Aerosol abuse

Organic solvents inhaled by abusers include gasoline, glue, aerosols, amyl nitrite, butyl nitrite, typewriter correction fluid, lighter fluid, cleaning fluids, paint products, nail polish remover, waxes, and varnishes. Chemicals in these products include nitrous oxide, toluene, benzene, methanol, methylene chloride, acetone, methyl ethyl ketone, methyl butyl ketone, trichloroethylene, and trichloroethane. 

Although deaths from exposure to CFCs have occurred during refrigeration repair, its use as solvents, and its use and abuse as aerosol propellant (Aviado 1994), no data specific to HFCs were located. 

Inhaled substances may be associated with practices and equipment that may lead to suffocation. Commonly abused inhalants include model glue, spray paints, cleaning fluids, gasoline, liquid typewriter correction fluid, and aerosol propellants for deodorants or hair sprays. Most inhalants produce a rapid high that resembles alcohol intoxication. If sufficient amounts are inhaled, nearly all solvents and gases produce a loss of sensation, and even unconsciousness. Adverse effects may include severe organ damage. 

N20 is used as an aerosol propellant in cans of whipped cream and some other food and beverage products. These products are also a source of N20 for some nitrous abusers. 

Four types of inhalants are abused (1) anesthetic gases (2) industrial solvents, including a variety of hydrocarbons, such as toluene (3) aerosol propellants, such as various fluorocarbons and (4) organic nitrites, such as amyl or butyl nitrite. The mode of action of the inhalant anesthetics has been discussed in Chapter 25 General Anesthetics. 

A wide variety of chemical products that give off fumes are inhaled for their psychoactive effects. Many inhalants are chemicals that are found in household products, such as cleaning solvents and aerosols. Since the chemicals are cheap and easily available, this kind of drug abuse is popular with some kids as young as seven, many of whom are not aware that even one use can be deadly. 

Refrigerants and aerosol propellants have been gases of abuse. Inhalation of high-concentration halogenated hydrocarbons causes euphoric effects and later... 

Much of the information about the harmful effects of organic solvents comes from studies of industrial exposure, although toluene abuse through sniffing of glues and other household sources of solvents (acrylic paints, adhesive cements, aerosol paints, lacquer thinners, shoe polish, typewriter correction fluids, varnishes, and fuels) has also been widely reported. 

The term glue-sniffing derives from the abuse of adhesives which often contain solvents such as toluene, ethyl acetate, acetone, or ethyl methyl ketone. These, and similar compounds, also occur in a diverse range of other commercial products which may be abused, e.g. shoe-cleaners, nail varnish, dry-cleaning fluids, bottled fuel gases (butane and propane), aerosol propellents, and fire extinguishers (bromochlorodifluoromethane). 

Only two poisons in this group require routine exclusion. These are cyanide and carbon monoxide. The main exceptions to diis general recommendation are cases arising from an incident on industrial premises, or the use and abuse of compressed solvent fuels and aerosols. In the former case, a list of the industrial gases used or available on site should be requested in die latter case, most of the relevant compounds are covered by head-space gas chromatography as mentioned above. 

Figure 3.1 Common household products, such as the ones pictured here, can be abused as inhalants. These products, including aerosol room deodorizers, cleansers, lighter fluid, correction fluid, and nail polish, emit vapors that, when inhaled, can intoxicate an individual. 

Aerosols comprise compounds such as spray paints, hair sprays, pain-relieving sprays, deodorants, fabric-protector sprays, vegetable frying-pan lubricants, and hundreds of other everyday chemicals that are found in homes or are readily available commercially. Products that create an aerosol use propellants to keep tiny particles suspended in the air. For the most part these propellants, not the liquid product, are the chemicals abused. Virtually any aerosol product can be abused. 

Trichloroethylene and 1,1,1-trichloroethane are used in correction fluids, dry-cleaning products, degreasing sprays, and solvents and spot removers. Bromochlorodifluoro-methane is a compound found in halon fire extinguishers that is abused. Freon is used for refrigeration and air conditioning systems. Anesthetics include halothane, chloroform, and the local anesthetic ethyl chloride. Methylene chloride is a component of rubber cement, paint strippers, and degreasing agents, and fluorocarbons are present in many types of aerosol sprays. 

Sudden sniffing deaths are responsible for more than half of the deaths due to inhalant abuse. This has been compared to a form of Russian roulette by Harvey Weiss, director of the National Inhalant Prevention Coalition, in which a user may die the first time they sniff, or the tenth time, or the hundredth time. If a sniffer has used inhalants before without consequence, that does not mean she does not have a chance of experiencing a cardiac arrhythmia. Sudden sniffing deaths are mostly associated with aerosols, butane, toluene, and propane. 

Volatile solvent abuse or glue sniffing, is common among teenagers, especially males. The success of the modem chemical industry provides easy access to these substances as adhesives, dry cleaners, air fresheners, deodorants, aerosols and other products. Various techniques of administration are employed viscous products may be inhaled from a plastic bag, liquids from a handkerchief or plastic bottle. The immediate euphoriant and excitatory effects are replaced by confusion, hallucinations and delusions as the dose is increased. Chronic abusers, notably of toluene, develop peripheral neuropathy, cerebellar disease and dementia damage to the kidney, liver, heart and limgs also occurs with solvents. Over 50% of deaths from the practice follow cardiac arrhythmia, probably caused by sensitisation of the myocardium to catecholamines and by vagal inhibition... 

Under 16 years volatile inhalants, e.g. solvents of glues, aerosol sprays, vaporised (by heat) paints, solvent or substance abuse, gluesniffing. ... 

Abuse of volatile substances (lighter fuel, aerosols, glue) is often more common amongst schoolchildren than amphetamines and ecstasy, and is increasing in some countries. 

A form of substance abuse of increasing interest is the recreational use of inhalants. Taken literally, this classification is useless, as it may be construed to include use of tobacco, crack cocaine, or marijuana (Sharp 1992). A better designation may be "volatile substance" abuse, a more accurate description of an important drug abuse pattern. Volatile substances that are commonly abused include glues, aerosols, anesthetics, cleaning agents, and solvents (Sharp 1992). Abuse of inhalants has been associated with a variety of toxicologies... 

Xiong L, Matthes JD, LiJ, et al MR imaging of spray heads toluene abuse via aerosol paint inhalation. AJNR Am J Neuroradiol 14 1195-1199,1993 Yamanouchi N, Okada S, Kodama K, et al White matter changes caused by chronic solvent abuse. AJNR Am J Neuroradiol 16 1643-1649, 1995 Zvosec DL, Smith SW, McCutcheon JR, et al Adverse events, including death, associated with the use of 1,4-butanediol. New Engl J Med 344 87-94, 2001... 

Industrial solvents Solvents and a wide range of volatile compounds are present in commercial products such as gasoline, paint thinners, aerosol propellants, glues, rubber cements, and shoe polish. Because of their ready availability, these substances are most frequently abused by children in early adolescence. Active ingredients that have been identified include benzene, hexane, methylethylketone, toluene, and trichloroethylene. Many of these are toxic to the Uver, kidneys, lungs, bone marrow, and peripheral nerves and cause brain damage in animals. 

Hallucinogens are drugs that alter perception and feeling. These include LSD, mescaline, psilocybin, and PCP. Inhalants are aerosols and volatile hydrocarbons such as airplane glue and paint thinner that give the drug abuser a buzz or feeling of euphoria. 

Rgure 3 Analysis of a whole blood specimen (200 pi) from a patient who died after abusing an aerosol designed for cleaning electrical components that contained FCs 11, 12, and 113. GC conditions as for Figure 1. Injection 150pi headspace. Detector... 

The major use of nitrous oxide is for anesthesia and analgesia. It is also used for cryosurgery. Nitrous oxide also finds use as an oxidizing gas for chemical (sodium azide) manufacturing, semiconductor manufacturing, atomic absorption spectrophotometry, and as a fuel oxidant for racing vehicles. Some product for this latter application is supplied with an additive to deter abuse of the product. Nitrous oxide is also used as a propellant for pressure or aerosol products (whipped cream is most prevalent). 

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