April 19, 2010 -- Inhalant abuse of common household products such as gasoline, paint, or air freshener is on the decline but still a deadly problem for children and teens, according to a new study.
When inhaled, the products can be more deadly than cocaine, researchers say. The problem peaks at age 14, but children as young as 6 are inhaling, says study co-author Toby Litovitz, MD, executive and medical director of the National Capital Poison Center in Washington, D.C.
''Inhalants are dangerous," Litovitz says. “Abuse happens in young children, and it happens with products readily available in your household."
For the study, her team tracked inhalant abuse cases reported to 60 U.S. poison centers from 1993 to 2008. They found a 33% decline over those years, but still gathered data on more than 35,000 cases of inhalant abuse -- including 167 deaths -- reported during the study period. Most cases involved children and teens.
Of note, there is one product category -- propellants -- in which the rate of abuse has increased from 2004-2008. Computer dusters and fluorocarbons are included in this group.
The study appears in the journal Pediatrics.
Inhalant Abuse: The Problem
About 10% to 15% of U.S. teens are thought to have an inhalant abuse problem, Litovitz says. The products are inhaled in a number of ways: a rag soaked with the chemical is held up to the face ("huffing"), the chemical is sniffed directly from the container or a plastic bag ("sniffing"), or the substances are put in a paper bag and the vapors inhaled ("bagging").
The appeal to users? "They get a high, but the high is subtle," Litovitz says. "There is a slight stimulation effect, and a disassociation effect."
When the researchers looked at the 35,000-plus inhalant abuse cases handled by the poison control centers, they were surprised at how young some of the users were. "We saw cases down to 6-year-olds," Litovitz says.
Tracking Inhalant Abuse: A Closer Look
In all, 3,400 different inhalant abuse products were reported, with propellants, gasoline, and paint the most often involved.
Most deadly, however, were butane, propane, and air fresheners.
Other products on the poison centers' report list:
- Paint thinners
- Lighter fluid
- Carburetor cleaner
- Adhesives and glues
- Inks or markers
- Polishes and waxes
- Aerosol deodorants
The new study differs in a number of ways from ongoing national surveys that track substance use trends, Litovitz says. It doesn't depend on self-reporting, and the cases from the poison centers are categorized by severity, from "no effect resulting from the inhalant exposure" to "death."
Although national surveys have found inhalant abuse equally among girls and boys, the new study found otherwise. "In our data, almost three-quarters of the cases involved boys," Litovitz tells WebMD.
That could reflect the study's look not just at users but at the severity of the inhalant's effect, she says. "Boys may pursue riskier use behavior," she says. Gasoline was the No. 1 product inhaled by boys; for girls it was propellants, such as duster sprays for computer cleaning.
"People use what they are comfortable with, what's around in their environments," Litovitz says.
''Fatality rates were higher than we expected them to be," she says. Although 167 deaths from 35,000-plus reports may not sound high, Litovitz says the fatality rate for young people turns out to be higher than for drugs many parents tend to worry about.
The overall fatality rate for inhalants used in the study was 5.5 per 1,000 cases, she says. In comparison, the fatality rate per 1,000 cases for teenagers reported in other research is 2.2 for cocaine and 3.7 for methamphetamines, Litovitz says.
For the deadliest inhalants, the fatality rate is much higher, she says. For instance, the death rate for butane inhalation was 58 of every 1,000.
Inhalant Abuse: Other Views
Kevin Conway, PhD, deputy director of the division of epidemiology services and prevention research for the National Institute on Drug Abuse, calls the 35,000-plus reports analyzed by Litovitz "a lot of calls."
"Given how dangerous these chemicals are to inhale, it really speaks to the scope of the problem," he tells WebMD.
The new data, he says, will add valuable information to the data collected by the ongoing national surveys. "I think this paper speaks to the importance of parents being more aware of the problem."
Parents should also take note of the young age at which some start inhalant abuse, he says. ''Inhalants are used by kids who are younger than those who [typically] use drugs," he says.
"Parents and the public need to be more aware that inhalants are readily available," he says."They're in the garage; they are in the bathroom."
The finding of more boys than girls inhaling products is a surprise, says Harvey Weiss, founder and director of the National Inhalant Prevention Coalition in Chattanooga. Other research has found differences at different ages, with girls sometimes more likely to abuse inhalants and other times boys more likely.
In his talks to parents, he says, "One of the messages I try to get across is, 'Your daughter may be more likely to do this than your son,'" he says.
Still, he says, the new study is valuable and will hopefully make parents more aware. He suggests parents keep an eye on products such as computer dusters. If cans begin to be used up quickly, he says, "that can act as an early warning," he says. So can a sudden change in behavior, Litovitz says.