When ordinary household items produce extraordinarily dire consequences, even common items can rapidly and understandably gain the spotlight, as proven by a case in November of 2018 when a Dutch teen died of cardiac arrest after inhaling a deodorant spray. According to the account published in the BMJ Case Reports, the 19-year old had draped a towel over his head and inhaled the butane from the spray, after which he became hyperactive and later collapsed, dying only days after he was placed in a medically induced coma.
But this case of abuse is not isolated in the Netherlands. In the U.S., the National Institute on Drug Abuse (NIDA) reports that inhalants, as these potentially psychoactive household products are called, reportedly account for as many as 200 deaths each year.
The combined accessibility and dependence liability of inhalants prove the need to re-examine how much we know and must know about the innocent-seeming products we may be using daily.
About Inhalants
While household products such as different sprays and paints may be the most familiar, inhalants refer to a variety of volatile compounds and chemicals, including industrial and medical substances that readily evaporate to a gaseous state at room temperature. This means that they easily emit vapor and as the name suggests, they are rarely taken by any method other than inhalation.
Usually stored in bottles and spray canisters, not much may distinguish an inhalant from other typical grocery items at a mere glance, though they may be packaged in pressurized containers to prevent vaporization.
The NIDA classifies inhalants into four categories – volatile solvents, aerosols, gases, and nitrites.
Paints and paint thinners belong to the first classification. Volatile solvents are liquid, generally come in larger amounts relative to the others, and can be readily purchased from retail stores. They can dissolve in solute and as inhalants, they can turn to gas at room temperature. Glues, gasoline, dry-cleaning fluids, and lacquer thinners, and office supplies like felt-tip markers and correction fluids, are listed under volatile substances.
Meanwhile, the tragic case of a young Netherlander mentioned above involved the misuse of aerosols, combinations of solvents, and propellants that commonly come in spray cans. A mist of liquid aerosols when the contents of these cans are dispersed and such can be inhaled by potential abusers to attain intoxication.
Aerosols cover several spray products, from fabric protectants to air fresheners and even cooking sprays.
Gases, on the other hand, can be either organic or inorganic and have plenty of households, industrial, and medical application. Most utilized may be nitrous oxide, popularly known as “laughing gas”, a sedative agent used to put patients in a calmer state for many dental procedures. Nitrous oxide can also be used in whipped cream dispensers as a whipping agent and in race cars to boost octane levels.
Many other anesthetic substances make up this class of inhalants, including chloroform, enflurane, isoflurane, and desflurane. Butane lighters and refrigerants are common household items containing the potentially addictive gas.
The last class of inhalants is often considered a special one, set apart from the aforementioned by its targeted region in the human body. While inhalants generally impact the brain or central nervous system, nitrites induce muscle relaxation by dilating the blood vessels. The use of nitrites is another distinguishing factor. Whereas volatile solvents, aerosols, and gases are abused for their mood-altering effects, nitrites are primarily used to enhance libido and sexual stamina.
Nitrite compounds may be known by such street names as “poppers” and “snappers” and due to their use in the context of sexual intercourse, may be associated with increased risks of contracting sexually transmitted diseases.
Not unlike the other inhalants, nitrites can prove beneficial in the right hands. Amyl nitrite, for instance, is used in the treatment of heart diseases and in some cases, as an antidote for cyanide poisoning. Inhalation of the substance can relieve the agonizing effect of angina attacks by relaxing the blood vessels, thereby facilitating the flow of blood and oxygen to the heart.
How Inhalants Work
The inhalation method can be through the nose or mouth, facilitated by special masks such as the case with laughing gases for dental operations or by more commonplace items from bags and rags to the container in which the product is readily packaged.
For example, in the case of aerosols, users may spray the substance directly into the mouth or nose. Others sniff or snort the substance from small openings in the container or from a paper or plastic bag. Nitrous oxides can be sniffed directly from balloons which contain them. Huffing is a method wherein a piece of cloth is soaked in a solvent before being placed into the mouth from where it will be inhaled.
Once inhaled, the chemical can reach the brain through the bloodstream, directly attacking the central and peripheral nervous system and causing intoxication.
Side-effects are comparable to those of inebriation, with disturbed speech, uncoordinated muscle movements, and dizziness being probable. Hallucinations and delusions are also possible depending on the amount breathed in. Among the short-term effects of breathing inhalants are headaches, vomiting, mood swings, and the side-effects of alcohol intoxication enumerated above.
Meanwhile, long-term abuse of these breathable chemicals can lead to irreparable damage in the nervous system and failure of the kidney and liver, as well as damage in the bone marrow, loss of hearing, and spasms.
Duration and Strength
The instability in the chemical composition of inhalants gives these substances their short lifespan, with two weeks being the average time for this drug to be excreted from the human body through exhalation or urination.
Still, several physiological factors can affect how long inhalants can stay in the system.
Organ health and metabolism are primary determinants, as they determine how efficiently toxic substances can be excreted from the body and otherwise counteracted. Genetics can play a role in a person’s metabolism. Age-wise, younger individuals tend to process chemicals faster since their systems are less likely to be experiencing organ dysfunction and degradation associated with aging.
Weight, height, and body composition also affect the staying time of inhalants in the body. Bigger individuals may be able to take in larger amounts of the drug before such can take effect but may also require larger amounts of medication to counteract the effect of these substances.
The amount of inhalants consumed is definitely something to be considered, as stronger doses can have adverse effects on the nervous system. Toluene, a compound found in paint thinners, and naphthalene, a chemical used in mothballs and such pest repellents, can damage tissues and the peripheral nervous system, producing effects comparable to those found in patients having suffered multiple sclerosis.
Abuse and Withdrawal: Seeing the Signs
The fact that these substances are easily accessible and readily purchased increases the risk of dependence, especially for adolescents and younger adults. Reportedly, children as young as twelve have been misusing inhalant substances, with 2.6 million being the estimated tally for the 12 to 17 age group.
With children and teens being susceptible to abuse of the drug, it is up to their guardians and other responsible adults to be aware of and promptly detect the warning signs of abuse and overdose. Treatment and recovery from addiction to inhalants are possible, but as with any other addictive substance, early detection and prevention are the optimal cure.
Stains and paints on the face, hands, and clothes are possible warning signs of abuse, so is the distinct odor of inhalants in the breath or garments.
Those concerned with inhalant abuse may also want to watch out for symptoms typically associated with alcohol intoxication on the suspected user. These signs include dizziness, poor coordination, inability to speak well, and nausea. Lack of concentration and loss of appetite may point to an abuse of these compounds.
Inhalants pose a high risk of overdose, with some substances causing damage more quickly than others even in small amounts. That’s why even accidental inhalation may require immediate medical attention.
As with the case of the late Dutch teen reported to have misused aerosols, cardiac arrest, preceded by fast and irregular heartbeats, is a possible medical consequence of inhalant abuse. When an excessive amount of the substance is inhaled, such can displace the oxygen in the lungs, causing asphyxiation. These fumes may also block the entry of oxygen in the lungs, thereby causing suffocation. Meanwhile, with vomiting being a side-effect of inhalant intoxication, choking can ensue when the user accidentally inhales the vomit.
The psychoactive properties of most inhalants can have lasting damage to the nervous system. In extreme cases, brain dysfunction can suspend body movements, leading to coma. Brain malfunction through the emission of uncontrolled electrical discharges can cause sudden muscle contractions, producing convulsions or seizures.
Stronger inhalants like toluene and naphthalene can severely damage, even destroy the nerve endings in the human brain.
Individuals who are under the influence of these inhalants are likewise more prone to accidents due to diminished muscle coordination associated with the substance.
Nitrite misuse, due to its role in enhancing sexual performance and pleasure, is associated with unprotected or otherwise unsafe sexual practices. But it’s not just its impact on the libido that increases risks related to sexually acquired diseases and infections. Nitrite compounds, when inside the body, can kill cells that help fight disease, thereby weakening the immune system and increasing the risk of getting tumors and infectious diseases.
Withdrawal symptoms are also good indicators of whether dependence has developed, so these are signs for which a concerned guardian may want to look out. In addition, individuals attempting to detox from the substance may want to know the normalcy of their body’s response to stopping misuse. For inhalants, vomiting, appetite loss, sudden mood swings, excessive sweating, and sleep troubles are all possible withdrawal effects one can anticipate during the detoxification process.
Treating Addiction
In ensuring recovery from inhalant dependence, treatment may be a lifelong process that includes medication and behavior alteration. It is best that the patient is first and foremost able to acknowledge and accept that he or she has indeed developed a dependence on the substances and that help is needed to address and manage such.
A common treatment is the Twelve-Step Facilitation (TSF), a recovery program aiming to instill self-awareness among patients so they may be able to recognize weaknesses which may have led to the addiction. The program involves group sessions where patients are able to share relevant experiences and empathize with one another, providing needed moral support and affirming the necessity of outside assistance in effectively dealing with dependence.
Cognitive-Behavioral Therapy assists patients in finding and employing healthier coping mechanisms in situations where they are at the highest risk of misusing inhalants and other toxic substances.
Motivational incentives, family therapy, and motivational enhancement therapy are also known the treatment of addiction. Patients may opt for one or a combination of the available treatment methods to facilitate faster and longer lasting recovery.
In the wrong hands and in the absence of proper education, even inconspicuous and seemingly harmless household products can pose very real threats to human functionality and human life. The inclusion of children and young adults in the equation only serves to set the cause for alarm higher.
But as with any form of addiction and overdose, damage caused by inhalants on the human mind and body are preventable. One simply needs to know where to look and what to look for.
