Use of inhalants tends to be higher among 8th-graders than 10th- or 12th-graders. Among 8th-graders, inhalants are the fourth most widely abused substances, behind alcohol, cigarettes, and marijuana.

Use of inhalants tends to be higher among 8th-graders than 10th- or 12th-graders. Among 8th-graders, inhalants are the fourth most widely abused substances, behind alcohol, cigarettes, and marijuana.

In 1996, more than one in five 8th-graders (21.2 percent) had used inhalants, which include glues, aerosols, and solvents, at least once in their lives. Annual and current use among 8th-graders was 12.2 percent and 5.8 percent, respectively. There was no statistically significant change in lifetime or annual use of inhalants by 8th-, 10th-, or 12th-graders between 1995 and 1996.

About 17 percent of adolescents in this country say that they have sniffed inhalants-usually volatile solvents such as spray paint, glue, or cigarette lighter fluid-at least once in their lives, according to NIDA's 1993 Monitoring the Future study, a national survey of 8th-, 10th-, and 12th-grade students. In fact, results from a number of surveys suggest that among children under 18, the level of use of inhalants is comparable to that of stimulants and is exceeded only by the level of use of marijuana, alcohol, and cigarettes.

Inhalant abuse, however, is a stepchild in the war on drugs. The abuse of inhalants, which includes a broad array of cheap and easily obtainable household products (see table), is not viewed in the same high-risk category as drugs such as alcohol, cocaine, and heroin. Some people tend to view inhalant "sniffing," "snorting," "bagging" (fumes inhaled from a plastic bag), or "huffing" (inhalant-soaked rag in the mouth) as a kind of childish fad to be equated with youthful experiments with cigarettes.

But inhalant abuse is deadly serious. Sniffing volatile solvents, which includes most inhalants, can cause severe damage to the brain and nervous system. By starving the body of oxygen or forcing the heart to beat more rapidly and erratically, inhalants can kill sniffers, most of whom are adolescents.

Survey data on the prevalence of inhalant abuse is difficult to obtain for a number of reasons, and information that does exist may under-emphasize the severity of the situation. No one knows how many adolescents and young people die each year from inhalant abuse, in part because medical examiners often attribute deaths from inhalant abuse to suffocation, suicide, or accidents. What's more, no national system exists for gathering data on the extent of inhalant-related injuries. Although medical journals have described the situation as serious, some researchers warn that doctors and emergency medical personnel are not adequately trained to recognize and report symptoms of inhalant abuse.

A Glossary of Terms

Bolt, Bullet, Climax, Locker Room, Rush. Street names for butyl nitrite, which is packaged in small bottles. Poppers and Snappers. Street names for ampules of amyl nitrite. Whippets. Balloons or plastic bags filled with nitrous oxide. Sniffing, Snorting. Terms for inhaling substances. Sudden Sniffing Deaths. Death, usually due to heart failure, within minutes of using an inhalant. Texas Shoe Shine. Spray paint containing toluene. Torch or Fire Breathing. Igniting exhaled volatile gas, such as propane or butane.

Types of Inhalants

Inhalants can be broken down into three major categories-volatile solvents, nitrites, and anesthetics. Volatile solvents are either gases, such as butane gas fumes, or liquids, such as gasoline or paint thinner, that vaporize at room temperature. Since the 1950s, the number of common products that contain volatile solvents has increased significantly. Besides gasoline and paint thinner, products with volatile solvents include spray paint, paint and wax removers, hair spray, odorants, air fresheners, cigarette lighter fuels, analgesic sprays, and propellant gases used in aerosols such as whipped cream dispensers.

Volatile solvents produce a quick form of intoxication-excitation followed by drowsiness, disinhibition, staggering, lightheartedness, and agitation. Because many inhalant products contain more than one volatile solvent, it is difficult to clearly identify in humans the specific chemical responsible for subsequent brain or nerve damage or death.

Some volatile solvents are inhaled by abusers because of the effects produced not by the product's primary ingredient but by propellant gases, like those used in aerosols such as hair spray or spray paint. Other volatile solvents found in aerosol products such as gold and silver spray paint are sniffed not because of the effects from propellant gases but because of the psychoactive effects caused by the specific solvents necessary to suspend these metallic paints in the spray. Nitrites historically have been used by certain groups, largely gay men, to enhance sexual experience and pleasure. Often called "poppers' or "rush," some nitrite products are sold as room odorizers. But use of nitrites has fallen off dramatically in recent years. This may be partly because products containing butyl, propyl, and certain other nitrites were banned in 1991, although products using chemical variants of the banned substances are still sold.

For the past 13 years, NIDA's Monitoring the Future survey has adjusted for the underreporting of nitrite use, recognizing that many survey respondents did not include information about nitrite use when answering survey questions about inhalant abuse. That's because most respondents fail to consider the use of nitrites as a form of inhalant abuse, unless prompted with specific questions mentioning "poppers, rush," or other nitrite-specific references, researchers say.

Some observers now believe that adjusting inhalant abuse survey results to combine nitrite use with volatile solvent use can lead to mistaken conclusions when viewing consolidated data over several years. That's because nitrite use is declining while volatile solvent use has been on the rise for a number of years. "In combining solvents with nitrites and then adjusting the data, it appears that inhalant use has not changed over the past 16 years when, in fact, solvent use has steadily increased for a decade and a half and just now may be leveling off," says Dr. Fred Beauvais, a psychologist at the Tri-Ethnic Center for Prevention Research at Colorado State University at Fort Collins.

Because the current inhalant profile lumping nitrites with volatile solvents leads to misleading data and inferences, many researchers believe that a scientific description of inhalant abuse should distinguish abuse of volatile substances from abuse of nitrites and perhaps anesthetics.

Within the other major category of inhalants, the anesthetics, the principal substance of abuse is nitrous oxide. A colorless, sweet-tasting gas used by doctors and dentists for general anesthesia, nitrous oxide is called "laughing gas" because it often induces a state of giggling and laughter. Recent anecdotal reports indicate that nitrous oxide is being sold illicitly to teenagers and young adults at outdoor events such as rock concerts and on the street. Nitrous oxide often is sold in large balloons from which the gas is released and inhaled for its mind-altering effects.

But nitrous oxide is no laughing matter. Inhaling the gas may deplete the body of oxygen and can result in death; prolonged use can result in peripheral nerve damage.

Inhalants and Their
Chemical Contents

Volatile Solvents

Adhesives

Airplane Glue Rubber Cement Polyvinylchloride (PVC) Cement

Aerosols

Spray Paint Hair Spray Deodorant, Air Freshener

Solvents and Gases

Nail Polish Remover Paint Remover Paint Thinner Typing Correction Fluid and Thinner Fuel Gas Cigarette Lighter Fluid Gasoline

Cleaning Agents

Dry Cleaning Fluid Spot Remover Degreaser

Dessert Topping Sprays

Whipped Cream, Whippets


Nitrites and Anesthetics

Nitrite Room Odorizers

"Poppers" and "Rush"

Anesthetics

Gas Liquid Local


Inhalant abuse is deadly serious. By starving the body of oxygen or forcing the heart to beat more rapidly and erratically, inhalants can kill sniffers, most of whom are adolescents.