A paint huffer’s prison photo.

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INHALANTS

INHALANTS classified as deliriants, comprise a wide variety of substances.

• Volatile substances present in numerous commercial products:• Paints, solvents and anesthetics

• Used for stupefying, intoxicating, and occasionally psychedelics effects.

• Inhaled through nose and/or mouth, occasionally sprayed directly into nose and/or mouth

Why are inhalants popular?Most inhalants are readily available,

inexpensive or free, and usually legal to purchase and possess. • The high is achieved within seconds and the effect dissipates

within a half of an hour. • Products are easy to conceal and are useful everyday products

(e.g., permanent markers, correction fluid) found in homes, offices,

and schools, it is difficult to prevent access to them. • And, because abusable products are so common, many youth do

not perceive them as harmful and do not understand the

consequences of using them.

ProductVolatile Solvents & Aerosols Gasoline and gasoline additives

Airplane glue Rubber cement and other gluesPVC cement Paint sprays (especially gold and silver metallic paints) Hairsprays and deodorantsLighter fluidFuel gas Dry-cleaning fluid, spot removers, correction fluid, degreasers

Nail polish removerPaint remover/thinners

Analgesic/asthma sprays Air dusters (End Dust,® Dust Off®)

Chemicals

Gasoline and high-octane fuel additives (e.g., STP®)Toluene, ethyl acetate Toluene, hexane, methyl chloride, acetone,methyl ethyl ketone, methyl butyl ketone Trichlorethylene, tetrachlorethylene Toluene, butane, propane, fluorocarbons

Butane, propane, chlorofluorocarbons (CFC’)Butane, isopropane Butane, isopropane Tetrachlorethylene, trichloroethane,trichloroethylene, xylene, petroleumdistillates, chlorohydrocarbons

Acetone, toluene, ethyl acetate Toluene, methylene chloride, methanol,acetone, ethyl acetate, esters

ChlorohydrofluorocarbonsDifluorethene, propane, isobutane, tetrafluoroethene

ProductVolatile NitritesRoom odorizers (“poppers”) (Locker Room,® Rush,® Liquid Gold,® Ram,® Rock Hard,® Stag,® Stud,® Thrust,® TNT,®)Heart medication (‘poppers, snappers”)

AnestheticsNitrous oxide Whipped cream propellant(“whippets,” laughing gas, “blue nun,”nitrous) Chloroform Ether Halothane, enflurane (liquid)Local anesthetic

Chemicals

(Iso)anyl nitrite, (iso)butyl nitrite, isopropyl nitrite, cyclohexyl nitrite

Nitrous oxideChloroform Ether Bromo chloro trifluoro ethane, chloroTrifluoro ether Ethyl chloride

Common dangers of inhalants:• The debilitating and potentially lethal effects can occur even with first

use.

• Sudden sniffing death syndrome is usually caused by the irregular heart rate induced by inhalants; other cardiac effects are hypertension, tachycardia, and bradycardia.

• Other significant effects include command seizures.

• Brain damage can be a consequence of chronic use.

• Additional dangers: • suffocation (e.g., from bagging)• fire-related injuries from inhalant combustion (especially if the

inhalant is heated or a cigarette is lit in a closed area where the inhalant is being abused)

• accidents related to impaired judgment, lack of motor skills, or high-risk behavior.

If inhalants are heated, dangerous amounts of pressure on lungs and tissue can freeze as substances vaporize

Chronic Inhalant AbuseContinued, chronic inhalant abuse has been associated with neurologicaldamage.• People who abuse inhalants chronically have demonstrated a range of

mental dysfunction, from mild cognitive impairment (e.g., lack ofconcentration or attention, poor memory, and poor learning skills) tosevere.

• In some instances these effects are permanent while in others they resolve after a long period of abstinence.

• Personality disorders, particularly antisocial personality, violent

behavior, and depression, have been associated with inhalant abuse.

PathophysiologyInhalants are highly lipid soluble.

• Easily cross both alveolar membranes and the blood-brain barrier.

• Exposure via the pulmonary route avoids first-pass hepatic metabolism. Onset of effect is seen in seconds.

• Volatiles accumulate in the brain (as well as other fatty tissues in the body).

• The mechanism of their effects is not entirely clear; the mechanism is "fluidization" or change in solubility of neuronal cell membranes.

• The potency of these drugs related to their solubility in water.

• Other actions proposed include specific molecular ion channels, whereby these chemicals would potentiate the effects of GABA on the GABA-A receptors.