Inhalant Abuse: Growing Problem Often Starts With Very Young

From the WebMD Archives

Aug. 4, 2000 -- You don't think of them as drugs. Air freshener, cooking spray, oven cleaner, felt-tipped pens, nail polish remover, and aerosol whipped cream ... things found in virtually any home. To drug abuse officials, they are known as "inhalants." And growing numbers of children -- some as young as 4 years old -- know they can get high from sniffing them.

And they get high quickly. Ten or 15 seconds of sniffing produces a high that lasts a few minutes. If they keep inhaling, there's dizziness. Some pass out. Some actually die. It's called sudden death syndrome, and it can happen the first time -- or the hundredth time -- a child takes a hit.

"I call it Russian roulette," says Harvey Weiss, director of the National Inhalant Prevention Coalition. "You can die at any time from some of this stuff. That just doesn't happen with other drugs, not in the age group we're talking about." In fact, sudden death syndrome is responsible for more than half of all deaths due to inhalant abuse, according to the American Academy of Pediatrics (AAP).

Every kid who takes a hit gets some permanent brain damage. "Every time someone uses an inhalant, large amounts of toxic chemicals enter the lungs and pass from the bloodstream into the brain," says a fact sheet from the AAP. "[Inhalants] damage and kill brain cells. The amount of fumes a young person inhales greatly exceeds what is considered safe even in a workplace setting."

Over the 10 years he's been monitoring this problem, says Weiss, he's heard some sad stories. "You really see some very significant deterioration among chronic users. You see memory loss, [brain] damage. Some will just fall over while you're talking with them. A lot just become vegetables ... The number of young people doing inhalants far exceeds all the other substances you see mentioned in the newspapers. More kids are doing inhalants than are doing ecstasy. But nobody talks about inhalants."

Among users, inhalant use is known as "huffing," "bagging," "sniffing," and "wanging." The problem cuts across all racial and social boundaries, Weiss tells WebMD. But among parents and doctors, there is little understanding of it, he says. Many don't even know the problem exists.

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He hears from the upper- and middle-class white parents whose children have died. They say, "I talked to my child about alcohol, sex, marijuana, and cocaine, but I never thought my child would do anything like this," Weiss tells WebMD. "Or they take their child to see a pediatrician or family doctor, and the doctor tells them they don't think it's a problem. They just don't recognize inhalant abuse ... When they come to me, they're saying 'What do I do now?'"

In fact, "the whiter the population, the wealthier the population, the less understanding there is that this is a problem," says Weiss. "There's a vision of who does inhalants, and it's poor people, people of color, people with not much of education. There's denial that this goes on in upper- and middle-class families, when in fact it cuts across all socioeconomic levels."

What are your kids doing with this stuff? Sometimes they sniff or inhale it directly from the container. Or they may spray the stuff into a bag or an empty soft drink can and breathe it in. Or they may spray or pour the substance onto a cloth or piece of clothing and inhale deeply. And nitrous oxide can be inhaled straight from a balloon.

Among the household items used: cooking spray, typewriter correction fluid, disinfectants, fabric protectors, furniture polish, oven cleaners, spray deodorants, hair spray, nail polish remover, butane, gasoline, glues and adhesives, rust removers, and spray paints.

"They are cheap, easy to get, and easy to hide," says the AAP. "For a few dollars, a can of butane offers a quick high. Or a child can sit in class and secretly sniff correction fluid. Because inhalants are legal, kids can easily make excuses if they are caught with them. Another appeal ... is the social part of using them ... most inhalant abuse is thought to be done with friends."

How can you recognize inhalant abuse in your child? Short-term effects include headaches, nausea, vomiting, loss of balance, dizziness, slurred and slow speech, mood changes, and hallucinations. Over time, inhalants can cause more serious damage such as loss of concentration, short-term memory loss, hearing loss, muscle spasms, permanent brain damage, and even death.

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Other warning signs: Unusual chemical breath odors, watery eyes, dazed or dizzy appearance, paint on the face and fingers, red or runny nose, spots or sores around the mouth, loss of appetite, anxiety, excitability, and irritability

Death likely occurs when a child gets panicky while inhaling, Earl Siegel, PharmD, director of the Cincinnati Children's Hospital Drug and Poison Information Center, tells WebMD. "We think the people who die from inhalants are those who get very scared, who take off running, maybe have some kind of trauma." The excitement triggers the body to release adrenalin, which can cause the heart to beat irregularly, he explains. "They're then getting no oxygen to the brain. They die in minutes. Even if there is life support next door, they won't make it to the emergency room."

Kids who have asthma could be especially at risk, he says. "They panic because they are having trouble breathing," then their heart can begin beating irregularly. "That's a one-two punch," he adds.

According to the Texas Commission on Drugs and Alcohol, inhalant deaths can also occur from asphyxia -- solvent gases cause the person to stop breathing from lack of oxygen. Users can also choke to death from their own vomit or suffocate, more common in those who inhale from plastic bags. There's also a risk of suicide -- coming down from a high causes some to feel depressed.

Deaths from inhalant abuse are underreported, says Siegel, because "no one is closely looking for this problem. Also, there's a stigma associated with this kind of death. Because of that, families often cover it up."

"It's happening in the good schools, in all the schools," says Siegel. "There are some good statistics from the University of Michigan that close to 20% of 8th graders are abusing inhalants, putting their lives at risk. While teens from 12 to 14 years old are most likely to abuse inhalants, statistics also suggest that very young children, 7 and younger, are abusing the stuff.

Drug education programs that target 13- to 15-year-olds just aren't cutting it, Siegel tells WebMD. "That's too late. Parents need to be talking to kids at a very early age, 3 or 4."

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And when parents talk to young kids, call them "poisons," not drugs, advises Weiss. "Kids understand that. From an early age, they're talked to about poisons. 'Don't touch that, that's a poison.' Parents feel more comfortable talking to them about it that way. And kids get it."

He's seen the dramatic results that approach can have. From 1990 to 1994, Weiss conducted a statewide educational program in schools throughout Texas -- and saw inhalant abuse drop by 50% in grades K through six; in high schools, it went down about 20%. When that program lost its funding, the numbers did a quick turnaround. Kids went back to huffing, Weiss tells WebMD.

Also, parents and other authority figures should remember that they are role models. "People use helium at parties to talk like Donald Duck." Siegel tells WebMD. He says it may not cause sudden death but it is a bad example for kids.

While most inhalants come from homes, 37 states regulate the sale to minors of certain products that can be huffed. Massachusetts requires retailers to ask for ID on glue or rubber cement purchases and maintain a log of these sales for the police to view at any time. In 19 states, huffers can be fined or subject to jail time or mandatory treatment. Also, in some parts of Texas, laws require merchants to keep spray paints under lock and key.

"But kids can get spray paint at home, at school -- it's a ubiquitous product," Weiss says. "Laws are not the answer. The answer truly is education and prevention."

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