Flashcards in Inhalant abuse Deck (21):
What is inhalant abuse?
Deliberate inhalation of a volatile substance to achieve an altered mental state
What percentage of Canadians 15yo reported lifetime use of inhalants in 2004?
1.3 +/- 0.3%
Which groups are more at risk for inhalant abuse?
1. School dropouts
2. Physical or Sexual abuse victims
8. Reduced family support
9. Deviant family environments
10. Poor school performance
11. Poor self-esteem
13. Psychiatric conditions
14. Other substance abuse
What are the most commonly abused inhalant substances?
Air fresheners 6%
What are the majority of inhalant-related deaths from?
Air fresheners 26%
What are examples of aliphatic, aromatic, and halogenated hydrocarbons?
Examples: Hair spray, air fresheners, deodorants
Fuels including cigarette lighters
Paint/polish removers, paint thinners, felt-tip markers, correction fluids, glues and rubber cements
Varnishes, lacquers,resins, lacquer thinners
Dry cleaning fluids, spot removers, degreasers
Computer/electronics cleaning sprays
Vegetable oil cooking sprays
Chemicals: Butane, propane, fluorocarbons
Gasoline, propane, benzene, butane
Trichloroethane, trichloroethylene, toluene, hexane, acetone, methylene chloride, ethyl acetate
Trichloroethane, tetrachloroethylene, xylene
Dimethyl ether, hydrofluorocarbons, hydrocarbons
Diethyl ether, halothane, enflurane, ethyl chloride
Other terms: Medusa, moon gas, poor man’s pot,
air blast, discorama, hippie crack,
chroming, gladding, whiteout
What are examples of nitrous oxide?
Whipping cream aerosols, balloon tanks, anesthetics
Other terms: Lauging gas, shoot the breeze, whippets,
What are examples of volatile alkyl nitrites?
Examples: Angina medications, ‘room odourizers’, videocassette recorder head cleaners, synthesized products
Chemicals: Amyl nitrities, butyl nitrites, cyclohexyl nitrite, isopropyl nitrite, other nitrites
Other terms: Medusa, moon gas, pearls, boppers,
snappers, poppers, amys, bolt, quicksilver, rush, climax, aroma of men, hardware, locker room, thrust
What is sniffing or snorting?
Direct inhalation of fumes
What is bagging?
Direct inhalation of fumes from a plastic or paper bag
What is huffing?
Direct inhalation of fumes from a rag or cloth soaked in the substance held over the mouth or nose
What is glading?
Direct inhalation of fumes from air freshener aerosols
What is dusting?
Direct spraying of aerosol cleaners into the mouth or nose
What are the immediate effects?
5. General depression including slurred speech, disturbed gait, dizziness, disorientation, drowsiness, sleep
7. Freezing and burning of face and upper aerodigestive tract
8. Respiratory arrest due to CNS depression
9. Fatal vagal depression from cooling of the larynx
10. "Sudden sniffing death syndrome" likely due primarily cardiac arrhythmia
11. Dangerous behavior
12. Aspiration and suffocation
13. Volatile alkyl nitrites vasodilatory effects i.e. hypotension, syncope, sensations of warmth and flushing
14. "Poppers" sphincter relaxation effect and penile engorgement in young men for anal sex with links to increased HIV transmission
What are the long term effects of inhalant abuse?
1. Irreversible damage of myelin and neuronal membranes by lipophilic chemicals
2. Brainstem dysfunction and a variety of motor, cognitive and sensory deficits --> irritability, tremor, ataxia, nystagmus, slurred speech, decreased visual acuity, deafness
3. Cardiomyopathy with distinct ECG changes
5. Emphysema-like abnormalities
6. Other pulmonary debilitations
7. Distal renal tubular acidosis
9. Bone marrow toxicity (i.e. aplastic anemia, leukemia) from hydrocarbons
10. Volatile nitrites --> immune impairment, replication of HIV and Kaposi's sarcoma, carcinogenic nitrosamine and methemoglobin as metabolites
11. Menstrual disorders
13. Spontaneous abortions
14. Teratogenic effects "fetal solvent syndrome"
15. Neonatal withdrawal: high-pitched cry, disturbed feeding and sleep
16. Poor school performance
17. Criminal behaviors
18. Abuse of other substances
19. Social maladjustment
20. Low self esteem
What signs of inhalation abuse are seen on presentation?
1. Odour on the breath
2. Stains, paint, glitter and/or odour on skin or clothing
3. Perioral dryness or pyodermas
4. "Huffer's rash"
5. Facial, oral/nasal or esophagopharyngeal freezing or burning w/ secondary edema of lips, oropharynx, trachea
6. Confusion, moodiness, irritability
7. Wheezing, emphysema, dyspnea
8. Poor hygiene
9. Weight loss
13. Muscle weakness
16. Poor appetite
What is the CRAFFT Screening Tool?
C --> Have you ever ridden in a Car driven by someone (including yourself) who was “high” or had been using alcohol or drugs?
R --> Do you ever use alcohol or drugs to Relax, feel better about yourself, or fit in?
A --> Do you ever use alcohol or drugs while you are by yourself or, Alone?
F --> Do you ever Forget things you did while using alcohol or drugs?
F --> Do your Family members or Friends ever tell you that you should cut down on your drinking or drug use?
T --> Have you ever gotten into Trouble while you were using alcohol or drugs?
HCP should make themselves aware of the following key points regarding inhalant abuse:
1. epidemiology and trends;
2. its signs and symptoms, effects and dangers, and the treatment of acute cases;
3. screening techniques; and
4. the availability of local resources for prevention, intervention and treatment.
What should HCP educate children, youth, schools, teachers, media and policy-makers about regarding inhalant abuse?
1. types and examples of abused chemicals;
2. signs and dangers of inhalant abuse;
3. intervention and treatment: what to do if someone suspects another is abusing;
4. combating misconception: advise that even casual substance abuse is dangerous.
What are recommendations regarding HCP?
1. play a guiding role in creating a network of health and community care for inhalant abusers;
2. guide policy regarding inhalant abuse prevention education and treatment;
3. ensure that the social determinants of health affecting inhalant abuse are understood and considered in policy;
4. advocate for the replacement of dangerous and psychoactive substances in common products with less harmful alternatives;
5. advocate for and contribute to research that increases our understanding of inhalant abuse – including epidemiology, and effective prevention and treatment strategies that address the social determinants of health – particularly in Aboriginal peoples, with research that is specific to First Nations, Métis and Inuit populations.