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PubMedDate not supplied

Central nervous system effects of chronic toluene abuse--clinical, brainstem evoked response and magnetic resonance imaging studies.

We describe the results of neurological evaluation, magnetic resonance imaging (MRI) of the brain and brainstem auditory evoked response (BAER) testing in 11 chronic toluene vapor abusers. Neurological abnormalities were seen in four of 11 individuals and included cognitive, pyramidal, cerebellar and brainstem findings. MRI of the brain was abnormal in three of 11 individuals and revealed the following abnormalities: 1) Diffuse cerebral, cerebellar, and brainstem atrophy; 2) Loss of differentiation between the gray and white matter throughout the CNS; and 3) Increased periventricular white matter signal intensity on T2 weighted images. BAERs were abnormal (control mean +/- 3 S.D.) in five of 11 individuals. As a group, the latency of V (p less than 0.01), the III-V interpeak (p less than 0.05) and the I-V interpeak latencies were prolonged compared to controls. All three individuals with abnormal MRI scans also had abnormal neurological examinations and BAERs. Two of five individuals with abnormal BAERs, however, had normal neurological examinations and MRI scans. Our data support previous findings of diffuse white matter involvement in chronic toluene abusers and suggest that BAERs may detect early CNS injury from toluene inhalation even at a time when neurological examination and MRI scans are normal. BAERs, therefore, may be a sensitive screening test to monitor individuals at risk from toluene exposure (either abusers or industrially exposed individuals) for early evidence of CNS injury.

Adult↗
PubMed1988

Heroin inhalation and asthma.

Opiate addiction is an increasing social problem, and there has been a change from taking opiates intravenously to inhaling them in many areas of Britain. Three patients with asthma who required mechanical ventilation soon after heroin inhalation were described. Two subsequently died of acute severe asthma. The patients were reluctant to admit to their addiction and persisted inhaling heroin despite medical advice and counselling. Opiate inhalation can provoke life threatening asthmatic attacks and should be considered in patients at risk of abusing drugs who have poorly controlled asthma.

Administration, Inhalation↗
PubMed1996

Severe burn injury from recreational gasoline use.

This report describes the case of a 13-year-old boy who suffered severe burns with inhalation injury during the recreational use of gasoline. Gasoline sniffing is a popular form of solvent abuse for young children and adolescents in isolated, rural communities. In addition to the neurological and physiological complications of gasoline inhalation, gasoline sniffers face the significant threat of severe burn injury or death resulting from ignition of the gasoline vapor as well as from extensive physical contact with the constituents of liquid gasoline.

Adolescent↗
PubMedDate not supplied

[Teratologic cranio-encephalic effects of chronic thinner inhalation in progenitors, in rats and humans].

Inhalation of thinner by youngsters and adolescents is an increasing drug abuse problem in Mexico. It presents serious repercussions upon socio-economic, cultural, legal and health (neurologic and psychiatric) problems. We report a comparative study in humans and rats which demonstrate the embryotoxic and craneo encephalic teratologic effects in the children and brood of progenitors who have chronically inhaled thinner (in the case of pregnant women, before, at the beginning and throughout pregnancy). Inhaled thinner passes directly to the blood stream and crosses the placentary barrier freely reaching the embryo. It may cause craneal bone and partial or total encephalon agenesia, added to macro and microscopic lesions secondary to direct aggression to the neuroepithelial germ cells. Abortions and premature labor with weight and size underdeveloped products and placentary hemorrhages occur. Usually these die, but if they survive they show trascendental mental retardation, as well as neurologic and psychiatric sequels.

Abnormalities, Drug-Induced↗
PubMed1998

MRI in chronic toluene abuse: low signal in the cerebral cortex on T2-weighted images.

MRI may be helpful in showing brain toxicity associated with chronic toluene inhalation. We report clinical and MRI findings over 3 years in a man with gradual neurologic decline secondary to toluene abuse. Cerebral atrophy most prominently involved the corpus callosum and cerebellar vermis. On T2-weighted images, loss of gray-white matter contrast, diffuse supratentorial white matter high-signal lesions, and low signal in the basal ganglia and midbrain were seen. In addition, MRI showed abnormal labor cortical low signal on T2-weighted images, most prominent in the primary motor and visual cortex. This cortical T2 shortening, not previously described in this condition, may reflect iron deposition.

Administration, Inhalation↗
PubMed2000

Methamphetamine overdose and fatality : 2 cases report.

Methamphetamine abuse is an important problem in Thailand. The number of addicts and abusers is increasing. Abusers usually use speed pills by oral ingestion or inhalation. The dose used is about 5-60 mg of methamphetamine while the lethal dose reported is 200 mg. Death due to methamphetamine toxicity is uncommon. In this paper, we report two cases of methamphetamine fatalities. Both cases were drug dealers. They swallowed a handful of methamphetamine tablets while being arrested. The autopsy revealed nonspecific findings. Using thin layer chromatography technique, methamphetamine was detected in the urine, blood, stomach and liver of the corpses. This circumstance has been reported elsewhere and might be increased in Thailand as more speed pills are circulated in illegal markets.

Adult↗
PubMed1992

Protracted phencyclidine coma from an intestinal deposit.

Phencyclidine is a common drug of abuse that can be taken orally, intravenously, or by inhalation. We describe a massive overdose of phencyclidine in a patient who swallowed a plastic bag containing the drug. Quantitative serum phencyclidine levels remained persistently elevated for several weeks. On hospital day 20, a plastic bag was passed via the rectum. Subsequently, the patient's serum phencyclidine levels fell in accordance with previously described pharmacokinetics. The patient rapidly recovered neurologic function. Persistently elevated serum drug levels should suggest continued drug absorption from a gastrointestinal deposit. We propose that colonoscopy and esophagogastroduodenoscopy be performed early in this setting.

Adult↗
PubMed1998

Cerebral perfusion impairment in a patient with toluene abuse.

We report the case of a 17-yr-old man diagnosed as a toluene abuser. He had an 8-mo history of toluene inhalation exposure and was admitted to this hospital with symptoms of auditory and visual hallucination. Magnetic resonance imaging (MRI) revealed no structural abnormalities both on T1- and T2-weighted images, whereas SPECT using 99mTc-ethyl cysteinate dimer (ECD) showed multifocally decreased perfusion in the cerebral cortex, basal ganglia and thalami. Our case indicates that SPECT detects early central nervous system injury from toluene inhalation even when neurological examination and neuroanatomic imaging such as MRI are normal.

Adolescent↗
PubMed1994

Methaemoglobinaemia due to amyl nitrite inhalation: a case report.

Methaemoglobinaemia is a potential toxic effect of aliphatic nitrites which are increasingly abused by male homosexuals and drug addicts because of marked vasodilating properties ('poppers'). In most instances, severe complications were described following the ingestion of large quantities of amyl, butyl or isobutyl nitrites. A deficiency in NADH-dependent haemoglobin reductase in some patients has been noted. This is the first report of symptomatic methaemoglobinaemia following the inhalation of amyl nitrite.

Administration, Inhalation↗
PubMed1994

Cognitive impairments in adolescent drug-abusers.

A basic neuropsychological test battery was given to 64 adolescents (57 males and seven females; mean age = 15.5) divided in two groups: (1) drug-abusers ("experimental group," n = 26), and (2) non drug-abusers ("control group," n = 38). Psychoactive substances included marijuana, "crack," solvent inhalation, gasoline sniffing, and alcohol. The following tests were used: (1) language, (2) perceptual recognition, (3) memory, and (4) praxic abilities. In general, performance was mildly (but nonsignificantly) lower in the experimental than in the control group. Only some neuropsychological test scores correlated with lifetime and amount of psychoactive drugs used. It was proposed that cognitive impairments in this sample of young drug-abusers may have been not evident because: (1) lifetime use was limited, due to the age of the subjects; and (2) in adolescents and pre-adolescents, toxic effects of drug-abuse might be manifested as a decrease in the rate of cognitive development rather than as a general cognitive decline.

Adolescent↗
PubMed2000

Course, severity, and treatment of substance abuse among women versus men.

OBJECTIVE: To assess the course and severity of substance-related disorder (SRD) in relation to gender. DESIGN: Retrospective data on course were obtained for several indices of substance use, abuse, and related morbidity. SETTING: Two university medical centers with alcohol-drug programs located in departments of psychiatry. SUBJECTS: A total of 642 patients were assessed, of whom 365 (57%) were men and 277 (43%) were women. METHODS: Data on course included demographic characteristics, family history of substance abuse, lifetime use, age at first use, years of use, use in the last year, periods of abstinence, and current diagnosis. Data on severity included two measures of SRD-associated problems (one patient rated and one interviewer rated), substance abuse versus dependence, self-help activities, and previous treatment. RESULTS: Women were more apt to be homemakers; to have a sibling or, if married, a spouse who abused substances; to be less apt to have ever used hallucinogens or inhalants; to have used substances for fewer years; to have used cannabis and inhalants for fewer days in the last year; to have a lower rate of current cannabis abuse/dependence; to have fewer legal problems related to substances (especially driving while intoxicated [DWI] charges); to have fewer outpatient admissions to treatment; to have fewer admissions to substance abuse treatment (all categories together), fewer lifetime days in treatment, and lower overall treatment cost (for all categories of treatment together). CONCLUSIONS: These data confirm earlier reports of a shorter course, less deviant drug usage, and--if married--a substance-abusing spouse. In addition, we found higher rates of familial substance abuse and lower rates of lifetime admissions, treatment days, and total cost of substance abuse treatment. Homemaking responsibilities, a substance-abusing spouse, a male-oriented treatment system, and/or a more rapid course may reduce substance abuse treatment for women.

Adult↗
PubMed1998

Ultrastructural changes of tissues produced by inhalation of thinner in rats.

Thinner is a substance that is used for industrial purposes and for drug abuse; addiction is of young people (average age, 7.5 years). Although the health problem of voluntary or nonvoluntary solvent sniffing is important, great attention has been paid to the epidemiology and pharmacology of paint thinner or industrial solvents inhalation, but studies at the morphological and biochemical level are scarce. This work describes the morphological changes in the lung, liver, kidney, adrenal glands, and central nervous system induced by short- (up to 4 weeks) and long-term (up to 14 weeks) periods of thinner inhalation in rats.

Administration, Inhalation↗
PubMed2004

Volatile substance abuse--post-mortem diagnosis.

A substantial number of children and adolescents world-wide abuse volatile substances with the intention to experience an euphoric state of consciousness. Although the ratio of deaths to nonfatal inhalation escapades is low, it is an important and preventable cause of death in young people. In the analytical investigation of volatile substances proper sample collection, storage and handling are important in view of the volatile nature of the compounds. Volatile organic compounds in post-mortem matrices such as blood, urine and tissues are generally determined by gas chromatography after extracting the compounds with methods such as static and dynamic headspace or even with pulse-heating and solvent extraction. In post-mortem cases, metabolites in urine seem less relevant, however, trichloroethanol and trichloroacetic acid were determined in several cases. When interpreting qualitative and quantitative results, researchers should be aware of false conclusions. The main reason why scepticism is necessary is the occurrence of losses of analytes during sampling, sample handling and storage, which results in false quantitation.

Administration, Inhalation↗
PubMed1998

The epidemiology of adolescent inhalant drug involvement.

OBJECTIVE: To fill some of the gaps in our knowledge of the epidemiology of inhalant drug use. We examine age, sex, and race or ethnicity variations in the occurrence of inhalant use as well as time trends and the purported transitory nature of inhalant use among adolescents in the United States. DESIGN: The data analyzed in this report were collected as part of the National Household Survey on Drug Abuse from 1990 through 1995. This annual survey is designed to provide cross-sectional information about the patterns of drug use among nationally representative samples of US household residents aged 12 years and older. PARTICIPANTS: The sample included 34826 adolescents aged 12 to 17 years who participated in the National Household Survey on Drug Abuse from 1990 through 1995 (N=2177-8005 per survey year). RESULTS: The use of inhalants, particularly aerosols and glue, increased during the first half of the current decade. Initiation of inhalant use is not limited to early adolescence and is not a transitory behavior among adolescents in the United States. The use of inhalants is equally common among members of both sexes, and non-Hispanic white youths are more likely to report use than are members of other race or ethnic groups. CONCLUSIONS: The increasing use of inhalants, their widespread availability, and the risks involved with their use indicate a need for more focused attention on this public health problem.

Adolescent↗
PubMed2005

[Cocaine abuse as precipitating factor of tumoral bleeding in an oligoastrocitoma].

Cocaine abuse has been associated with a variety of intracranial haemorrhagic disorders, such as intracerebral, subdural or subarachnoidal haemorrhage. Frequently, these patients harbour underlying vascular malformations, like cerebral aneurysms or arteriovenous malformations (AVM). To the best of our knowledge only two cases of tumoral haemorrhage induced by cocaine abuse have been previously reported. We describe a new case of intracerebral haemorrhage after cocaine inhalation, in which both the preoperative imaging studies and the pathological examination showed a brain tumour as the origin of the haemorrhage. We think that cocaine abuse may be considered as a new precipitating factor in intratumoral haemorrhage.

Adult↗
PubMed2002

Allelic association analysis of the dopamine D2, D3, 5-HT2A, and GABA(A)gamma2 receptors and serotonin transporter genes with heroin abuse in Chinese subjects.

Five candidate genes, the receptors DRD2, DRD3, HTR2A and GABA(A)gamma2, and the serotonin transporter (5-HTT) were analyzed for association with heroin abuse. We examined three polymorphisms (promoter - 141DeltaC, Ser311Cys, and TaqI) in the DRD2 gene, one polymorphism (Ser9Gly) in the DRD3 gene, two polymorphisms (promoter - 1438G/A and T102C) in the HTR2A gene, two polymorphisms (VNTR and Del/Ins) in 5-HTT gene, and one polymorphism (G3145A) in GABA(A)gamma2 gene in 121 Chinese heroin addicts and 194 controls. None of the polymorphisms differed significantly for allele, genotype, or haplotype frequencies, except for the DRD2 promoter polymorphism - 141DeltaC (genotype-wise and allele-wise, P = 0.05, uncorrected). An additional 344 subjects with heroin abuse and 104 controls were investigated for the - 141DeltaC polymorphism. In the second sample, there were no significant difference of genotype or allele frequencies between subjects with heroin abuse and normal controls. When we divided the sample by route of administration into nasal inhalers and IM or IV injectors, however, it produced a significant difference between inhalers of heroin and controls (genotype-wise, P = 0.006, allele-wise, P = 0.016) but not for injectors of heroin (genotype-wise, P = 0.81, allele-wise, P = 0.69). We also found that LD between all polymorphisms we examined in the gene was weak, possibly explaining why we see association of this polymorphism with heroin abuse but not with other markers in the gene. Overall our results indicates that the HTR2A, 5-HTT, DRD3 and GABA(A)gamma2 genes are not likely to be a major genetic risk factor for heroin abuse in this population, with the exception of possible association between nasal inhalation and DRD2 promoter - 141DeltaC polymorphism.

Adolescent↗
PubMed1975

Fatal arrhythmia following deodorant inhalation: case report.

With the removal from the general marketplace of volatile hydrocarbons which have been previously abused by "thrill-seekers", new and often unlikely products are now being exploited by those who whish to escape reality. Many of these products have proven harmful. An example of such an unusual product is reported in this case of a sixteen-year-old male who inhaled Arrid Extra-Dry aerosol deodorant and subsequently died following ventricular fibrillation. The only findings at autopsy were cerebral edema, pulmonary edema and generalized visceral congestion.

Adolescent↗
PubMed2000

[Propane abuse. Extreme dose increase due to development of tolerance].

In spite of its serious sequelae, volatile substance abuse (VSA) attracts very little public attention in Germany. Our case report describes an adult male who inhaled propane for recreational purposes. Initially, he achieved short-lived euphoria and hallucinations. He compensated for the developing tolerance by increasing the dosage, finally consuming 5 litres of fluid propane daily. Getting such quantities was facilitated by his occupational access to propane. Since he abused the propane in an apartment house, he also exposed third parties to the danger of explosion. Clinical examination revealed disturbances in orientation, restricted perceptivity and concentration, reduced mnemonic performance, and psychomotor agitation. All these symptoms diminished during a 6-month follow-up. The relationship of his organic mental disorder to the abuse of propane was not clear, since he had also abused alcohol.

Administration, Inhalation↗