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PubMed1991

Reversibility of psychiatric symptoms in a chronic solvent abuser: a case report.

The acute mental status changes associated with inhaled solvent use have been well described. The potential long-term neuropsychiatric sequelae of inhaled solvent use are not as well characterized. We present here the case of a 20-year-old male with a 7-year history of inhaled solvent (toluene) use whose neurological and psychiatric status were followed closely over a 1-month period on an inpatient psychiatric unit.

Adult↗
PubMed1985

Myocardial infarction associated with cocaine abuse.

We report a patient who sustained a myocardial infarction after inhaling cocaine. He developed a persistent wall motion defect that was present 18 months after the acute event despite resolution of electrocardiographic evidence of infarction.

Journal Article↗
PubMed1986

Carboxyhemoglobinemia caused by inhalation of methylene chloride.

Spray-paint inhalation, once a common and inexpensive source of drug abuse, is now rare. Newer organic solvents, such as methylene chloride, were thought to decrease the toxicity of aerosol solvents, but they carry unique toxicities of their own. Methylene chloride toxicity is difficult to diagnose, as early symptoms are similar to those associated with many intoxicants; however, a rising carboxyhemoglobin level, despite removal of the patient from the source of exposure, is pathognomonic. In dealing with industrial exposures or organic aerosol abuse, a carboxyhemoglobin level should be part of the initial diagnostic workup, and treatment with oxygen is mandatory until toxicity resolves.

Adult↗
PubMed1981

Severe tracheobronchitis from inhalation of an isobutyl nitrite preparation.

Isobutyl nitrite has recently become a popularly abused drug in the United States. Although many adverse effects, including headache, hypotension, and methemoglobinemia, are known to occur following exposure to this class of drugs, little has been written concerning the effects of illicit use of isobutyl nitrite. In this case, severe tracheobronchitis developed following short-term exposure by inhalation of this drug.

Adult↗
PubMed2006

Accidental autoerotic death by volatile substance abuse or nonsexually motivated accidents?

In contrast to typical autoerotic fatalities, when death is due to asphyxia mostly by mechanical compression of the neck, atypical autoerotic accidental deaths (AADs) involve sexual self-stimulation by other means such as electrocution or inhalation of chemical agents. Especially in lethal cases of volatile substance abuse (VSA), a differentiation between suicide or sexually or nonsexually motivated accident is often complicated in practical casework. Considering the small number of AADs involving chemical substance abuse reported in the literature, the number of unreported cases seems to be very high. We report about 5 lethal cases of VSA; analysis was performed using headspace solid-phase microextraction (HS-SPME) and gas chromatography-mass spectrometry (GC/MS). When headspace sampling is not performed at autopsy, the analysis of volatile substances can be very complicated. In 2 cases, an AAD was diagnosed considering findings at the scene, reconstruction of the event, and discussion of the circumstances of the death. These findings demonstrate the importance of VSA in atypical autoerotic asphyxia. Therefore, in cases of suspected lethal inhalational intoxications, as a matter of principle, headspace asservation should be performed at autopsy and an autoerotic motivational background should be taken into consideration for differential diagnosis.

Accidents↗
PubMed2003

Health hazards and risks for abuse among child labor in Jordan.

The phenomenon of child labor has become the main concern of developing countries. The literature related to child labor discusses the causes and socioeconomic factors contributing to child labor but few studies examined risks for physical, emotional, and sexual abuse among child labor. Therefore, the purpose of this qualitative study was to identify the characteristics of working children as well as identify health risks and risks for abuse associated with child labor. A convenience sample of 41 children working in the industrial city of Irbid were interviewed by using a semistructured interview guide. Findings revealed that children who were engaged in child labor were poor and dropped out of school to assist their families financially. The findings also showed that children were exposed to health hazards such as inhaling chemicals and physical injuries. Physical, verbal, and sexual abuse also were present among these children. The findings from this study concluded that child labor creates an unhealthy environment for socially disadvantaged children. Health professionals, including pediatric and community health care providers, have an instrumental role that needs to be focused on protecting children, enforcing policies, and implementing strategies to help socially and economically disadvantaged children.

Adolescent↗
PubMed2005

Nicotine as a typical drug of abuse in experimental animals and humans.

RATIONALE AND BACKGROUND: Tobacco use through cigarette smoking is the leading preventable cause of death in the developed world. Nicotine, a psychoactive component of tobacco, appears to play a major role in tobacco dependence, but reinforcing effects of nicotine often are difficult to demonstrate directly in controlled laboratory studies with animal or human subjects. OBJECTIVE: To review the major findings obtained with various procedures developed to study dependence-related behavioral effects of nicotine in experimental animals and humans, i.e., drug self-administration, conditioned place preference, subjective reports of nicotine effects and nicotine discrimination, withdrawal signs, and ratings of drug withdrawal. RESULTS: Nicotine can function as an effective reinforcer of drug-seeking and drug-taking behavior both in experimental animals and humans under appropriate conditions. Interruption of chronic nicotine exposure produces withdrawal symptoms that may contribute to relapse. Difficulties encountered in demonstrating reinforcing effects of nicotine under some conditions, relative to other drugs of abuse, may be due to weaker primary reinforcing effects of nicotine or to a more critical contribution of environmental stimuli to the maintenance of drug-seeking and drug-taking behavior with nicotine than with other drugs of abuse. Further experiments are also needed to delineate the role other chemical substances inhaled along with nicotine in tobacco smoke play in sustaining smoking behavior. CONCLUSION: Nicotine acts as a typical drug of abuse in experimental animals and humans.

Animals↗
PubMed2004

An adolescent with a different substance abuse: case report.

From the beginning of history, it is a well known fact that some people admire to substances making them tipsy and stories about them were told and heard in everywhere and in every time. As shown in several studies, psychiatric disorders related to substance abuse especially in adolescents are becoming more prevalent in all countries including Turkey every year and this is another well-known reality of our time. There are many known psychoactive substances affecting the mental well being of young people and disturbing their social adaptation skills. Inhalants are the preferred psychoactive substances between the young people because of the factors making their abuse become widespread such as cheapness, ease of availability and frequent use in daily life. Here we report an adolescent with a different substance abuse.

Administration, Inhalation↗
PubMed1990

Pulmonary toxicity of inhaled and intravenous talc.

Talc (magnesium silicate) is a widely used, generally considered benign substance. It is principally used as an inert filler material in drug tablets or as a drying ingredient in baby powders. However, in both cases inappropriate use can lead to severe pulmonary toxicological responses. On the one hand, intravenous injection of 'solubilized', CNS active pills can produce microemboli in small pulmonary vessels. This can lead to various degrees of granuloma formation, compromised pulmonary function, or death. Overzealous application of baby powder can also produce severe pulmonary complications if the infant inspires the powder. Although the data are relatively scarce, a number of reports suggest the existence of a chronic problem in this area.

Granuloma↗
PubMedDate not supplied

Severe acute thinner intoxication.

Thinner which contains aromatic hydrocarbons such as xylene, toluene and N-hexane is widely used in industrial plants manufacturing dyes, plastic, varnishes and glues. Chronic intoxication due to abuse of solvents, including thinner, by workers who inhale the solvent vapor is frequently encountered. Acute intoxication with ingestion of excessive amounts is relatively rare and usually fatal. It is reported that 45-50 ml of orally ingested thinner is enough to cause severe complications. The case reported here was forced to drink 200 ml of thinner by an older friend, and presented with severe complications such as rhabdomyolysis, polyneuropathy, chemical pneumonia and coma. To the best of our knowledge this is the first case reported in the literature to survive acute thinner intoxication with such complications.

Acute Disease↗
PubMed2004

A study of commercial sex and HIV/STI-related risk factors among hospitality girls in entertainment establishments in Wuhan, China.

BACKGROUND: Commercial sex is illegal in China but there are still many hospitality girls (HGs) working at licenced entertainment establishments in many places in the country. Hospitality girls can be categorised as sex-HGs and non-sex-HGs. OBJECTIVE: To understand the proportion of sex-HGs and non-sex-HGs, the prevalence of HIV and sexually transmitted infections, and the high-risk behaviours among HGs. METHODS: A total of 257 HGs at 29 entertainment establishments (13 sauna/massage parlors, 10 dancing/karaoke bars and six barbershops) from seven urban districts in Wuhan were investigated and studied with a two-step sampling frame during November and December 1999. Information on sexual practices, drug abuse, condom use and other related factors were collected by anonymous interviewer-administered questionnaires. Anonymous laboratory testing was performed on 185 (72%) serum samples obtained for HIV-1 and HSV-2 by enzyme-linked immunosorbent assay. RESULTS: Of the 257 HGs, the mean age was 22.7 years (range 16-36 years); 147 (57.2%) stated they were sex-HGs, 15 (5.8%) were drug users, of whom 12 (80%) were injecting and 3 (20%) were inhaling. Sex-HGs was significantly correlated with drug abuse (P < 0.01, OR = 11.47). Among the 147 sex-HGs, 29 (19.7%) had sex with male clients more than seven times per week, 76 (51.7%) claimed to have used condoms consistently. The sero-prevalence survey of 185 HGs revealed that none tested HIV seropositive, and 40 (21.6%) were HSV-2 seropositive, which was positively correlated with sex-HGs (P < 0.01, OR = 3.13). CONCLUSIONS: Although the HIV epidemic in Wuhan has not yet reached a high level, HIV/AIDS prevention and control must be taken into account in entertainment establishments because of the existing high risk-taking behaviours and high STI incidence among HGs. It is feasible to carry out epidemiological investigations, which are concerned with sensitive topics such as sex, drug abuse, etc, among community-based female sex workers if designed and implemented prudently.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Adolescent inhalant use among male patients in treatment for substance and behavior problems: two-year outcome.

UNLABELLED: Adolescent inhalant users are significantly more likely than other patients to have conduct disorder, to report abuse and neglect, and to have previously attempted suicide. Yet little has been published regarding treatment outcome for inhalant users. METHODS: Eighty male adolescents admitted to a residential treatment program underwent baseline assessment during treatment, and follow-up assessment at two-years post admission. Subjects reporting any lifetime inhalant use at baseline (n = 34) were compared to the other patients (n = 46) on 4 outcome variables. RESULTS: Adolescents reporting any lifetime inhalant use at baseline assessment reported twice as many past-year conduct disorder symptoms at two-year follow up (p = 0.03). The relationship between inhalant use and conduct disorder symptoms remained significant (p = 0.03) in analyses that controlled for age, time in jail or restricted environments in the 6-months preceding follow-up, as well as baseline-reported lifetime number of conduct disorder symptoms. Inhalant users were not significantly worse on these other outcome measures: crime in the last month (p = 0.60), days of nontobacco substance use in the last 6 months (p = 0.65), or, commission of selected crimes in the last 6 months (p = 0.06). CONCLUSIONS: Inhalant use among adolescent males in treatment for substance and behavior problems may predict more severe conduct disorder symptoms after treatment.

Administration, Inhalation↗
PubMed1996

Passive inhalation of cannabis smoke: a novel defence strategy?

Defence lawyers sometimes argue that the presence of cannabinoid metabolites in the defendant's blood or urine resulted from passive unintentional inhalation of environmental cannabis smoke. It would be useful to be able to differentiate passive inhalation from active use so as to discourage the potential abuse of this phenomenon by the defence. Four cases from two jurisdictions in which passive cannabis smoking was used as a defence are presented to illustrate this dilemma. It remains impossible to define objectively an upper limit for blood and urine levels in cases of passive inhalation of cannabis from the environment. However, a claim of passive inhalation, or indeed 'deliberate passive exposure' could be discouraged by making it an offence to place oneself in a position of being 'concerned' in the use of the drug. The onus should be on the defendant to prove that he had not attempted to extricate himself from the situation, being aware of the smoking of cannabis in his immediate vicinity; ignorance would not be an excuse.

Journal Article↗
PubMed1991

Inhalation injuries and burns in the inner city.

Burns in the urban environment present special problems. Although there generally is ready access to appropriate care and short transport times, burn injury remains a serious concern. Inhalation injuries, electrical and chemical burns, and burns as a result of abuse or assault are common problems.

Burn Units↗
PubMed1999

Irreversible blindness after amyl nitrite inhalation.

PURPOSE: To present a case of blinding bilateral acute optic nerve disease in a 15-year-old male apparently induced by inhalation of amyl nitrite. METHODS: Sequentially over four days he lost his four altitudinal visual hemifields, leaving atrophic discs and only 2/60 and a small field in the better eye. Scannings by CT and MRI and a full laboratory research gave no specific clue to the pathogenesis. CONCLUSIONS: No similar cases have been described in the more than 100-year history of pharmacological use of amyl nitrite for angina pectoris, and pharmacologically it is hard to point out a rationale behind the sequential visual loss As an alternative to frank toxicity, therefore, we have considered a parainfectious mechanism as related to an influenza-like disease immediately prior to the abuse episode.

Administration, Inhalation↗
PubMed2006

Severity profiles of substance-abusing patients in Italian community addiction facilities: influence of psychiatric concurrent disorders.

Mental health and addiction services have traditionally evolved separately in many European countries, with policy reflecting this. Differences in severity profiles between users of the community addiction services with comorbidities of mental illness and substance misuse and those with substance misuse only were studied using a matched case-control study design, with regard to the main substance (opiates or cocaine) patients were dependent on. Patterns of substance abuse and diagnostic features were evaluated according to the Addiction Severity Index (ASI) and DSM-IV. Mentally ill substance abusers are significantly more likely to have used amphetamines, inhalants and having been polydrug users. They are particularly impaired in medical and family/social relationships ASI composite scores, but less in drug use. Severity profiles and needs of dually diagnosed patients require assessment and treatment skills that should be provided through adequate links with mental health system.

Adult↗
PubMed1993

Inhaled 1,1,1-trichloroethane-produced physical dependence in mice: effects of drugs and vapors on withdrawal.

1,1,1-Trichloroethane (TCE), a widely used and abused solvent, was investigated for its ability to produce physical dependence in mice. Cessation of 4 days of continuous inhalation of TCE (500-4000 ppm) resulted in a withdrawal syndrome characterized by handling-induced convulsions and increased susceptibility to pentylenetetrazol-induced convulsions. The severity of withdrawal convulsions was diminished by 30 to 60 min of reexposure to 2000 to 4000 ppm TCE or to the vapor of another widely used and abused solvent, toluene (1000-2000 ppm). Ethanol (1-2 g/kg), midazolam (0.3-1 mg/kg) and pentobarbital (30 mg/kg) were also effective in decreasing the withdrawal severity; however, chlorpromazine (3 mg/kg) and phenytoin (30 mg/kg) were without effects. These data suggest that TCE has the ability to produce physical dependence of the central nervous system depressant drug type. Taken together with other evidence for similarities in the pharmacological and behavioral effects of TCE and depressant drugs of abuse, these data support the hypothesis that the basis for TCE abuse may be its ability to produce ethanol- and depressant drug-like effects.

Administration, Inhalation↗