Become aware of the problem. Inhalants are common household, school, and office products inhaled by youth to get "high." While they are being used as drugs, they are, in reality, poisons. Inhalant users are at risk for suffocation, accidents, burns and Sudden Sniffing Death Syndrome (cardiac and/or respiratory arrest). Damage to the nervous system, lungs, liver, and kidneys can also occur. Youth are generally not aware of the dangers of inhalant use and need to be educated. It is also important that parents are educated about the hazards of inhalant use so that they can monitor their children.
Know what to look for. Abusable products are found everywhere. They include solvents, solvent-based products, fuels, gases and products in aerosol containers. Examples of paraphernalia are aerosol cans, paper and plastic bags, rags, and soda cans. Slang terms for inhalant abuse, though uncommon in Massachusetts, include sprayers, sprayheads, spray, huffing, sniffing, and bagging. Substances that are smoked (such as tobacco, marijuana, or crack cocaine) or snorted (such as cocaine) are not considered inhalants.
Inhalant intoxication looks similar to alcohol intoxication (initial euphoria followed by central nervous system depression), with the same patterns of poor judgment, lack of coordination, and disinhibition. Visual and aural hallucinations often occur. Inhalant users who have been surprised, scared, or chased are at increased risk for heart arrhythmias and fatal heart attacks. Chronic users may be underweight and have rashes around their mouth and nose. They may have hand tremors and problems with memory and thinking.
Know who is using. 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. Youth may use inhalants while alone or in groups. Older teens and adults may use inhalants with alcohol and other drugs. There have also been reports of inhalant use while driving.
Know the laws. The inhalation of vapors and gases from common, legal products, such as household, school, and office products to get "high" is illegal in Massachusetts (Massachusetts General Law 270-18). Amyl nitrite, referred to as "poppers" and used medically to relieve the pain of angina, comes in an ampule and requires a prescription. Butyl nitrite and isobutyl nitrite, sold as "Rush" or "Locker Room," are sold illegally as room odorizers in sex paraphernalia shops and are Class D Controlled Substances (Massachusetts General Law 94C; Section 31). Solvent-based glues and cements sold to minors must contain an irritant (such as oil of mustard), and the law requires that minors present proper identification and register in a permanently bound log (Massachusetts General Law 270-19).
Policing strategy: Massachusetts General Law 270-18 is a misdemeanor with the power of arrest. It requires that a police officer observe the use of inhalants for the purpose of producing "intoxication, euphoria, excitement, exhilaration, stupefaction, or dulled senses or nervous system" in order to arrest a person. Once it has been determined that the product is being used illegally, charges may also be brought for purchase, sale, and possession. Be on the alert for drivers appearing to be driving erratically who may be operating the vehicle under the influence of inhalants.
Juvenile court strategy: If you suspect or know of inhalant, alcohol, or other drug use, a substance abuse assessment should be performed by a court clinic or local substance abuse clinic. (Contact the Massachusetts Substance Abuse Information and Education Helpline at 1-800-327-5050 to find a community outpatient clinic nearby. These clinics provide free care for indigent clients; others receive care based on a sliding fee or insurance coverage.) Even if it turns out to be a false alarm, your actions send a clear message about substance use. If inhalants, alcohol, or other drugs are a concern, the court may stipulate that a court-involved juvenile follow through on the recommendations of the assessment. In instances where urine tests for drugs are being used, specific tests can be ordered for inhalants.
If you are concerned about a child's behavior, be sure to follow up. Ask about inhalants and be specific about why you are concerned. Don't dismiss your gut feelings that something is not right. Remember, one of the attractions of inhalants is that adults are not aware of them and don't recognize their illegal use. If you have questions about a substance, call the Regional Center for Poison Control and Prevention Serving Massachusetts and Rhode Island at 1-800-222-1222.
If you suspect a young person is in crisis because of inhalant intoxication, experts recommend taking these 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 because scaring or agitating the person may increase the risk of Sudden Sniffing Death Syndrome (cardiac and/or respiratory arrest).
- Minimize distractions and try to keep the person from moving.
- Stay with the person until he or she receives medical attention.
Don't tolerate any experimentation. Even limited inhalant use can be fatal. Studies show that one-third of the deaths from inhalant use were among first-time users. Seek an alcohol and drug assessment and take appropriate action.
Make sure youth are getting the message about the dangers of all substance use including inhalant use. The primary message is that inhalants are poisons and are dangerous like other poisons. Care should be taken to not dismiss inhalant use as harmless experimentation. If you are talking to a child or teenager about inhalants, stress what the dangers are, not what products may be abused or how they may be abused.
For more information: Contact your local Massachusetts Regional Center for Healthy Communities for videos and written information (call 1-800-327-5050 for the location), the Regional Center for Poison Control and Prevention Serving Massachusetts and Rhode Island (1-800-222-1222) or the Massachusetts Inhalant Abuse Task Force (617-624-5140 or visit our web site at www.state.ma.us/dph/inhalant).
Rev. Mar 4, 2003