Note: This document has been edited to remove the names of specific products that can be abused. To receive the full text of the document, contact the Massachusetts Inhalant Abuse Task Force at questions.bsas@state.ma.us (please send us your name and postal address) or 617-624-5140.

BULLETIN

This bulletin is being issued to alert education, healthcare, and other youth-serving professionals about the little-known problem of inhalant abuse among youth. In 2001, one out of eight Massachusetts public high school students reported trying inhalants at least once.

Inhalant Abuse Alert

Introduction: 1

What is Inhalant Abuse:

Inhalant abuse is the intentional breathing in of gas and vapors with the goal of getting high. It does not refer to snorting cocaine or smoking substances such as tobacco, marijuana, crack cocaine or opium. There are over 1,000 common household, school, and industrial products that can be abused, including solvents, solvent-based products gases, fuels, and aerosols. For questions about the toxic effects of a substance, contact the Regional Center for Poison Control and Prevention Serving Massachusetts and Rhode Island at 1-800-222-1222.

Who is at Risk:

One out of eight Massachusetts high school students have tried inhalants. It's happening in all parts of the Commonwealth and among all types of children. Use may start as early as the third grade and generally increases through middle school. The highest proportion of lifetime use is among ninth-graders, white and rural youth. 1

Patterns of Abuse:

There are many patterns of use, depending on the age, ethnicity and size of the community. Some inhalant users report experimentation as early as the third or fourth grade. Often, they learn about inhalants from a friend or family member, television, or through word-of-mouth, but rarely are they aware of the dangers. Inhalants may be used alone or with a small group of peers. They are attractive to children because they are easy to obtain, free or inexpensive, difficult to detect, and many adults are not aware of the problem and don't take use seriously. Unlike other substances, inhalants are legal to possess for their intended use; although in Massachusetts, the possession, use, purchase or sale of these products for the purpose of causing intoxication is illegal [Massachusetts General Law, Chapter 270-18].

Effects of Inhalant Use:

Inhalants produce an effect within seconds that may last from fifteen to forty-five minutes. These substances generally act as central nervous system depressants. After an initial euphoria, a depressed state follows that can be accompanied by sleepiness or sleep. Inhalants lower breathing and heart rates and impair coordination and judgment. Dosages are repeated to maintain intoxication.

Dangers of Use:

Inhalants can cause severe and permanent damage to the brain, peripheral nerves, kidneys, liver, bone marrow, and other organs. Some inhalants cause chromosome and fetal damage much like Fetal Alcohol Syndrome. More than any substance, inhalants can cause sudden death resulting from heart arrhythmia and suffocation. Chronic inhalant users can develop physical addiction (with tolerance and withdrawal symptoms) and psychological dependence.

Signs:

There are several signs associated with inhalant abuse. If you suspect a child or adolescent is abusing inhalants, look for: 3

  • Discarded product containers
  • Bags, rags, gauze, or soft drink cans used to inhale the fumes
  • Traces of odors of paint, gasoline, or glue

Physical symptoms of abuse may include:

  • Facial rash
  • Blisters or soreness around the nose, mouth, or on the lips
  • Runny nose and frequent sniffing
  • Irritated or glazed eyes and dilated pupils
  • Frequent unexplained coughing
  • Hand tremors
  • Unusual harsh breath odor

A person who is intoxicated from sniffing inhalants may exhibit:

  • Extreme mood swings
  • Uncontrolled laughter
  • Grandiose and hostile speech
  • Bizarre risk-taking
  • Increased irritability and anger
  • Violent outbursts
  • Nausea, loss of appetite, vomiting
  • Hallucinations and convulsions

What do you do if you suspect a young person is in crisis as a result of inhalant intoxication? Experts recommend several steps:

  • Lay the person on his or her side to prevent aspiration of vomit.
  • Call an ambulance.
  • See that he or she gets fresh air.
  • Remain calm and supportive. Agitating the person may increase the risk of Sudden Sniffing Death Syndrome.
  • Minimize distractions and try to keep the person from moving.
  • Stay with the person until he or she receives medical attention.

Assessment Considerations:

1) Because inhalants are seen by many substance abusers as "low status" or "childish", children may be especially reluctant or embarrassed to admit use. 2) Many youth confuse "inhaling" with "smoking" or "snorting." For example, you might ask, "Have you ever inhaled anything to get high? For instance, the gases or fumes or vapors from household products or products used in a shop, art projects or a garage. I am not talking about anything you might smoke, like tobacco, marijuana, or crack or anything you might snort like cocaine." 3) Because youth are generally not aware of the special dangers of inhalants, any child who has experimented with them even once should receive inhalant prevention education. Parent education is also essential.

Treatment Considerations:

1) Individuals who are regular users of inhalants can take thirty to forty days or more to detoxify. Adequate detoxification is crucial to successful treatment. 2) Inhalants can produce both psychological dependence and physical addiction. Withdrawal symptoms may include hand tremors, nervousness, excessive sweating, hallucinations, chills, headaches, abdominal pain, muscular cramps, and delirium tremens. 3) Inhalant abusers have very high relapse rates. Aftercare and follow-up are extremely important. 2

Treatment Options:

Through its network of community providers, the Massachusetts Department of Public Health supports outpatient and residential programs for youth who are abusing inhalants and other drugs. For information on programs, call the Massachusetts Substance Abuse Information and Education Helpline (1-800-327-5050).

Prevention Strategies:

Telling youth about the names and types of abusable products increases the likelihood that some youth will experiment with inhalants. A key prevention message is that inhalants should be equated with poisons, pollutants, and toxins, and not drugs. Children should not be taught what products can be abused, rather the damaging effects of inhalants should be stressed. 4 Other strategies include teaching inhalant refusal skills; supporting positive youth development and leadership; and educating parents and other community members. For more information on inhalant prevention, contact the Massachusetts Inhalant Abuse Task Force (617-624-5140) or visit www.mass.gov/dph/inhalant.

Sources:

1 "2001 Massachusetts Youth Risk Behavior Survey Results," Massachusetts Department of Education, September 2002.
2 Riedel, Steven. "Inhalants: A Growing Health Concern." Behavioral Health Management, May-June 1995, V15, N3, P28 (3).
3 ________ "A Breath of Death," Adolescence, September 1993
4 Groves, Mark. Sniffing and Huffing: A Comprehensive Guide for the Prevention and Treatment of Children's Inhalant Abuse, The Eden Statewide Children's' Chemical Health Services Project, Minneapolis, MN, 1996 (Phone: 612-874-9441).
 

Rev: March 4, 2003

 


This information is provided by the Bureau of Substance Abuse Services within the Department of Public Health.