Background information

What are volatile substances?

Volatile substances are chemicals that give off fumes at room temperature [1][2][3]. They are also called 'inhalants' because they are breathed (inhaled) through the mouth and nose. Volatile substance use (VSU) refers to intentionally inhaling ('sniffing', 'huffing', 'bagging' or 'chroming') these substances for the purpose of getting intoxicated (being under the influence) [4].

Volatile substances are a type of psychoactive drug. Psychoactive drugs are drugs taken for pleasure that act on the brain to alter the way we think, feel, or act. Intoxication through the use of volatile substances reduces the ability of the central nervous system (the brain and spinal cord) to function. The effects of a volatile substance are felt quickly after inhaling because the large surface area of the lungs allows the blood to quickly transport it to the brain [5]. This causes the level of the drug in the blood to be at its highest point within minutes of use.

There are around 250 products used in the house or for medical or industrial reasons that contain potentially intoxicating volatile substances [1]. Many of these are easily available and not expensive.

What types of volatile substances are there?

There are four groups of volatile substances [6]:

• solvents - liquids or semi-liquids, for example [4][6]:
  • correction fluid and thinner
  • dry-cleaning fluid
  • modelling glue
  • nail polish remover
  • petrol
  • paint thinner and paint remover
  • rubber cement
  • sealant
  • glue
  • felt-tip marker

• aerosols - sprays containing propellants and solvents, for example [4][6]:
  • deodorant
  • hairspray
  • vegetable oil spray
  • spray paint (the use of spray paint as a volatile substance is referred to as 'chroming')

• gases - medical anaesthetics and fuel gases, for example [4][6]:
  • fuel gas
  • lighter fluid
  • refrigerant
  • nitrous oxide (found in whipped cream dispensers)

• nitrites - unlike the other three groups of inhalants, this group does not affect the central nervous system [6]. Nitrites dilate the blood vessels (make the blood vessels bigger) and relax the muscles. People mostly use nitrates to increase sexual pleasure rather than for intoxication. Examples of products in this group include:
  • video head cleaner
  • room deodoriser
  • leather cleaner.

How are volatile substances inhaled?

All volatile substances are inhaled [6]. There are several different ways to inhale, including:

• sniffing or snorting fumes from a container
• spraying aerosol directly into the nose or mouth
• inhaling fumes that have been sprayed or put in a plastic/paper bag (known as 'bagging')
• holding a cloth that has been soaked in a volatile substance over their mouth and nose while breathing (known as 'huffing')
• inhaling from balloons that have been filled with nitrous oxide.

Who uses volatile substances?

Volatile substances are most commonly used by: [1][4]:

• young people experimenting with VSU, but who do not continue to use it
• disadvantaged young people who repeatedly use volatile substances
• young people in some remote Indigenous communities where petrol sniffing is common
• disadvantaged adults who may use volatile substances when they do not have access to alcohol (opportunistic use).

Why do people use volatile substances?

Volatile substances are used by people for many different reasons, including [7][8][9]:

• to relieve boredom
• to block hunger pains
• to cope with emotional distress
• for the exciting effects of intoxication
• to establish the reputation of being a 'rebel'
•  to display power.

What are the physical effects of volatile substance use?

The effects of VSU are experienced within a few minutes and only last for a short time, usually less than an hour [3]. In some cases, volatile substance use can cause serious long-term effects, even death.

Many of the harmful physical effects from VSU are reversible, especially for people who do not use volatile substances often [3][4]. The damage caused by VSU is cumulative: the more a person uses volatile substances, the most likely it is that they will have permanent brain injury [1], but not all experts agree how much damage is caused by VSU [1][3].

There are short-term and long-term physical effects of VSU [1][3][6]:

Short-term physical effects	Long-term physical effects
a feeling of wellbeing feeling tired headache blurred vision slurred speech nausea and vomiting being more likely to take risks agitation and aggression confusion hallucinations loss of coordination stomach pain abnormal heartbeat loss of consciousness death	red, watery eyes nosebleeds having no energy indigestion dizziness frequent cough shortness of breath ringing in the ears temporary chest pain stomach ulcers chronic headache inflammation of the area around the nose attention, memory and problem solving issues depression loss of hearing and sight lack of coordination of muscle movements seizures and epilepsy (fitting) weak bones damage to the heart, lungs, liver and kidneys brain damage Parkinson's disease some cancers

Sudden sniffing death

Some inhalants can cause 'sudden sniffing death' which is death from cardiac arrest (when the heart stops beating) [1][10]. Certain inhalants contain gases that make the myocardium (muscle tissue of the heart) sensitise to adrenaline (a hormone involved the body's reaction to stress). In this state, a sudden surge of adrenaline (for example, from a frightening hallucination or intense physical activity) can cause an irregular heartbeat that can be fatal. Sudden sniffing death can happen after a single use and is associated with inhaling butane, propane, and the chemicals found in aerosols [6].

Asphyxiation

People who inhale petrol can die as a result of asphyxiation (dying because they cannot breathe). The oxygen in the lungs is displaced by the inhaled petrol gases which can stop the user from breathing [1][11]. Inhaling petrol from a bag or in a restricted space (such as under a blanket) increases the risk of death from asphyxiation. The risk of death from asphyxiation also applies to Opal fuel [12]. Spraying volatile substances directly into the mouth may also cause asphyxiation because the cooling agents in the aerosol propellant freeze the larynx (voice box) [13].

Brain function problems

VSU is related to a variety of problems with brain functioning, including [14][15][16][17]:

• shorter attention span
• memory problems
• difficulties with problem solving
• dementia
• Parkinson's disease.

The severity of problems can range from mild impairment to severe issues like dementia and Parkinson's disease [14][15][16][17]. Brain functioning problems from VSU seem to be cumulative: the more a person uses volatile substances, the worse the brain injury. Evidence suggests that it is possible to recover from VSU, but only if the person stops before any major damage has been done [18][19][20][21].

Volatile substances during pregnancy

If volatile substances are used by pregnant women, the chemicals may affect their unborn babies [22]. Problems associated with VSU during pregnancy include:

• miscarriage (loss of the baby early in pregnancy)
• low birthweight (if a baby is of low birthweight it is more likely to die and have a number of health problems)
• prematurity (birth that happens too early, when the baby is not fully developed)
• developmental delays (when a baby or child learns new things more slowly than other children of the same age)
• physical abnormalities
• behavioural issues later in life.

What are the social effects of volatile substance use?

VSU is associated with a variety of social harms that can affect the person who uses volatile substances, their families, their communities, and wider society [1]. While it is not possible to say that VSU causes social problems, VSU is associated with many social issues, including [1][4]:

• not attending school regularly and not doing well in school
• missed chances to learn cultural knowledge
• not being able to get a job
• alienation and isolation from family, friends, and community
• bad reputation in the community
• more likely to have trouble with the police
• more likely to be homeless
• damage to spirit
• fear of violence in the community (caused by volatile substance users)
• more antisocial behaviour (fighting, vandalism, etc).

References

1. d'Abbs P, Maclean S (2008) Volatile substance misuse: a review of interventions. Barton, ACT: Australian Government Department of Health and Ageing
2. MacLean S, D'abbs PH (2006) Will modifying inhalants reduce volatile substance misuse? A review. Drugs: Education, Prevention, and Policy; 13(5): 423-439
3. Parliament of Victoria, Drugs and Crime Prevention Committee (2002) Inquiry into the inhalation of volatile substances: final report. Melbourne: Drugs and Crime Prevention Committee
4. Consensus-based clinical practice guideline for the management of volatile substance use in Australia (2011) National Health and Medical Research Council
5. Wille SMR, Lambert WEE (2004) Volatile substance abuse—post-mortem diagnosis. Forensic Science International; 142(2-3): 135-156
6. National Institute on Drug Abuse (2005) Research report series – inhalant abuse. Maryland: National Institute on Drug Abuse
7. Carroll A, Houghton S, Odgers P (1998) Volatile solvent use among Western Australian adolescents. Adolescence; 33(132): 877–889
8. Cheverton J, Schrader T, Scrogings Z (2003) Sniffing around the valley: chroming in Brisbane’s inner-city. Brisbane: Brisbane Youth Service
9. Brady M (1992) Heavy metal: the social meaning of petrol sniffing in Australia. Canberra: Aboriginal Studies Press
10. Bass M (1970) Sudden sniffing death. Journal of the American Medical Association; 212(12): 2075-2079
11. National Institute on Drug Abuse (2010) NIDA InfoFacts: inhalants. Retrieved 2010 from http://drugabuse.gov/infofacts/inhalants.html
12. Cavanagh G (2008) Inquest into the death of Kenny Malthouse. Hermannsburg, NT: Coroner's Court, Northern Territory
13. Chalmers E (1991) Volatile substance abuse. Medical Journal of Australia; 154(Feb 18): 269-274
14. National Inhalant Abuse Taskforce (2005) National Directions on Inhalant Abuse: consultation paper. Melbourne: National Inhalant Abuse Taskforce
15. Hageman G, van der Hoek J, van Hout M, van der Laan G, Steur EJ, de Bruin W, Herholz K (1999) Parkinsonism, pyramidal signs, polyneuropathy, and cognitive decline after long-term occupational solvent exposure. Journal of Neurology, Neurosurgery and Psychiatry; 246(3): 198-206
16. Pezzoli G, Canesi M, Antonini A, Righini A, Perbellini L, Barichella M, Mariani CB, Tenconi F, Tesei S, Zecchinelli A, Leenders KL (2000) Hydrocarbon exposure and Parkinson’s disease. Neurology; 55(5): 667-673
17. Ramón MF, Ballesteros S, Martinez‐Arrieta R, Jorrecilla JM, Cabrera J (2003) Volatile substance and other drug abuse inhalation in Spain. Clinical Toxicology; 41(7): 931–936
18. Cairney S, Maruff P, Burns CB, Currie J, Currie B (2004) Neurological and cognitive impairment associated with leaded gasoline encephalopathy. Drug and Alcohol Dependence; 73(2): 183-188
19. Cairney S, Maruff P, Burns CB, Currie J, Currie BJ (2004) Saccade dysfunction associated with chronic petrol sniffing and lead encephalopathy. Journal of Neurology, Neurosurgery and Psychiatry; 75(3): 472-476
20. Cairney S, Maruff P, Burns CB, Currie J, Currie BJ (2005) Neurological and cognitive recovery following abstinence from petrol sniffing. Neuropsychopharmacology; 30(5): 1019-1027
21. Rosenberg NL, Sharp CW (1997) Solvent toxicity: a neurological focus. Substance Use & Misuse; 32(12-13): 1859-1864
22. Jones H, BalsterR (1998) Inhalant abuse in pregnancy. Obstetrics & Gynecology Clinics of North America; 25: 153-167

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