Chapter 81

Inhalant abuse is defined as the deliberate inhalation of vapors for the purpose of changing one's consciousness or becoming "high." It is also referred to as volatile substance abuse and was first described in 1951.32 Inhalants are appealing to adolescents because they are inexpensive, readily available, and sold legally. Initially, inhalant abuse was viewed as physically harmless, but reports of "sudden sniffing death" began to appear in the 1960s.9 Shortly thereafter, evidence surfaced of other significant morbidities, including organic brain syndromes, peripheral neuropathy, and withdrawal.

The demographics of inhalant abuse differ markedly from those of other traditional substances of abuse. The 2003 National Survey on Drug Use and Health found that more than 2.6 million youths between the ages of 12 and 17 years used inhalants at least once in their lifetime.122 Inhalants were the most frequently reported illicit xenobiotics used in the past year by 12- and 13-year-old adolescents, and youths aged 12 to 17 years continued to report higher rates of past-year use than did adults aged 18 years and older. The lifetime prevalence of inhalant use peaked among 8th graders at 15.6%. The median age of first use is 13 years.7 A worrisome trend reported by the 2007 Monitoring the Future Study is that perceived risk of even one-time use of an inhalant has fallen steadily since 2001.89

Although long considered to be a problem among boys, there has been a steady increase of inhalant abuse among girls, and their lifetime prevalence now equals that of boys.11 In the United States, the problem is greatest among children of lower socioeconomic groups, and non-Hispanic white adolescents are the most likely and black adolescents the least likely to use inhalants.85 Although inhalant use is a problem in both urban and rural communities, its prevalence is higher in rural settings.116 This may relate to the easier access that teens in urban areas have to other drugs of abuse.

Inhalant abuse includes the practices of sniffing, huffing, and bagging. Sniffing entails the inhalation of a volatile substance directly from a container, as occurs with airplane glue or rubber cement. Huffing involves pouring a volatile liquid onto fabric, such as a rag or sock, and placing it over the mouth and/or nose while inhaling and is the method used by more than 60% of volatile-substance abusers.85Bagging refers to instilling a solvent into a plastic or paper bag and rebreathing from the bag several times; spray paint is among the xenobiotics commonly used with this method. A newly reported form of abuse, "dusting," refers to the inhalation of compressed air cleaners containing halogenated hydrocarbons (eg, CRC Dust Off™), marketed for cleaning computers and electronics equipment. Reports of such exposures, including death and ventricular dysrhythmias, doubled in 2005 and tripled in 2006, yet dusting is not perceived to be harmful by users and, surprisingly, many users do not consider it a ...

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