A paint huffer’s prison photo.

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INHALANTS

OverviewInhalants, including Anesthetics

Description of inhalants, including anesthetics that are abused.Physiological factors associated with abusing these substances.Psychological factors associated with abusing these substances.Cultural issues associated with abusing these substances.

What are inhalants, including anesthetics?“Inhalants…comprises a wide variety of substances:

Volatile liquids that give off fumes,Gases that come in pressurized tanks or bottles,and aerosol cans that are sprayed.”“….are used for their stupefying, intoxicating, and occasionally psychedelic effects.”“…are inhaled through the nose and/or mouth and occasionally sprayed directly in the mouth or nose” (p. 306)

Inaba, D., & Cohen, W. (2007). Uppers, downers, all arounders (6th ed.). Medford, OR: CNS Publications.

What are inhalants, including anesthetics?

“There are three main groups of inhalants and dozens of subgroups….

Volatile solvents (and aerosols). Most of these substances are synthesized from petrochemical and combined with other chemicals….Volatile nitrates. These drugs…are used clinically as blood vessel dilators….and…’room fresheners.’Anesthetics. These were developed to block pain or induce unconsciousness during surgical or other medical procedures” (p. 306).

Inaba, D., & Cohen, W. (2007). Uppers, downers, all arounders (6th ed.). Medford, OR: CNS Publications.

Ummm….room fresheners…NOT!

Inhalants, including Anesthetics – Volatile Solvents & Aerosols

Volatile Solvents & AerosolsGasoline and gasoline additives

Airplane glue Rubber cement and other glues

PVC cement Paint sprays (especially gold and silver metallic paints) Hairsprays and deodorants

Lighter fluidFuel gas Dry-cleaning fluid, spot removers, correction fluid, degreasers

Nail polish removerPaint remover/thinners

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

Air Conditioning Coolant (Freon)

ChemicalsGasoline and high-octane fuel additives

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, petroleum distillates, chlorohydrocarbons

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

ChlorohydrofluorocarbonsDifluorethene, propane, isobutane, tetrafluoroethene

Freon

Inhalants, including Anesthetics – Volatile Nitrates & Anesthetics

Volatile Nitrites1) “Aliphatic” or “Alkyl” Nitrates (aka “Room Fresheners,” “video/tape head cleaner,” “sneaker cleaner,” or “poppers”) i.e. - Locker Room,® Rush,® Bolt,® Climax,®

2) Amyl Nitrates - Heart medication (aka “poppers” or “snappers”) – prescription inhalant

AnestheticsNitrous oxide - Whipped cream propellant(aka “whippets,” laughing gas, or “blue nun”)

ChloroformEtherHalothane, enflurane (liquid)

Local anesthetic

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

Amylnitrate

Nitrous oxide

ChloroformEtherBromo chloro trifluoro ethane, chlorotrifluoro ether

Ethyl chloride

Physiological effects associated with abusing inhalants, including

anestheticsPathophysiology

Inhalants 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.

Physiological effects associated with abusing inhalants, including

anesthetics

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

Physiological effects associated with abusing inhalants, including

anesthetics

Physiological effects associated with abusing inhalants, including

anestheticsChronic Inhalant Abuse

Continued, 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.

Physiological effects associated with abusing inhalants, including

anesthetics

Physiological effects associated with abusing inhalants, including

anesthetics

Physiological effects associated with abusing inhalants, including

anesthetics

Physiological effects associated with abusing inhalants, including

anestheticsCommon 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.

Physiological effects associated with abusing inhalants, including

anesthetics

Psychological effects associated with abusing inhalants, including

anesthetics

Cultural issues associated with abusing inhalants, including anesthetics

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.