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The effects of abused inhalants on mouse behavior in an elevated plus-maze.

Previous research has shown that abused inhalants (i.e., the volatile solvents) share some of the pharmacological properties of drugs used in the treatment of anxiety. In an attempt to further examine commonalities in the effects of inhalants and central nervous system depressant drugs, the behavioral effects of inhaled 1,1,1-trichloroethane, toluene, methoxyflurane and the convulsant vapor flurothyl were examined and compared to those of diazepam in the elevated plus-maze, a test used to predict antianxiety effects. After inhalant exposure or diazepam injection, mice were placed in the center of an elevated plus-maze and the number of entries and time spent in each type of arm (open versus closed) were measured during 5-min tests. Exposure to increasing concentrations of toluene produced concentration-related increases in the total number of open arm entries and the total time spent on the open arms, a pattern of behavioral effects similar to that produced by diazepam. A similar pattern was observed for increasing concentrations of 1,1,1-trichloroethane and methoxyflurane but changes in open arm activity were only observed at concentrations that increased locomotor activity. Conversely, only decreases in open arm time and number of entries were observed for flurothyl. The increasing evidence for commonalities in the behavioral effects of volatile solvents and depressant drugs may provide a foundation for understanding the neurobehavioral basis of inhalant abuse.

Administration, Inhalation↗

Childhood histories of attention-deficit hyperactivity disorders in Japanese methamphetamine and inhalant abusers: preliminary report.

The present study examined childhood histories of attention-deficit hyperactivity disorder (ADHD) in 54 methamphetamine and 12 inhalant abusers using the Wender Utah Rating Scale. The inhalant abusers experienced initial drinking at a younger age than methamphetamine abusers (P=0.038). The Wender Utah Rating Scale score was significantly higher in the inhalant abusers than in the methamphetamine abusers (P=0.013) although 83.3% of inhalant and 55.6% of methamphetamine abusers had higher scores than the cut-off for ADHD. These findings suggest that drug abuse is associated with childhood ADHD, and that inhalant abusers have a higher incidence of childhood ADHD than methamphetamine abusers.

Adolescent↗

EEG and autonomic responding to verbal, spatial and emotionally arousing tasks: differences among adults, adolescents and inhalant abusers.

The present study investigated the physiological responses of an adolescent inhalant abuse group, an adolescent non-abuse group, and an adult non-abuse group elicited by three types of tasks: verbal, spatial, and emotionally arousing. Each group consisted of 10 male Mexican-American subjects. Bilateral EEG and electrodermal activity, as well as heart rate, were monitored. While exploring for possible heart rate and hemispheric alpha wave differences in response to predominantly verbal and spatial tasks, an attempt was also made to discover if electrodermal responses could be bilaterally differentiated. Another purpose of the study was to explore possible psychophysiological differences between a younger and older group, and between an inhalant abusing group and a non-abuse group, in response to the three types of tasks. Results indicated that attempts to produce task-related EEG hemispheric asymmetry were largely nonsuccessful. Bilateral electrodermal responses were also not greatly differentiated. It was suggested that stronger task manipulations were needed. Significant group differences were found for initial physiological response levels (adults demonstrated higher levels than the two adolescent groups) and for heart rate response to the emotionally arousing task (non-abusing subjects demonstrated greater heart rate acceleration than inhalant abusing subjects). It was suggested that group differences in initial levels occurred due to the adult groups's greater involvement in the experimental situation. Heart rate differences to the emotionally arousing situation were discussed in terms of Zuckerman's sensation seeking hypothesis.

Adolescent↗

The psychiatrist and solvent-inhalant abuse: recognition, assessment, and treatment.

Solvent-inhalant abuse, existent for a century, has been gradually increasing in several sectors of our society over the last few decades. This form of substance abuse involves a variety of pharmacological agents as well as several target groups at risk. A key strategy for effective intervention is early recognition in clinical as well as other settings. Psychiatrists should appreciate the clinical manifestations of these substances because they often appear in psychiatric settings. Assessment and treatment of the solvent-inhalant abuser must take into account the special pharmacological, demographic, and ecological factors associated with this particular form of substance abuse.

Adult↗

Explosive burns during abusive inhalation of butane gas.

Explosion burns during abusive inhalation of butane gas rarely occurred in the past, but recently it has become a social problem among groups of teenagers. This cause constitutes 1.6% of admissions due to flame burn at the burn unit of Hallym Medical Center. A retrospective review during a five-year period identified 48 patients. The male to female ratio was 3:1. The mean age of patients was 16 years and 8 months. The places where the accidents occurred were commonly bedrooms or motel rooms. There were nine group settings of 27 patients at the time of the accident. Inhalation injury (n = 12) was noted on admission. The average burn size was 28.5 percent of the total body surface area. All patients sustained burn injury on the face, arms and hands and 24 patients among them had extended burn areas on the trunk and/or lower extremity. 22 patients (mean hospital stay; 51.6 d) required skin grafting and 12 patients (mean hospital stay; 22.3 d) were treated with conservative management. The mortality rate was 10.4 percent. Explosion burns during abusive inhalation of butane gas can result in mortality as well as major burn injuries.

Accidents↗

Inhalational abuse of methanol products: elevated methanol and formate levels without vision loss.

Inhalant abuse of methanol-containing products has increased over the last decade. We performed a prospective observational study of 7 subjects who presented to an ED after inhalant abuse of methanol-containing hydrocarbon products. Four patients had a methanol level greater than 24 mg/dL and 2 had an anion gap greater than 17 mEq/L. The mean formic acid level was 71 microg/mL, and 1 patient had a level considered high enough to induce retinal toxicity (>200 microg/mL). No patient had an abnormal ophthalmologic examination. All patients were treated with intravenous folate, 2 received alcohol dehydrogenase blockade, and no patient received hemodialysis or intravenous bicarbonate. All patients' acidosis resolved within 4 hours. The methanol and formic acid levels are lower than those reported after methanol ingestion. These preliminary data suggest that inhalant abusers of methanol products may have significantly elevated methanol and formic acid levels, but are at low risk for methanol induced complications of visual dysfunction and refractory acidosis.

Acidosis↗

Caregiver predictors of adolescent inhalant abuse in rural Appalachia.

OBJECTIVE: To explore caregiver correlates of adolescent inhalant abuse. METHODS: Youth were surveyed about inhalant use. Caregivers were surveyed about demographics, behaviors, family environment, perceptions of parent/ adolescent interaction, coping strategies, caregiver monitoring of youth and self-reported substance use. Multiple logistic regression with backward elimination was used. RESULT: Of the 218 dyads recruited, 94% of the youth inhalant and inhalant non-users were correctly classified using a model constructed from independent variables. CONCLUSION: We believe that parent-based educational training services should be studied that provide information about inhalant abuse and encourage open communication, adaptive coping, and adequate monitoring skills.

Adaptation, Psychological↗

Antioxidant enzymes and lipid peroxidation in adolescents with inhalant abuse.

Glue and thinner sniffing is a serious medical problem since the volatile constituents of these substances can lead to severe damage to bone marrow, liver, kidney, brain, and heart. The exact mechanisms responsible for tissue and organ damage in children with inhalant abuse have not yet been determined. In this study, we aimed to determine the levels of antioxidant enzymes and malondialdehyde in children with inhalant abuse. Erythrocyte and plasma glutathione peroxidase (GSH-Px) activities, erythrocyte superoxide dismutase (SOD) activity, and erythrocyte and plasma malondialdehyde (MDA) levels were measured as biological markers of oxidative damage and lipid peroxidation in 37 glue and thinner (inhalant) abusers. The levels were compared with those of the 27 well-matched healthy adolescents. Erythrocyte SOD activity and erythrocyte and plasma MDA levels were significantly higher, whereas erythrocyte and plasma GSH-Px activities were significantly lower in children with inhalant abuse when compared to controls (p<0.01). These findings imply that chronic inhalation of volatile substances can alter the levels of antioxidant enzymes including SOD and GSH-Px, and can increase lipid peroxidation in adolescent abusers.

Adolescent↗

A retrospective assessment of inhalant abuse in the barrio: implications for prevention.

An interview questionnaire was administered to a group of primarily Hispanic identified inhalant users (N = 40) and a comparison group of neighborhood youths (N = 17) in the barrio of Phoenix, Arizona. This retrospective assessment revealed that inhalant abusers had a history of multiple problems, stressors, and difficulty with school and the criminal justice system; initiated drug use between the ages of 10 and 15; confined their drug use primarily to marijuana, alcohol, and inhalants; and often came from families with drug problems. Inhalant abusers from drug-involved families experienced more poverty and family disruption, perceived their friends as being more favorable to the use of drugs and inhalants, and were less involved in conventional youth activities (e.g., sports, school, church, hobbies) than were inhalant abusers from drug-free families. The results are discussed in terms of developing preventative programs for this population.

Adolescent↗

Inhalant abuse and the abuse of other drugs.

AIMS: To examine the relationship between inhalant abuse and other substances of abuse. DESIGN: Survey using a structured interview administered by a single trained interviewer. SETTING: A juvenile detention facility. PARTICIPANTS: 209 children incarcerated at the facility over a 3-month period. SELECTION PROCEDURE: Consecutive sample. INTERVENTIONS: None. MEASUREMENTS/FINDINGS: The structured interview was adapted from the American Drug and Alcohol Survey, which has been extensively used to obtain substance abuse epidemiologic data. We collected information on inhalants, alcohol, marijuana, downers, pep pills, lysergic acid diethylamide (LSD), cocaine, designer drugs, phencyclidine (PCP), Talwin and Ritalin, speed, and narcotics. The chi-square or Fisher exact test were used when appropriate. Mean ages of initial experimentation were as follows: inhalants, 9.7 years; marijuana, 11.9 years; alcohol (inebriated), 12.0 years; cigarettes, 11.2 years; for the remaining substances of abuse, the mean age was 13.2-14.7 years. Thirty subjects had used inhalants. Significant relationships were found between inhalants and cocaine (p = .004), Talwin and Ritalin (p = .001), downers (p = .01), and narcotics (p = .003). CONCLUSIONS: For children incarcerated in a juvenile detention facility in our community, inhalant abuse is associated with the later use of other substances of abuse. If this finding is replicated in other populations, it underscores the need for effective preventive strategies.

Administration, Inhalation↗

Effects of the abused inhalant toluene on ethanol-sensitive potassium channels expressed in oocytes.

Toluene (methylbenzene) is representative of a class of industrial solvents that are voluntarily inhaled as drugs of abuse. Previous data from this laboratory and others have shown that these compounds alter the function of a variety of ion channels including ligand-gated channels activated by ATP, acetylcholine, GABA, glutamate and serotonin, as well as voltage-dependent sodium and calcium channels. It is less clear what effects toluene may have on potassium channels that act to reduce the excitability of most cells. Previous studies have shown that ethanol potentiates the function of both the large conductance, calcium-activated potassium channel (BK) and specific members of the G-protein-coupled inwardly rectifying potassium channels (GirKs). Since toluene and other abused inhalants share many behavioral effects with ethanol, it was hypothesized that toluene would also enhance the function of these channels. This hypothesis was tested using two-electrode voltage-clamp electrophysiology to measure the activity of BK and GirK potassium channel currents expressed in Xenopus laevis oocytes. As reported previously, ethanol potentiated currents in oocytes expressing either BK or GirK2 channels. In contrast, toluene caused a concentration-dependent inhibition of BK channel currents with 3 mM producing approximately 50% inhibition of control currents. Currents in oocytes injected with GirK2 mRNA were also inhibited by toluene while those expressing GirK1/2 and 1/4 channels were minimally affected. In oocytes co-injected with mRNA for GirK2 and the mGluR1a metabotropic receptor, exposure to glutamate potentiated currents evoked by a high-potassium solution. Toluene inhibited these glutamate-activated currents to approximately the same degree as those induced under basal conditions. The results of these studies show that toluene has effects on BK and GirK channels that are opposite to those of ethanol, suggesting that these channels are unlikely to underlie behaviors that these two drugs of abuse share.

Animals↗

[Inhalant abusers and psychiatric symptoms].

There are different opinions about the cause of chronic psychiatric symptoms observed in drug abusers between Japanese and foreign psychiatrists. The Japanese seem to recognize the chronic psychosis as the result of drug abuse. In the other hand, foreigners diagnose these cases as dual diagnosis of drug abuse and psychosis. Authors studied the problem in this research. One of the authors has examined 120 inhalant abusers of all, in- and out-patients in Kanagawa Prefectural Center of Psychiatry, Serigaya Hospital from 1991 to 1995. These patients were classified into three groups: psychosis group (23 patients), dependence group (51 patients) and abuse group (46 patients) according to their clinical courses and psychiatric symptoms. The psychosis group consists of patients who showed psychiatric symptoms such as hallucination, delusion and thought disturbance for long time after detoxification. The dependence group contains patients whose inhalant dependence was severe and met DSM-4 Diagnostic Criteria for Substance Dependence, but manifested no chronic psychiatric symptoms after detoxification. The patients belonging to abuse group were at the earlier stages of inhalant abuse and had no chronic psychiatric symptoms. The average age of the first inhalant abuse was 14.7 years old in the psychosis group, 14.8 years in the dependence group and 14.7 years in the abuse group. The average years of abuse was 9.0 years in the psychosis group, and 8.5 years in the dependence group. There was little difference between these two groups. The psychosis patients manifested chronic symptoms 5.7 years on average after the first abuse of inhalants. About one forth (26.1%) of the psychosis patients and only 5.9% of the dependence patients had family history of schizophrenia. The difference was statistically significant. These results suggest that chronic psychiatric symptoms are caused not only by inhalant abuse, but also by the genetic factors of psychosis of each patient. There have been several reports that many patients with dual diagnosis of substance dependence and other mental disorders are poly-drug abusers. In our study, 43.4% of the psychosis group patients and 19.6% of the dependence group patients had the past history of abuse of other drugs including methamphetamine and marijuana. The difference was, however, not statistically significant.

Adolescent↗

Prevalence survey of inhalant abuse.

Although there is a paucity of hard epidemiologic data on the prevalence of inhalant abuse, there is considerable anecdotal evidence that such abuse is continuing. Recently, we received repeated reports that one particularly public housing project in Atlanta had high rates of inhalant abuse, and to assess the prevalence of such abuse in children 4 to 20 years old, we conducted a random household survey in 400 of the project's 1,140 units. In an attempt to get complete and reliable data, wer chose and trained 10 residents as interviewers. Fifty youngsters were identified as ever having used inhalants, representing a sample prevalence of approximately 4%. The typical sniffer was a male, age 15, in the 9th grade or currently out of school. Some sniffers, though, continued to use inhalants into the 20s. Not unexpectedly, sniffers were found to use alcohol and other drugs at greater rates than other children. Although the parents of sniffers often said that they recognized drug-related problems in their children, the seldom sought help. Nevertheless, most residents felt that a drug-counseling program should be established in the project to provide alternative recreational activities.

Adolescent↗

The role of the laboratory in detecting inhalant abuse.

OBJECTIVE: To provide an overview of inhalant abuse including the extent of the problem, types of products abused, modes and signs of abuse, pharmacology and effects of volatile substances, the role of the laboratory, and interpretation of laboratory results.

Administration, Inhalation↗

Inhalant abuse and dependence among adolescents in the United States.

OBJECTIVE: To examine the patterns of inhalant use and correlates of the progression from inhalant use to abuse and dependence among adolescents aged 12 to 17. METHOD: Study data were drawn from the 2000 and 2001 National Household Surveys on Drug Abuse. Multinominal logistic regression was used to identify the characteristics associated with progression to inhalant abuse and dependence. RESULTS: Inhalant use was common among the studied adolescents. Among adolescents aged 12 to 17, 0.4% met DSM-IV inhalant abuse or dependence criteria in the past year. Inhalant abuse and dependence affected adolescents regardless of gender, age, race/ethnicity, and family income. The progression from inhalant use to abuse or dependence was related to early first use, use of multiple inhalants, and weekly inhalant use. Adolescents with inhalant use disorders reported coexisting multiple drug abuse and dependence, mental health treatment, and delinquent behaviors. CONCLUSIONS: Adolescents with an inhalant use disorder may represent a subgroup of highly troubled youths with multiple vulnerabilities. Because early use is associated with progression to abuse and dependence, prevention programs should target elementary school-age children.

Administration, Inhalation↗

Inhalant abuse in the pediatric population: a persistent challenge.

Inhalants remain one of the most commonly abused substances by adolescents in the United States today. Recent epidemiologic studies have demonstrated a decrease in the prevalence of inhalant abuse, but overall rates remain high. Inhalants have the potential to result in serious organ system dysfunction or even sudden death. This article reviews the most recent epidemiologic data on inhalant abuse, summarizes the types of substances used and their mechanism of actions, and discusses clinical toxicity and medical management.

Administration, Inhalation↗

Inhalant abuse in an Indian boarding school.

The authors describe inhalant abuse among children in an American Indian elementary boarding school. They discuss the initial interventions made to control this problem, such as providing a lower adult-child ratio and improving staff morale and child management skills and developing a volunteer program to improve the quality of the children's experience after school hours. They suggest that such preventive efforts be made early to interrupt the destructive cycle of dependence on external agents.

Child↗

Brain SPECT findings in long-term inhalant abuse.

This study evaluates brain perfusion in long-term inhalant abusers of toluene, acetone, benzene and derivatives. Ten patients in the age range 16-18 years (mean, 17.3+/-0.67 years), who had been inhalant dependent for a mean period of 48.3+/-6.2 months, but who had stopped using inhalants for 1-11 months (mean, 5.4+/-2.1 months), and ten controls (mean age, 17.3+/-0.67 years) were included in the study. Psychiatric tests, biochemical tests and Tc-99m-hexamethylpropyleneamine oxime (Tc-99m-HMPAO) brain single photon emission computed tomography (SPECT) were performed on all patients. Brain SPECT images were evaluated qualitatively and quantitatively. The mean IQ level was found to be 84 (by psychological tests). Brain SPECT showed non-homogeneous Tc-99m-HMPAO uptake and hypoperfusion areas in all patients (five left temporal, one right temporal, two left temporal plus bilateral parietooccipital, one biparietal and one left temporoparietal). Seven patients had hyperperfused foci (unifocal in five patients and multifocal in two patients). Six hyperperfused foci were in a parietal and one in a temporoparietal location. This study suggests that inhalant dependents exhibit serious abnormalities in brain SPECT images, including hypo-hyperperfusion foci and non-homogeneous uptake of the radiopharmaceutical. A further study with a larger number of patients and long-term follow-up may help to reach a more specific conclusion.

Adolescent↗