Inhalant abuse: Recognize it, talk about it

A boy, age 15, inhales the fumes of propane gas from the family grill and collapses.
A 13-year-old boy inhales fumes from cleaning fluid and ends up in the hospital on life support.
Another boy, age 11, dies in a public bathroom. Next to him is a plastic bag and a container filled with the butane fuel that's used in cigarette lighters.

These incidents, reported by the Consumer Product Safety Commission, underline the potentially fatal risks of inhalant abuse by children and adolescents.

Inhalants are commonly available, inexpensive and legal substances. Children can walk into any grocery store, hardware store or pharmacy and pick them off the shelf. And after obtaining inhalants, children easily can conceal the products in jackets, backpacks, closets or dresser drawers. John E. Huxsahl, M.D., a child and adolescent psychiatrist at Mayo Clinic, offers this analogy: “Imagine supermarket shelves lined with 'Saturday Night Specials' “cheap handguns “for sale to anyone for the price of a can of hair spray. As ludicrous as it may seem, that image is not so far from reality."

Inhalants are plentiful
In the 1950s, inhalant abuse was known by a more benign term “"glue sniffing." But that phrase does scant justice to the long list of inhalants that kids abuse, such as:

Gasoline
Lighter fluids
Paint thinners
Nail polish remover
Aerosol sprays
Marking pens
Deodorants
Household cleaners
Anesthetics
Fabric protectors
Correction fluids (such as Whiteout and Liquid Paper)

These are just a few examples. In fact, over 1,000 types of inhalants are abused.

Almost 1 in 5 teens abuses inhalants
Inhalant abuse can start in grade school and continue throughout adolescence. According to a 1993 survey by the National Institute on Drug Abuse, about 17 percent of American teenagers report abusing inhalants at least once in their lives. That's about the same number who use stimulants.

One reason for their popularity is that inhalants produce a quick, powerful high. “Since the ancient Greeks, inhalation has been recognized as a highly effective means of consuming drugs," Dr. Huxsahl says. “The extensive capillary surface of the lungs allows rapid absorption, with a subsequent 'rush' that often has been described as second in intensity only to intravenous injection."

Sniffing offers just one way to get high. Kids can also “huff" “soak rags in inhalants and press the rags to their mouths. Another option is “bagging" “inhaling fumes from chemicals poured into in plastic bags.

Know the risks
People who abuse inhalants often look and act like people who are intoxicated from alcohol. Immediate manifestations can include:

Excitation followed by drowsiness
Increased irritability
Lightheadedness
Sleeplessness
Dizziness
Hallucination
Loss of inhibition
Disruptive behavior

With chronic abuse comes more risks “weight loss, muscle weakness, lack of coordination and addiction. Other possible effects include damage to the brain, heart, kidneys and liver.

These effects are no surprise, given the chemical makeup of many inhalants. When children sniff, “huff" or “bag," they can ingest a host of toxic chemicals “butane, propane, fluorocarbons, nitrites and more.

Rarely, inhalant abuse even causes “sudden sniffing death" “rapid, irregular heartbeat (arrhythmia) that leads to cardiac arrest. This can happen to first-time abusers. Sometimes death occurs indirectly from inhalant abuse. For instance, teenagers may sniff inhalants, get behind the wheel and end up in a fatal car crash.

Recognize clues
Unfortunately, adults often fail to recognize inhalant abuse. Parents and physicians may be more concerned about children's use of alcohol, nicotine and illegal drugs such as marijuana.

Preventing inhalant abuse starts with spotting clues of the problem. For example:
Your child has unusual-smelling breath.
You see signs of intoxication, such as blurred or incoherent speech, staggering or dizziness.
You consistently notice spots or sores around your child's mouth or nose.
You see paints or chemical stains on your child's face, fingers or clothing.
You find clothing with strong chemical odors.
You find strong-smelling rags and empty containers hidden in closets or drawers.

Discuss the dangers
As a parent, your stand on any form of chemical use makes a difference. Tell your children about the risks. Let them know that you won't tolerate their inhalant abuse. Also make sure that your child's doctor, teachers, counselors and coaches know about the inhalant abuse. Open discussion can prevent a tragedy.

Acknowledgements: Mayo Clinic