Combating Inhalant Abuse

Combating Inhalant Abuse

With all the influences coming at today’s youth from every direction, it’s sometimes tough for parents to know how best to protect their children from those that can cause them irreparable harm. You know you can’t shield them from everything, but you also know that if you try too hard or come on too strong, they may reject your words and gravitate toward unhealthy behavior as a means of defiance or asserting independence. They’re also vulnerable, meaning they haven’t the wisdom of world-years or the knowledge of the actual dangers that may befall them – particularly in the use and abuse of readily available drugs. One of the most common forms of drug abuse at early ages (adolescents and early teens) is inhalants.

What are Inhalants?

The National Survey on Drug Use and Health (NSDUH) defines inhalants as liquids, sprays and gases that people sniff or inhale for the purpose of getting high or feeling good – but their use can cause damage to major systems and cognitive processes.
Examples of inhalants include many household products such as aerosols, air fresheners, glue, spray paint, cleaning fluids, gasoline, propane, nail polish remover, correction fluid, and marker pens. According to the 2008 Monitoring the Future Study, unlike all other classes of drugs, use of inhalants is most common among younger adolescents and tends to decline as they grow older.

Some of this may be due to the fact that inhalants are cheaper and easier to obtain than other classes of drugs, such as marijuana, ecstasy, and prescription drugs used for non-medical purposes. They are also legal to buy and use and most often are found in the home.

As youth become older, they may graduate to other drugs, having left the “kids’ drugs” behind. Availability of other drugs is also a factor as adolescents mature, as is their ability to pay for the drugs.

• Young Teens – Among past-year inhalant initiates age 12 to 15, common inhalants included lighter fluid or gasoline, glue, shoe polish or toluene (a solvent).

• Older Teens – Among past-year inhalant initiates age 16 to 17, nitrous oxide or whippets were the most common form of inhalants used.

Prevalence of the Problem

In 2008, 729,000 persons aged 12 or older were first-time users of inhalants within the past 12 months, according to the 2009 National Household Survey on Drug Use from the Substance Abuse and Mental Health Services Administration (SAMHSA). The percentage of those under the age of 18 was 70.4 percent.

In terms of overall first-time users in the past 12 months, the numbers are down from 871,000 in 2003, 851,000 in 2004, and 877,000 in 2005. That’s the good news.

But a more disturbing trend is that the average age at first use among recent initiates is decreasing. In 2008, the average age was 15.9 years, compared to 17.1 years in 2007.

The number of individuals aged 12 and older in 2008 who were dependent upon or abused inhalants was 175,000 – numbers which have not significantly changed between 2007 and 2008 or between 2002 and 2008.

The 2008 Monitoring the Future Study, which studies drug use and trends in 8th through 12 grades, found that there may be “generational forgetting” about the hazards of inhalant abuse. Currently, relatively low proportions of youth perceive “great risk” in using inhalants once or twice. A Partnership for a Drug-Free America anti-inhalant campaign in 1995 and 1996 succeeded in raising awareness about such dangers, but those adolescents are now grown, and the subsequent generation of youth has not benefited from such messages. This, says the MTF study, is worrisome.

While 80 percent of those surveyed in the MTF study said they disapproved of inhalant use, this percentage has been gradually falling off since 2001, especially among 8th graders.

Before the 6th or 7th grade, inhalants are the third most popular abused substance after alcohol and tobacco, reports the National Inhalant Prevention Coalition. Furthermore, after the 7th grade, inhalants drops to fourth place after alcohol, tobacco and marijuana, but their use far exceeds the other substances. Inhalants are considered a “gateway” drug leading to other drug use. But the difference is that with inhalants, even first-time use can lead to death.

A SAMHSA (2006) report of records of admissions treatment show that adolescents age 12 to 17 represented 48 percent of all substance abuse treatment admissions for inhalants. The report, from the Drug and Alcohol Services Information System (DASIS), shows that adolescents who reported inhalant abuse were more likely to have a co-occurring mental health problem. Forty-five percent of adolescent admissions reporting inhalants had a concurrent psychiatric disorder, compared to 29 percent who did not report inhalants.

Facts About Inhalants

Separating fact from fiction is an important way to combat inhalant abuse. Being armed with the specifics about the dangers of inhalants gives parents, caregivers, and educators tools with which to counter the misconceptions adolescents and teens have about the dangerous practice.

Harmful Vapors – Many adolescents and teens think that because inhalants are found in many household products, they must be safe. The truth is that, while there are legal and useful purposes for these products, they are not intended to be inhaled. In fact, the products carry specific warnings on the packaging that include language such as the following on Easy-Off BAM Grime & Lime Remover, “Vapor may be harmful. Avoid breathing in vapor. If inhaled, move to fresh air. Get medical attention if needed.”
One Huff Can Kill – Another mistaken belief many young people hold is that they’ve seen their friends huffing vapors – or they’ve done it themselves – with no apparent ill effects. They think that they can huff once or twice or 10 or 100 times and be just fine. This is playing a deadly game. The fact is that even one huff can kill an individual. Or, it could be the 10th, 100th or anytime in-between. Medical experts say that there’s absolutely no way of predicting when huffing will lead to major health consequences – even death.

Inhalants Make You Lose Control – The ingredients in household products – that cause harmful vapors when inhaled – affect the brain in very unpredictable ways. The vapors can make the individual act irrationally, lose control, or become violent and act in a deadly manner.

Club Inhalants – Chemicals distributed at dance clubs and concerts in the form of amyl nitrite and isobutyl nitrite (“poppers”) and nitrous oxide (“whippets”) can permanently damage both body and brain.

Inhalant Use Linked to Major Depressive Episode – A recent NSDUH study found that the rate of past-year inhalant use was more than twice among youth aged 12 to 17 who had a major depressive episode (MDE) in the past year than among those who did not. Furthermore, an estimated 218,000 youth had used inhalants and experienced a MDE in the past year. Youth age 12 to 13 had the highest past-year inhalant usage after experiencing MDE, as compared with youth in the same age group who had used inhalants but had not experienced MDE (13.9 versus 3.7 percent).

How Inhalants are Used

Inhalants can be breathed through the nose or mouth in a variety of ways:

• Snorting or sniffing fumes from containers
• Spraying aerosols directly into the nose or mouth
• Bagging – sniffing or inhaling fumes from substances sprayed or deposited inside a plastic or paper bag
• Huffing – from an inhalant-soaked rag stuffed in the mouth
• Inhaling from balloons filled with nitrous oxide

How Inhalants Affect the Body

There isn’t a part of the body that benefits from inhalant use. Just the opposite is true, in fact. Here are some of the areas of the body that are most affected by inhalants.

• Brain – Sniffing, or huffing, the fumes or substances from products such as glue, household cleaners, paint thinners, solvents or spray paints produce an immediate high. That’s the major attraction for users, who seek the instant gratification of a euphoric state. But the speed and extent to which inhalants affect the brain, in comparison with other substances, is what makes them so dangerous. Before the user knows what has happened, irreversible physical and mental damage to the brain can occur.

• Heart – The human body requires oxygen in order to survive. Inhalants starve the body of its required oxygen intake. This forces the heart to work harder to pump and distribute the oxygen. It may make the heart beat irregularly or too fast. This is very dangerous to the body.

• Damage to Other Body Parts – Besides the heart and the brain, chronic (or occasional or even first-time) use of inhalants may cause nosebleeds and nausea, result in the development of problems with the liver, kidneys, and lungs. Long-term inhalant abuse leads to a wasting of the muscles, loss of muscle tone and strength.

• Loss of Function – Regular inhalant users may permanently lose the ability to perform everyday functions such as thinking, talking, and walking.

• Coma – The brain shuts down all but the most vital functions.

• Sudden Death – Inhalants can cause sudden death in the user due to suffocation, choking on their own vomit, or having a heart attack.

Signs of Inhalant Use and Abuse

You know when your child doesn’t look or act right. Sometimes, however, it’s difficult to tell what’s causing the problem, whether it’s a sudden illness, emotional difficulties, trouble at school, or involvement with drugs, alcohol – or inhalants. There are some specific signs to be on the lookout for that may indicate the use or abuse of inhalants.

• Appearance that seems drunk, dazed or dizzy
• Breath odor that seems unusual
• Chemical smell on clothing
• Depression
• Eyes that are red
• Inattentiveness
• Irritability
• Lack of coordination
• Paint stains on body and/or clothing
• Runny nose
• Slurred speech

Treatment for Inhalant Abuse

Treatment experts say that because of the damage that neurotoxic chemicals do to the brain, chronic inhalant abusers should be considered as having a dual diagnosis of chemical dependency and mental illness. While many of the techniques and approaches used in typical alcohol and drug treatment may apply, other more specific issues also need to be addressed by the treatment professionals.

The first requirement, if inhalant abuse is suspected, is a complete medical exam. The physician seeks to determine if there is any damage to the central nervous system, kidney or liver abnormalities, lead poisoning, the possibility of cardiac arrhythmia or pulmonary (lungs) distress, and any nutritional deficiencies.

Long-term inhalant abusers will most likely require a longer term of detoxification – getting the chemicals out of the body. This is because the chemicals stay in the fatty tissues of the body longer. Detoxification time may be weeks, instead of days for the casual inhalant abuser.

Neurological or neuropsychological testing should be considered early in the treatment process. Testing should be repeated in several months in order to assess improvement. Anecdotal evidence points to dramatic improvement in cognitive functioning over the course of treatment.

Therapeutic intervention with the family helps by educating parents and siblings provides tools and bonding skills. Assessment of any other alcohol or substance abuse present in the family is also recommended.

Counseling for the inhalant abuser is critical in order to help the individual break the patterns of substance abuse, learn coping skills, and develop better communication skills. Often inhalant use is a group activity. This will necessitate the patient finding new friends who do not abuse inhalants.

Length of treatment time varies, but for chronic, long-term inhalant abusers, it far exceeds the typical “28-day” treatment program and may extend for many weeks and months. That is because inhalants remain in the body for extended periods of time. In addition, intensive aftercare and follow-up are essential in order to build up the patient’s life skills, and to help re-integrate the individual back into the family, school and community.

Recommendations for treatment include individual and group counseling, regular medical checkups to detect relapses, maintenance and evaluation of records on a regular basis, and involvement of the families in the treatment process.
Specific intake and assessment considerations include:

• Determining the extent, duration, range and context of the inhalant products abused
• Medical screening
• Neurological tests
• Behavioral/emotional patterns
• Cognitive history/testing
• Evaluation of other drug use
• Possession/access to the inhalant products abused
• Family history
• Peer group

When Parents Should Be Concerned

Education about the hazards of inhalant abuse, types of inhalants, taking precautions to safeguard inhalants, and having candid and frequent discussions with your children about inhalants can go a long way toward helping to keep your family safe.
Parents should be concerned if they see any of the warning signs previously listed, or empty containers of those products in closets, under the bed, or about the bedroom – which may signal the presence of inhalant abuse. Seek medical attention for obvious signs of physical and mental distress, and consult with your physician about the advisability or necessity of treatment to combat inhalant abuse.

For more information on inhalants, or to obtain referrals to treatment programs in your community, contact SAMHSA’s Health Information Network at 1-877-SAMHSA-7 (1-877-726-4727), available in English and Spanish. TTY number is 1-800-487-4889.
When in doubt, seek help – immediately. It’s better to be safe than sorry.

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