Licit and illicit drugs
Jason Payne-James, Richard Jones in Simpson's Forensic Medicine, 2019
Solvents such as toluene volatize at room temperature, allowing users to inhale the fumes, a practice referred to as ‘huffing’. Use of these agents and others such as glue, or gas fuel for cigarette lighters is much less common now than previously. Glue-sniffing was more frequent in the 1980s but still occurs. Clinical examination may reveal traces of the inhalant, such as glue, around an individual's mouth and face, with the persistent odour of the relevant inhalant. Some individuals may have evidence of singeing of beard or hair, or evidence of old burn injury to the face, as many of the agents used for such practices are highly flammable and do not associate well with lighted cigarettes. Toluene, as opposed to the solvents found in hair spray, dry-cleaning fluid and gasoline, is the agent most often responsible for fatal intoxication. The mechanism seems to be the disruption of normal cardiac electrical activity. Inhalation of any solvent will result in transient euphoria, headache and ataxia. Members of this group selectively destroy brain white matter, and a distinctive pattern can be identified in the MRI scans of chronic abusers. Solvents share some properties with other depressants such as barbiturates, benzodiazepines and even alcohol. However, the solvents, as a group, interact with so many different receptor subtypes that their actual mechanism of action remains unclear.
Other Asphyxial Deaths
Sudhir K. Gupta in Forensic Pathology of Asphyxial Deaths, 2022
Infants dying due to accidental suffocation because of heavy bedding is common. Infants can also turn over while asleep, resulting in accidental smothering. This is one of the causes of sudden infant death syndrome (SIDS), and smothering comes under category 2 of the San Diego definition of SIDS. Overlaying by an intoxicated mother can also cause smothering in infants. Children playing with plastic bags are more prone to accidental suffocation. Sometimes, a plastic sheet might adhere to the mouth and the nose due to electrostatic forces, causing accidental smothering. Adults can also get accidentally smothered while involved in acts of bondage, which can also be considered as autoerotic asphyxiation. Adults involved in inhalant abuse such as glue sniffing can also get accidentally smothered. Other than in the above-mentioned scenarios and in some other rare circumstances, adults commonly are not victims of smothering unless otherwise inebriated or suffering from diseases like epilepsy. Elderly people are more prone to homicidal smothering along with infants and children. Hands, pillows, adhesive tapes, plastic sheets/bags, wet toilet papers, glue, coal dust, sand, mud, grains, etc. are the various means that can be used to cause smothering.
Hydrocarbons*
Bev-Lorraine True, Robert H. Dreisbach in Dreisbach’s HANDBOOK of POISONING, 2001
These compounds are commonly used as solvents in rubber and plastic cement. Toluene is the usual ingredient in the cement used for glue sniffing. In experimental animals the toxicities of benzene, toluene, and the three xylenes are similar either by injection or by inhalation, and the lethal quantity ranges from 2 to 5 g/kg; benzene is the most toxic. The toxic level of benzene in humans is around 0.2 g/kg, and for toluene and xylene it is 0.5–1 g/kg. In practice, the low vapor pressure of xylene reduces the inhalation hazard from this substance. In large amounts these compounds depress the central nervous system; repeated exposure to small amounts of benzene or toluene depresses the bone marrow.
Characteristics and circumstances of volatile solvent misuse-related death in Australia, 2000–2021
Published in Clinical Toxicology, 2023
Shane Darke, Emma Zahra, Johan Duflou, Amy Peacock, Michael Farrell, Julia Lappin
Volatile solvent misuse is a frequently observed form of substance use, with a recognised diagnosis of Inhalant Use Disorder [1]. The term covers the inhalation of substances that vaporise at room temperature for the purpose of intoxication or sexual experience enhancement [1,2]. While there is a wide range of such solvents, they may be broadly categorised as gas fuels (e.g., cigarette lighter cannisters, gas bottles), gasoline (petrol), aerosol propellants (e.g., air fresheners, deodorant spray), solvents from adhesives and paints (e.g., glue, spray paints), volatile anaesthetics (e.g., nitrous oxide), and nitrites (e.g., amyl nitrite) [2]. These solvents have industrial and domestic uses independent of their psychotropic properties. They may be inhaled directly from gas cannisters, from plastic bags or balloons in which a volatile solvent has been inserted, and from cans into which volatiles such as gasoline have been poured. In the case of nitrous oxide, two-gram cannisters used in whipped cream dispensers are frequently inhaled [3,4]. Recently, there has been concern about the increasing availability of large cannisters (e.g., 1–3 kilograms) of nitrous oxide, and the concomitant increased risk involved [4].
Multi-Organ System Injury from Inhalant Abuse
Published in Prehospital Emergency Care, 2019
H. Evan Dingle, Saralyn R. Williams
Commonly abused volatile hydrocarbons are divided into several categories based on their chemical structure. Examples of aliphatic (straight chain) hydrocarbons include propane, butane, and gasoline. These may be found in bottled fuel and cigarette lighter fluid. The alkyl halides, which contain fluorinated or chlorinated hydrocarbons, are often used as propellants in aerosol cans, but are also found in refrigerants (Freon), paint strippers, and the dry cleaning industry. DFE is an example of this class of hydrocarbons. The aromatic (cyclic) hydrocarbons, such as toluene and benzene, are found in paint thinners, glues, paint sprays, varnishes, and other adhesives. Some less commonly abused hydrocarbons include nitrites, which may be found in air fresheners, as well as ethers and ketones, which are common in nail polish remover, adhesives, and paint (4). The presence of the aforementioned substances at the scene may suggest inhalant abuse.
Inhalant misuse reported to America’s Poison Centers, 2001–2021
Published in Clinical Toxicology, 2023
Raymond L. Hogge, Henry A. Spiller, Sandhya Kistamgari, Marcel J. Casavant, Natalie Rine, Nichole L. Michaels, Motao Zhu, Gary A. Smith
Most inhalant misuse reported to US poison centers involved males or a single substance, and approximately 40% involved teenagers, which is consistent with previous studies [8–10,13–15]. The low cost and easy availability of inhalants may facilitate their misuse among teenagers [4,7,16]. Additionally, the highly lipophilic nature of these compounds enables them to induce a euphoric effect that resolves within several hours, thereby allowing the misuse to occur undetected by parents and educators [4,7,14,16]. Inhalant misuse can disrupt mechanisms of energy balance to cause a reduction in body weight and height, with the peak period of inhalant misuse overlapping with the adolescent growth spurt [17–19]. Inhalant misuse is associated with problems related to mental health, relationships with others, involvement with law enforcement, and use of other drugs, although these observed associations are complex [4,7,13,15,19].
Related Knowledge Centers
- Acetone
- Amyl Nitrite
- Butane
- Cannabis
- Nitrous Oxide
- Substance Intoxication
- Toluene
- Volatilisation
- Poppers
- Impact Glue