Inhalant abuse
Background
- first described in the 1950s
- most common abusant in preteens 11-13yo
- most abused: gasoline, solvents like toluene, spray paints, lighter fluid, air fresheners, glue, and electronic cleaners (halogenated hydrocarbons)
- includes: "sniffing", "huffing", "bagging", and "dusting"
Clinical Features
- euphoria, hallucinations
- neuro: impaired motor activity, ataxia, depressed mentation, withdrawal potential
- cardiac: widened QRS, prolonged QT, syncope, arrhythmias
- may cause dermal burns
- "sudden sniffing death" - thought to be occur with sudden catechol surge on a "sensitized" myocardium
Differential Diagnosis
Drugs of abuse
- 25C-NBOMe
- Alcohol
- Amphetamines
- Bath salts
- Cocaine
- Difluoroethane
- Ecstasy
- Gamma hydroxybutyrate (GHB)
- Heroin
- Inhalant abuse
- Hydrocarbon toxicity
- Difluoroethane (electronics duster)
- Marijuana
- Kratom
- Phencyclidine (PCP)
- Psilocybin ("magic mushrooms")
- Synthetic cannabinoids
- Chloral hydrate
- Body packing
Diagnosis
Workup
Management
- If teen founded down with sudden death with history of recent inhalant abuse, recommended to try a beta-blocker (propanolol, esmolol) given the myocardial sensitization in addition to CPR, etc