Vidyya Medical News Servicesm
Vidyya, from the Sanskrit "vaidya," a practitioner who has come to understand the science of life.
|Volume 1||Published - 14:00 UTC 08:00 EST 16-September-2000|
Next Update - 14:00 UTC 08:00 EST 17-September-2000
Gender differences in inhalant abuse have been identified at different points in childhood. One study indicates inhalant abuse is higher for boys than girls in grades 4 through 6, occurs at similar rates in grades 7 through 9-when overall use is highest-and becomes more prevalent again among boys in grades 10 through 12. The National Household Survey on Drug Abuse (NHSDA), an annual survey of drug use among the Nation's noninstitutionalized civilians, reports that similar percentages of 12- to 17-year-old boys and girls abused inhalants in 1998. However, the percentage of 18- to 25-year-old males who abused inhalants was more than twice that of females in that age group, suggesting that sustained abuse of inhalants is more common among males.
People who abuse inhalants are found in both urban and rural settings. Research on factors contributing to inhalant abuse suggests that adverse socioeconomic conditions, rather than racial or cultural factors per se, may account for most reported racial and ethnic differences in rates of inhalant abuse. Poverty, a history of childhood abuse, poor grades, and dropping out of school all are associated with inhalant abuse. Native American youths who live on reservations, where socioeconomic distress and school dropout rates are high, typically have higher rates of inhalant abuse than both the general population of young people and those Native American youths who do not live on reservations.
What is the
|How can inhalant abuse be recognized?|
Despite the declines in abuse among schoolchildren in recent years, inhalants are still being abused at higher rates than they were a decade ago, according to the NHSDA. The 1998 survey indicates that the rate of first use among 12- to 17-year-olds rose significantly from 8.4 to 18.8 per 1,000 potential new users from 1989 to 1995 and remained at those levels through 1997. The rate of first use of inhalants for young adults aged 18 to 25 also rose, from 3.7 to 10.7 per 1,000 potential new users between 1989 and 1996, before leveling off in 1997.
MTF's lifetime prevalence figures also indicate that the percentages of students who have tried inhalants remain at high levels. In 1999, 19.7 percent of 8th-graders, 17.0 percent of 10th-graders, and 15. 4 percent of 12th-graders said they had abused inhalants at least once in their lives. These data raise a question: How can fewer 12th-graders than 8th-graders consistently report they have ever abused inhalants? Possibly, many 12th-graders fail to recall their much earlier use of inhalants or, more troubling, many 8th-grade inhalant abusers may have dropped out of school by the 12th grade and are no longer included in the survey population. The latter explanation is supported by research that shows higher rates of inhalant abuse among children who have poor grades or have dropped out of school than among their classmates who remain in good standing in school.
Inhalants can be breathed in through the nose or the mouth in a variety of ways, such as:
Inhaled chemicals are rapidly absorbed through the lungs into the bloodstream and quickly distributed to the brain and other organs. Within minutes of inhalation, the user experiences intoxication along with other effects similar to those produced by alcohol. Alcohol-like effects may include slurred speech, an inability to coordinate movements, euphoria, and dizziness. In addition, users may experience lightheadedness, hallucinations, and delusions, such as thinking they can fly.
Because intoxication lasts only a few minutes, abusers frequently seek to prolong the high by continuing to inhale repeatedly over the course of several hours, a very dangerous practice. With successive inhalations, abusers can suffer loss of consciousness and death. At the least, they will feel less inhibited and less in control. After heavy use of inhalants, abusers may feel drowsy for several hours and experience a lingering headache.
|Brain damage in a toluene abuser|
Many brain systems may be involved in the anesthetic, intoxicating, and reinforcing effects of different inhalants. Nearly all abused inhalants (other than nitrites) produce a pleasurable effect by depressing the CNS. Evidence from animal studies suggests that a number of commonly abused volatile solvents and anesthetic gases have neurobehavioral effects and mechanisms of action similar to those produced by CNS depressants, which include alcohol and medications such as sedatives and anesthetics.
A recent study indicates that toluene, a solvent found in many commonly abused inhalants including airplane glue, paint sprays, and paint and nail polish removers, activates the brain's dopamine system. The dopamine system has been shown to play a role in the rewarding effects of many drugs of abuse. Nitrites, in contrast, dilate and relax blood vessels rather than acting as anesthetic agents.
The chemicals found in solvents, aerosol sprays, and gases can produce a variety of additional effects during or shortly after use. These effects are related to inhalant intoxication and may include belligerence, apathy, impaired judgment, and impaired functioning in work or social situations. Dizziness, drowsiness, slurred speech, lethargy, depressed reflexes, general muscle weakness, and stupor are other possible effects. For example, research shows that toluene can produce headache, euphoria, giddy feelings, and inability to coordinate movements. Exposure to high doses can cause confusion and delirium. Nausea and vomiting are other common side effects.
Inhaled nitrites dilate blood vessels, increase heart rate, and produce a sensation of heat and excitement that can last for several minutes. Other effects can include flush, dizziness, and headache. Unlike other inhalants, which are abused mainly for their intoxicating effects, nitrites are abused primarily because they are believed to enhance sexual pleasure and performance.
A strong need to continue using inhalants has been reported among many individuals, particularly those who abuse inhalants for prolonged periods over many days. Compulsive use and a mild withdrawal syndrome can occur with long-term inhalant abuse. Additional symptoms exhibited by long-term inhalant abusers include weight loss, muscle weakness, disorientation, inattentiveness, lack of coordination, irritability, and depression.
Inhalant abusers risk an array of devastating medical consequences. Prolonged sniffing of the highly concentrated chemicals in solvents or aerosol sprays can induce irregular and rapid heart rhythms and lead to heart failure and death within minutes of a session of prolonged sniffing. This syndrome, known as "sudden sniffing death," can result from a single session of inhalant use by an otherwise healthy young person. Sudden sniffing death is particularly associated with the abuse of butane, propane, and chemicals in aerosols. Inhalant abuse also can cause death by:
Animal and human research shows that most inhalants are extremely toxic. Perhaps the most significant toxic effect of chronic exposure to inhalants is widespread and long-lasting damage to the brain and other parts of the nervous system. For example, both animal research and human pathological studies indicate that chronic abuse of volatile solvents such as toluene damages the protective sheath around certain nerve fibers in the brain and peripheral nervous system. This extensive destruction of nerve fibers is clinically similar to that seen with neurological diseases such as multiple sclerosis.
The neurotoxic effects of prolonged inhalant abuse include neurological syndromes that reflect damage to parts of the brain involved in controlling cognition, movement, vision, and hearing. Cognitive abnormalities can range from mild impairment to severe dementia. Other effects can include difficulty coordinating movement, spasticity, and loss of feeling, hearing, and vision.
Inhalants also are highly toxic to other organs. Chronic exposure can produce significant damage to the heart, lungs, liver, and kidneys. Although some inhalant-induced damage to the nervous and other organ systems may be at least partially reversible when inhalant abuse is stopped, many syndromes caused by repeated or prolonged abuse are irreversible.
Abuse of inhalants during pregnancy also may place infants and children at increased risk of developmental harm. Animal studies designed to simulate human patterns of inhalant abuse suggest that prenatal exposure to toluene or trichlorethylene (TCE) can result in reduced birth weights, occasional skeletal abnormalities, and delayed neurobehavioral development. A number of case reports note abnormalities in newborns of mothers who chronically abuse solvents, and there is evidence of subsequent developmental impairment in some of these children. However, no well-controlled, prospective study of the effects of prenatal exposure to inhalants in humans has been conducted, and it is not possible to link prenatal exposure to a specific chemical to a specific birth defect or developmental problem.
|Hazards of chemicals found in commonly abused inhalants|
Nitrites are abused mainly by older adolescents and adults. Typically, individuals who abuse nitrites are seeking to enhance sexual function and pleasure. Research shows that abuse of these drugs in this context is associated with unsafe sexual practices that greatly increase the risk of contracting and spreading such infectious diseases as HIV/AIDS and hepatitis.
Recent animal research raises the possibility that there may be a link between abuse of nitrite inhalants and the development and progression of infectious diseases and tumors. The research indicates that inhaling nitrites depletes many cells in the immune system and impairs immune system mechanisms that fight infectious diseases. A recent study found that even a relatively small number of exposures to butyl nitrite can produce dramatic increases in tumor incidence and growth rates in animals.
Fact sheets on the health effects of inhalants and other abused drugs and other drug abuse topics can be ordered free of charge, in English and Spanish, from NIDA Infofax at 1-888-NIH-NIDA (1-888-644-6432) or, for deaf persons, 1-888-TTY-NIDA (1-888-889-6432).
Anesthetic: An agent that causes loss of sensation.
Central nervous system: The brain and spinal cord.
Dementia: A condition of deteriorated mentality.
Dopamine: A neurotransmitter present in regions of the brain that regulate movement, emotion, motivation, and feeling of pleasure.
Epidemiology: The sum of the factors controlling the presence or absence of a disease or condition.
Toxic: Causing temporary or permanent effects that are detrimental to the functioning of a body organ or group of organs.
Withdrawal: A variety of symptoms that occur after use of an addictive drug is reduced or stopped.
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