in babies born to women who sniffed solvents such as gasoline.
In the short term, death from solvent use occurs most commonly from aspiration of vomit while unconscious or from a combination of respiratory depression and hypoxia, the second cause being especially a risk with heavier-than-air vapors such as butane or gasoline vapor. Deaths typically occur from complications related to excessive sedation and vomiting. Actual overdose from the drug does occur, however, and inhaled solvent use is statistically more likely to result in life-threatening respiratory depression than intravenous use of opioids such as heroin. Most deaths from solvent use could be prevented if individuals were resuscitated quickly when they stopped breathing and their airways cleared if they vomited. However, most inhalant use takes place when people inhale solvents by themselves or in groups of people who are intoxicated. Certain solvents are more hazardous than others, such as gasoline.
In contrast, a few inhalants like amyl nitrate and diethyl ether have medical applications and are not toxic in the same sense as solvents, though they can still be dangerous when used recreationally. Nitrous oxide is thought to be particularly non-toxic, though heavy long-term use can lead to a variety of serious health problems linked to the destruction of vitamin B12 and folic acid.
Sources: National Institute on Drug Abuse, NIH, Wikipedia. (Collected 2023)