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Inhalant Overdose Symptoms and Finding Addiction Treatment Options
Many of the commonly abused inhalants are products available in the home or otherwise easily obtained that are inhaled for a rapid and short-lived high.
Inhalants fall into several categories, including:
Though the precise effects vary, many of the inhalants act quickly to affect the user in ways that often resemble acute alcohol intoxication, such as:
- Impaired coordination.
- Slurred speech.
Inhalant abuse creates many negative short-term effects and can contribute to long-term health problems. Inhalant misuse may even result in sudden death.
What Are Inhalants?
An inhalant is any substance capable of producing fumes or vapors that a person can breathe in to become intoxicated.1-5 The intoxication may resemble a euphoric high similar to the feeling of drunkenness.2,5 Although many drugs can be inhaled (e.g., via smoking or insufflated methods), the inhalants are a unique substance category because this is their primary or only route of administration.2,3
More than 1,000 different items can present a serious threat to the user when inhaled.
Inhalants carry a special risk compared to other drugs of abuse because a majority of them are simple, everyday products available in the home or place of business. A huge number of substances and products qualify as inhalants, as well. In fact, more than 1,000 different items can present a serious threat to the user when inhaled.5
While there are an overwhelming number of inhalants, they can be separated into 4 basic categories based on their effects and type:1-3
- Volatile solvents. The most common type of inhalants found in a wide variety of settings, volatile solvents start as liquids before they become gaseous at room temperature. Volatile solvents include:
- Paint thinner.
- Dry cleaning fluids.
- Nail polish remover.
- Contact cement.
- Correction fluids.
- Felt-tip markers.
- Aerosols. Often found in spray bottles and cans, aerosols contain both solvents and propellants. Aerosols include:
- Spray paint.
- Canned or compressed air (e.g., computer dusters).
- Hair and deodorant spray.
- Vegetable oil sprays.
- Fabric protector sprays.
- Gases. Excluding automobile gasoline, there are many forms of gases that can be found in many residential and business locations, as well as in the medical field where they are used as anesthetics. Gases include:
- Butane in lighters.
- Propane used to fuel gas grills.
- Whipped cream cans.
- Refrigerant gases.
- Nitrous oxide (laughing gas).
- Nitrites. Sometimes referred to as poppers, snappers, or rush, amyl nitrite was historically used in the management of chest pain. Unlike other classes of inhalants that are used to get high, some nitrites are abused to boost sexual experiences. Commonly abused nitrite substances include:
- Video head cleaner.
- Room deodorizer.
- Leather cleaner/shoeshine.
- Liquid aroma.
People abuse inhalants in several different ways, such as:1,3,6
- Sniffing. This involves opening a container of an inhalant and breathing in the fumes directly from the vessel.
- Spraying. If someone is abusing an aerosol, they may spray it directly into their mouth or nose.
- Bagging. This involving placing or spraying the inhalant into a paper or plastic bag and inhaling the contents.
- Huffing. This method involves soaking a rag or other piece of cloth in the inhalant before either holding it up the nose or placing it in the mouth.
- Balloons. By filling a balloon with the desired gas, the user will breathe in the substance directly from the balloon. This practice is common with nitrous oxide.
Other terms reflect the specific item being inhaled. Examples of this include:6
- Glading. Inhaling air freshener spray.
- Dusting. Inhaling aerosol containers filled with compressed air marketed for removing dust.
How Can I Tell if Someone’s Using Inhalants?
The signs of inhalant abuse may be more covert and subtle than with other drugs of abuse because these substances are mostly legal. Plus, only small amounts of inhalants are needed to produce a high.6 However, there are signs to look out for that include:1,6
- An abnormally large supply of items that can be used as inhalants or a large supply of empty containers.
- Having the strong smell of chemicals on clothes or the breath.
- Stains on clothes or skin, especially on the hands or face.
- Discarded or hidden rags that smell of chemicals.
- “Huffer’s rash” (a dryness or infection around the mouth or nose). The rash will appear yellow in those abusing nitrites.
- Freezing or burns on the face, nose, mouth, or esophagus.
- Swelling of the lips.
You may also notice signs of impairment in the user’s physical and mental health immediately after use (described below).
With so many types of inhalants and methods to abuse them, the short-term effects of inhalants vary greatly.3
Many people seek the desired short-term effects of inhalants that resemble alcohol intoxication and include:1,3,6
- An initial excited or elated feeling.
- Lack of inhibition.
- Numbness or reduced perception of pain.
The high quickly gives way to the unwanted short-term effects of inhalant use, including:1,3,6
- Slurred speech.
- Appetite loss.
- Poor judgment.
- Inability to pay attention.
- Visual hallucinations.
- Changes in blood pressure that cause blackouts.
How Dangerous Are Inhalants?
Inhalants might seem harmless because many of them are found around the house, but in fact, abusing them is extremely risky. As many as 200 people die due to inhalant complications every year.3
One main reason inhalants are so dangerous is the speed with which they affect the body. When a person breathes in an inhalant, the substance is quickly absorbed by the lungs into the bloodstream. Once in the blood, the drugs are carried to the brain and other major organs throughout the body.1 The effects begin within seconds of inhalation, but last for only a few minutes, which leads many to abuse the drug again right away.2,3 This style of “rapid-fire” use can heighten the effects of inhalants while significantly increasing the risks.1,2
The effects begin within seconds of inhalation, but last for only a few minutes, which leads many to abuse the drug again right away.
Once in the brain, most inhalants act as central nervous system (CNS) depressants, providing a pleasurable euphoric high.3 There is also evidence that many inhalants that have the solvent toluene in them trigger the activity of dopamine.3 Dopamine is an important neurotransmitter that influences movement, emotion, pleasure, and reward.3 Dopaminergic surges in the brain caused by continued inhalant use can pave the way to compulsive use and eventually addiction.3
Inhalant Addiction and Withdrawal
Signs of inhalant use disorder—or inhalant addiction—will include:
- Strong desires and cravings to continue using inhalants even when negative outcomes are likely.
- Unsuccessful attempts to end or decrease inhalant use.
- Problems satisfying responsibilities at home, work, or school.
- Spending more time and energy using inhalants and then recovering from intoxication.
- Social isolation, changing peer groups, or new conflict with loved ones regarding use.
Inhalant users may suffer uncomfortable inhalant withdrawal symptoms when they try to quit, especially if they have used high doses of inhalants over a long period of time.1 Symptoms include:4,6
- Low appetite.
- Sleep problems.
- Mood changes.
Although rare, some people withdrawing from inhalants will have symptoms that mirror those of sedative withdrawal, including:7
- Muscle cramps.
People using inhalants consistently for 3 months or more have a greater chance of developing withdrawal symptoms when use ends. The average duration of withdrawal symptoms is between 2 and 5 days.7
Ongoing use of inhalants allows chemicals consumed to accumulate in the body and brain, which may have an overwhelmingly negative impact on a person’s well-being.1,3
In the brain, inhalant abuse can cause:1
- Direct damage to nerve cells. Inhalant use can destroy the protective cover that surrounds nerves and limits the communication between them. When the nerve cells are damaged in this manner, people can suffer from muscle spasms, shaking, poor motor coordination, and speech problems.
- Anoxic injury to brain cells. Inhalants frequently cause a condition called hypoxia by preventing brain cells from accessing oxygen. When cells do not receive the needed oxygen, they become damaged, which can impair functioning based on the region of the brain injured.
Many of the long-term effects of inhalants are determined by the exact substance being abused.1
- Nitrites are known to:
- Lower the immune system.
- Damage the red blood cells’ ability to carry oxygen through the blood.
- Benzene (an aromatic hydrocarbon with a number of chemical derivatives) can:
- Lower the immune system.
- Cause reproductive problems.
- Destroy bone marrow.
- Increase the chances of cancer.
- Trichloroethylene found in spot removers can:
- Cause liver disease.
- Harm reproduction.
- Trigger hearing and vision loss.
Other long-term effects of inhalant abuse include:1,3
- Heart damage.
- Kidney damage.
- Muscle weakness.
- Chronic cognitive decline (impaired thinking).
- Damage to red blood cells, resulting in insufficient oxygen delivery to tissues.
- Nerve damage resulting in chronic pain.
- Birth defects and developmental problems in children of mothers that heavily abused inhalants during pregnancy.
With long periods of abstinence, it is possible for damage to be reversed to the brain or other organs. However, in some cases, the unwanted consequences of inhalant abuse are permanent.3
Is It Possible to Overdose?
Yes. A person can easily overdose on inhalants, even during their first use.3
Something that makes overdose possible is the fact that, in many cases, a single inhalant product typically contains a large number of chemicals.2
Symptoms of inhalant overdose include:4
- Extreme drowsiness and sedation.
Inhalants are deadly when they cause the user’s heart to beat irregularly and then stop suddenly only minutes after consumption. This certain type of overdose is called “sudden sniffing death” and may be more likely when the person is physically active in the moments following inhalation.2-4
Sudden sniffing death is not the only way that inhalant use can be fatal, however. Other deadly effects of inhalant use include:1,3
- Asphyxiation. Repetitively using inhalants rapidly fills the lungs with chemical vapors and leaves no space for oxygen, resulting in death from asphyxiation.
- Suffocation. Some users will place a plastic bag over their heads during inhalation. This act can lead to suffocation, as the bag prevents air from entering the lungs.
- Choking. Inhalant use may cause vomiting. Like with alcohol, this situation can lead to choking as the vomit is inhaled into the lungs.
- Deadly injuries. During inhalant intoxication, people suffer from both worsening coordination and poorer judgment. This combo can result in injuries, e.g., from falls and motor vehicle accidents.
- Convulsion and seizures. Inhalants can cause problematic electrical firing in the brain, leading to convulsions and seizures that may be deadly.
- Coma. An overwhelming level of inhalants in the body can trigger a major brain shutdown, with only the most necessary functions continuing.
No matter the individual, the situation, or the substance being used, inhalants present a great risk for short-term, long-term, and deadly effects. Because of this, any time a person inhales a substance, they put themselves in significant danger.
How Is Overdose Treated?
Treatment for overdose must happen quickly to avoid serious injury or death. Treatment will focus on:6
- Decontamination. The user may have contaminated their clothing or skin with inhalants, creating a possibility of continuous inadvertent exposure.
- Stabilizing cardiovascular issues. If the user is suffering from effects like low blood pressure or irregular heart rhythm, medical professionals can offer medications to help return normal functioning.
- Assessing organ damage. Even if the individual survives the immediate aftermath of the overdose, organ damage is possible, so medical personnel will screen kidney, liver, and heart status to determine treatment needs.
- Boosting comfort. Inhalant overdoses are dangerous, and they are uncomfortable as well. Once safety is established, staff will work to improve comfort and provide supportive care.
Teens and Inhalants
Inhalants are used by young teens because they are cheap, easily available, and more difficult for parents or other loved ones to detect.
With most substances of abuse, older adolescents and young adults consume drugs at rates higher than people in their early teens. Inhalant abuse is the rare exception to this rule, as younger people are more likely to use these substances than older people.1 For many, inhalants will be the first substance that they abuse.
Inhalants are used by young teens because they are cheap, easily available, and more difficult for parents or other loved ones to detect.1
According to the National Institute on Drug Abuse for Teens, in 2016:1
- 7% of 8th graders admitted abusing inhalants in their lifetime (1.8% in the prior month).
- 6% of 10th graders admitted abusing inhalants in their lifetime (1% in the prior month).
- 5% of 12th graders admitted abusing inhalants in their lifetime (0.8% in the prior month).
For comparison, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that only 0.2% of the total population 26 and over used inhalants in the last month.8
Among 8th graders, females are more likely to abuse inhalants than males.3 Additional characteristics of people more likely to abuse inhalants include:3
- Poor socioeconomic conditions/low income.
- A history of abuse as a child.
- Poor academic performance.
- Having dropped out of school.
Nitrites: A Unique Risk
As mentioned previously, inhalants represent a vast array of substances with one class separating itself from the rest: nitrites. Unlike the other types of inhalants, nitrites tend to be abused by a distinct subgroup of people interested in the drug’s sexual side effects.1-3
Effects of nitrites include:6
- Hypotension/ low blood pressure.
- Loss of consciousness.
- Sensations of being warm and flushed.
This class of drug dilates blood vessels in the body, which results in:6
- Sphincter relaxation.
- Penile engorgement.
Because of these effects, nitrites are most commonly used by a demographic slightly older than other inhalant users. Often, nitrites are used by gay men before and during sex to increase comfort and heighten pleasure.1,6 The specific risks associated with nitrite abuse include:1,6
- Increased transmission of infectious diseases. People abusing nitrites are less likely to practice safe sex, which can lead to HIV/AIDS and hepatitis being spread throughout the community of abusers.
- Impaired immune system. Nitrites can diminish the immune system, reducing the body’s ability to effectively fight disease.
- Increased cancer risk. Exposure to even limited amounts of nitrites like butyl nitrite can increase the risk of Kaposi’s sarcoma.
Getting Help for Addiction
Seeking professional treatment for any substance use disorder is a needed step to achieve and maintain a drug-free lifestyle. Getting help for people with inhalant addiction demands special care and consideration because inhalant abusers are often young.6
Effective treatment for inhalant use disorders will depend on the individual’s state, goals, strengths, and supports and will typically be a multistep process. Having a complete medical and psychological assessment by an addiction specialist will help ensure that the most appropriate level of care is offered.
Treatment may include:2,6,7,9,10
- Detoxification. Withdrawal symptoms are possible when someone ends inhalant abuse, and professional detoxification can assist during this time. During detox, the body is rid of harmful toxins. This can be done with or without medical assistance, but medical care helps to prevent or minimize any potential physical or mental health complications that arise during this period. Detox is usually a short-term and highly structured treatment. While it is an important facet of getting clean, detox is only the first step in treatment.
- Inpatient/residential treatment. These programs require the individual to live in the treatment center as they receive intensive care from staff that are available day and night. Inpatient/residential programs can be extremely beneficial for those suffering from severe addictions and whose home environment is triggering and/or lacking support.
- Outpatient treatment. Providing a somewhat less intense level of care, outpatient programs allow the person to live at home, work, and tend to other responsibilities while in treatment. The person will arrive at the treatment center, attend sessions, and return home. Outpatient programs vary, and include:
- Partial hospitalization programs (PHPs) – 5 or more weekly sessions lasting 4-6 hours.
- Intensive outpatient programs (IOPs) – at least 2 weekly sessions typically lasting 3 hours or more.
- Standard outpatient – regularly scheduled appointments at weekly, biweekly, or monthly intervals.
Regardless of the specific treatment environment, professional inhalant addiction treatment will likely use several behavioral therapies to establish and maintain recovery, such as:2
- Cognitive behavioral therapy (CBT) – to help people understand how their thoughts, feelings, and behaviors led to inhalant use and to teach strategies for identifying, avoiding, and managing triggering situations.
- Motivational incentives/ contingency management (CM) – to offer rewards, vouchers, and prizes for achievements related to inhalant abstinence.
Group therapy and support groups (e.g., 12-step programs like NA) provide opportunities for continued teaching and practice of tools learned during treatment.9 Group settings sometimes backfire in the case of adolescents, however, because adolescents can tend to reinforce the benefits of substance use with each other. The decision to enter this form of therapy should be considered carefully by the treatment team.10
Inhalant abuse can seem minor because many of the items are commonplace and the high typically doesn’t last long, but abuse of inhalants is perilous and can be fatal in an instant. Finding specialized, professional treatment can help stop inhalant abuse in its tracks—and potentially prevent any future substance abuse.
- National Institute on Drug Abuse for Teens. (2016). Inhalants.
- National Institute on Drug Abuse. (2017). DrugFacts: Inhalants..
- National Institute on Drug Abuse. (2012). Research Report Series: Inhalants.
- Department of Health & Human Services – Victoria, Australia. (2016). Inhalants.
- Drug Enforcement Administration. Drug Fact Sheet: Inhalants.
- Baydala, L. (2010). Inhalant abuse. Paediatrics & Child Health, 15(7), 443–448.
- Substance Abuse and Mental Health Services Administration. (2015). Detoxification and Substance Abuse Treatment.
- Substance Abuse and Mental Health Services Administration. (2015). Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health.
- National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide.
- National Institute on Drug Abuse. (2014). Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide..