SOLVENTS

SOLVENTS

If there were ever a drug category to "just say no" to, this is it. This cate­gory of chemicals is literally a wastebasket of anything that anyone can get in vapor form and then inhale. It consists of all sorts of industrial chemicals, such as toluene, benzene, methanol, chloroform, Freon and other coolants, paints, glues, and gases. We take the position that these compounds are so toxic to both the first-time user and the long-term user that they should never be used under any circumstances. However, we all know that people do inhale these chemicals, and so in the para‑ graphs that follow, we will describe a few of the more common agents and talk about their toxicity.

WHAT THEY ARE AND HOW THEY WORK

These compounds have only two characteristics in common (other than their toxicity). First, they form gases that can be inhaled. Second, they produce more or less the same feelings that alcohol and anesthetics do.

Solvent abusers usually inhale these chemicals through crude methods, generally called "huffing." They soak rags with the chemicals and breathe through the rags, or put the chemicals in a can or cup and breathe the fumes. As with inhalational anesthetics, once the user begins to inhale, the blood levels peak in a few minutes and most of the agents are absorbed by body fat. As blood levels rise, there is dizziness, disorientation, perhaps an initial period of stimulation followed by depression, and a sense of being light­headed. Some users describe changes in their perception of objects or time and/or have delusions or hallucinations involving any of the senses. Mus­cular incoordination occurs as levels increase, along with ringing in the ears (tinnitus), double vision, abdominal pain, and flushing of the skin. These are followed by the standard symptoms associated with chemical depression of the central nervous system: vomiting, loss of reflexes, cardiac and circulation problems, suppression of respiration, and (possibly) death.

The most dangerous effect of inhalant use is "sudden sniffing death," which occurs during the abuse of coolants and propellants (like Freon), and fuel gases (like butane and propane), which probably induce abnor­mal heart rhythms. Death may occur because the chemicals depress the excitability of the heart cells that set the beating pattern, while at the same time increasing the sensitivity of these and other heart cells to the stimu­lant epinephrine (adrenaline).

We do not know exactly how these compounds produce their mental effects. However, based on the physical effects, we can assume that they work in the same manner as anesthetics.

TOXICITY

There is such a large number of diverse compounds that it is impossible to

list all of the toxic effects of every one of them. Also, long-term inhalant users almost always use other drugs, so it is difficult to sort out which toxic effect belongs to which drug or which combination of drugs. But there is one common thread that runs through all of these compounds. Many users are injured not from direct toxic effects of these agents but from trauma related to their use. Disorientation and loss of muscular coordination make accidents more likely, and because many of these chemicals are flammable, serious burns occur. In one well-respected study, 26 percent of deaths associated with inhalant use were from

accidents.

Also, people commit suicide under the influence of inhalants. In the same research study, 28 percent of the deaths associated with inhalant use were from suicide. Did the inhalants cause depression and suicide, or did the suicide-prone individuals use inhalants to relieve their pain? Both are probably true, as is the case with so many other drugs.

First-time users can and do die. In a British study of 1,000 deaths from inhalant use, about one-fifth of the deaths were to first-time users. The deaths were from a variety of causes, but each was associated with inhal­ant use. This is a remarkable statistic, and it should make anyone wary of

ever trying these chemicals.

If a person lives long enough to be classified as a chronic inhalant user, what are the long-term effects? Many research studies have been pub­lished on this subject, but almost all of them involve case studies of people that were referred with specific medical problems. Mere are no broad studies covering large numbers of inhalant users without reported medi­cal problems. So we don't know from a statistical perspective what the long-term toxic risk is. However, the medical studies of individuals who do report problems are sobering. One neurological study of abusers referred for medical treatment showed that thirteen out of twenty people (65 percent) studied had central nervous system damage as revealed by clinical examination and neurological imaging. Another study showed damage in 55 percent of a different group of people.

One of the best-studied chemicals is toluene. It is a common industrial solvent and a component of glues. In one study of chronic abusers, eleven out of twenty-four patients had damage to the part of the brain called the cerebellum. This area of the brain is well known for controlling fine, del­icate muscle movements, and new studies suggest that it might also play a part in learning. Whether cerebellar impairment clears when the abuse stops has not been determined. Some studies suggest that the cells in this area die. Other brain areas, including the visual and other nerve path INHALANTS 165 ways, are affected as well, but we caution that complete and controlled human studies are impossible to do.

Tests of intellectual function show that abusers have problems with memory, attention, and concentration. Like the physical studies, these studies also considered small numbers of patients who were ill, so we have to be careful in the interpretation of these results. However, there is no question that some people get very sick and suffer substantial central ner­vous system damage from the chronic use of inhalants.

Other body functions also suffer. The combined list of compounds and the body functions they impair is huge, and it gets larger every day as research shows new effects of these chemicals. It is enough to say that long-term usage of inhalants can damage the heart, lungs, kidneys, liver, blood, and many other areas, in addition to the nervous system. These chemicals are truly not for human consumption.