A paint huffer’s prison photo. Thesmokinggun .

1. A paint huffer’s prison photo. Thesmokinggun.

2. INHALANTS

3. Overview • Inhalants, including Anesthetics • Description of inhalants, including anesthetics that are abused. • Physiological factors associated with abusing these substances. • Psychological factors associated with abusing these substances. • Cultural issues associated with abusing these substances.

4. What are inhalants, including anesthetics? “Inhalants…comprises a wide variety of substances: • Volatile liquids that give off fumes, • Gases that come in pressurized tanks or bottles, • and aerosol cans that are sprayed.” • “….are used for their stupefying, intoxicating, and occasionally psychedelic effects.” • “…are inhaled through the nose and/or mouth and occasionally sprayed directly in the mouth or nose” (p. 306) Inaba, D., & Cohen, W. (2007). Uppers, downers, all arounders (6th ed.). Medford, OR: CNS Publications.

5. What are inhalants, including anesthetics? • “There are three main groups of inhalants and dozens of subgroups…. • Volatile solvents (and aerosols). Most of these substances are synthesized from petrochemical and combined with other chemicals…. • Volatile nitrates. These drugs…are used clinically as blood vessel dilators….and…’room fresheners.’ • Anesthetics. These were developed to block pain or induce unconsciousness during surgical or other medical procedures” (p. 306). Inaba, D., & Cohen, W. (2007). Uppers, downers, all arounders (6th ed.). Medford, OR: CNS Publications. Ummm….room fresheners… NOT!

6. Inhalants, including Anesthetics – Volatile Solvents & Aerosols Volatile Solvents & Aerosols Gasoline and gasoline additives Airplane glue Rubber cement and other glues PVC cement Paint sprays (especially gold and silver metallic paints) Hairsprays and deodorants Lighter fluid Fuel gas Dry-cleaning fluid, spot removers, correction fluid, degreasers Nail polish remover Paint remover/thinners Analgesic/asthma sprays Air dusters (End Dust,® Dust Off®) Air Conditioning Coolant (Freon) Chemicals Gasoline and high-octane fuel additives Toluene, ethyl acetate Toluene, hexane, methyl chloride, acetone, methyl ethyl ketone, methyl butyl ketone Trichlorethylene, tetrachlorethylene Toluene, butane, propane, fluorocarbons Butane, propane, chlorofluorocarbons (CFC’) Butane, isopropane Butane, isopropane Tetrachlorethylene, trichloroethane, trichloroethylene, xylene, petroleum distillates, chlorohydrocarbons Acetone, toluene, ethyl acetate Toluene, methylene chloride, methanol, acetone, ethyl acetate, esters Chlorohydrofluorocarbons Difluorethene, propane, isobutane, tetrafluoroethene Freon

7. Inhalants, including Anesthetics – Volatile Nitrates & Anesthetics Volatile Nitrites 1) “Aliphatic” or “Alkyl” Nitrates (aka “Room Fresheners,” “video/tape head cleaner,” “sneaker cleaner,” or “poppers”) i.e. - Locker Room,® Rush,® Bolt,® Climax,® 2) Amyl Nitrates - Heart medication (aka “poppers” or “snappers”) – prescription inhalant Anesthetics Nitrous oxide - Whipped cream propellant (aka “whippets,” laughing gas, or “blue nun”) Chloroform Ether Halothane, enflurane (liquid) Local anesthetic Chemicals (Iso)anyl nitrite, (iso)butyl nitrite, isopropyl nitrite, cyclohexyl nitrite Amylnitrate Nitrous oxide Chloroform Ether Bromochlorotrifluoro ethane, chloro trifluoro ether Ethyl chloride

8. Physiological effects associated with abusing inhalants, including anesthetics • Pathophysiology • Inhalants are highly lipid soluble. • Easily cross both alveolar membranes and the blood-brain barrier. • Exposure via the pulmonary route avoids first-pass hepatic metabolism. Onset of effect is seen in seconds. • Volatiles accumulate in the brain (as well as other fatty tissues in the body). • The mechanism of their effects is not entirely clear; the mechanism is "fluidization" or change in solubility of neuronal cell membranes. • The potency of these drugs related to their solubility in water. • Other actions proposed include specific molecular ion channels, whereby these chemicals would potentiate the effects of GABA on the GABA-A receptors.

9. Physiological effects associated with abusing inhalants, including anesthetics If inhalants are heated, dangerous amounts of pressure on lungs and tissue can freeze as substances vaporize

10. Physiological effects associated with abusing inhalants, including anesthetics

11. Physiological effects associated with abusing inhalants, including anesthetics Chronic Inhalant Abuse Continued, chronic inhalant abuse has been associated with neurological
damage. • People who abuse inhalants chronically have demonstrated a range of mental dysfunction, from mild cognitive impairment (e.g., lack of
concentration or attention, poor memory, and poor learning skills) to
severe. • In some instances these effects are permanent while in others they resolve after a long period of abstinence. • Personality disorders, particularly antisocial personality, violent behavior, and depression, have been associated with inhalant abuse.

12. Physiological effects associated with abusing inhalants, including anesthetics

13. Physiological effects associated with abusing inhalants, including anesthetics

14. Physiological effects associated with abusing inhalants, including anesthetics

15. Physiological effects associated with abusing inhalants, including anesthetics Common dangers of inhalants: • The debilitating and potentially lethal effects can occur even with first use. • Sudden sniffing death syndrome is usually caused by the irregular heart rate induced by inhalants; other cardiac effects are hypertension, tachycardia, and bradycardia. • Other significant effects include command seizures. • Brain damage can be a consequence of chronic use. • Additional dangers: • suffocation (e.g., from bagging) • fire-related injuries from inhalant combustion (especially if the inhalant is heated or a cigarette is lit in a closed area where the inhalant is being abused) • accidents related to impaired judgment, lack of motor skills, or high-risk behavior.

16. Physiological effects associated with abusing inhalants, including anesthetics

17. Psychological effects associated with abusing inhalants, including anesthetics

18. Cultural issues associated with abusing inhalants, including anesthetics Why are inhalants popular?
Most inhalants are readily available, inexpensive or free, and usually legal to purchase and possess. • The high is achieved within seconds and the effect dissipates within a half of an hour. • Products are easy to conceal and are useful everyday products (e.g., permanent markers, correction fluid) found in homes, offices, and schools, it is difficult to prevent access to them. • And, because abusable products are so common, many youth do not perceive them as harmful and do not understand the consequences of using them.