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|National Drug Intelligence Center
National Drug Threat Assessment 2005
The abuse of inhalants poses a relatively low threat to the country; however, inhalant abuse, particularly among adolescents, may be increasing and remains a concern of law enforcement and public health agencies. Inhalants are chemical vapors that produce mind-altering effects when users inhale them by sniffing or snorting. These chemical vapors are found in more than 1,000 household products that are available and intended for legitimate uses and typically belong to several broad categories: volatile solvents (paint thinner, gasoline, correction fluid, glue), aerosols (paint, deodorant, hairspray), gases (ether, chloroform, nitrous oxide), and nitrites (cyclohexyl nitrite, amyl nitrite, and butyl nitrite). (See Table 25.)
Side effects associated with the abuse of inhalants include dizziness, strong hallucinations, delusions, belligerence, apathy, and impaired judgment. Long-term abusers experience additional problems including weight loss, muscle weakness, disorientation, inattentiveness, lack of coordination, irritability, and depression. Individuals who cease abusing inhalants often endure withdrawal symptoms such as sweating, rapid pulse, hand tremors, insomnia, nausea or vomiting, hallucinations, and grand mal seizures.
Chronic inhalant abuse may cause serious and sometimes irreversible damage to the user's kidneys, lungs, and brain. Death can occur after a single use of inhalants or after prolonged use. SSD may result within minutes of inhalant abuse from irregular heart rhythm leading to heart failure.
The estimated number of individuals reporting past year inhalant use is relatively high. According to NSDUH, an estimated 2.1 million people aged 12 or older used inhalants in 2003.
Predominant User Groups
Inhalant abuse is most prevalent among adolescents and progressively less so among older age groups. According to NSDUH 2003 data, past year inhalant use was reported by a higher percentage of those aged 12 to 17 (4.5%) than those aged 18 to 25 (2.1%) and 26 or older (0.2%). MTF 2003 data also show rates of past year use were much higher among eighth graders (8.7%), tenth graders (5.4%), and twelfth graders (3.9%) than among college students (1.8%) and young adults (1.4%).
Younger inhalant users are more likely to be female. NSDUH 2003 data reveal that past year rates of use for inhalants among persons aged 12 or older were higher among males (1.0%) than females (0.7%). However, among the most prominent user group--those aged 12 to 17--4.6 percent of persons reporting past year inhalant use were female, while 4.3 percent were male. MTF 2003 data also show higher use among young females: 9.6 percent of eighth grade females and 5.6 percent of tenth grade females report past year inhalant use compared with 7.7 and 5.2 percent of eighth and tenth grade males. Among twelfth graders, however, rates were higher for males (5.2%) than females (2.9%) as they were for adults aged 19 to 30 (1.9% males compared with 0.8% females).
According to NSDUH 2003 data, inhalants are more commonly used by Whites and Hispanics (0.9 percent for both groups) than by Blacks (0.4%). MTF data also reveal that inhalant use is higher among Whites overall. In 2003 past year inhalant use was reported by 8.8, 6.6, and 4.9 percent of White eighth, tenth, and twelfth graders compared with 9.6, 4.8, and 2.7 percent of Hispanic and 4.9, 2.0, and 1.5 percent of Black students in eighth, tenth, and twelfth grades.
Past year inhalant use in urban areas appears to be nearly equal to that of rural areas among older age groups. NSDUH data indicate that in 2003, past year rates of inhalant use among persons aged 12 or older were 0.9 percent in Large Metro areas and 0.8 percent in Nonmetro areas. MTF 2003 data reveal that among twelfth graders, too, past year inhalant use was similar in Large MSAs and Non-MSAs (3.5% and 3.7%, respectively). However, eighth and tenth graders in Non-MSAs (10.1% and 7.1%, respectively) reported past year use at rates higher than in Large MSAs (8.0% and 4.8%, respectively).
Trends in Use
Inhalant abuse among adults is much lower than among adolescents and continues to decline. MTF data show that past year rates of use for inhalants among college students rose to a high of 4.1 percent in 1997 before dropping to 1.8 percent in 2003 (see Figure 58). Among young adults, past year rates of inhalant use have been declining since 1999; rates of use for this age group were at their lowest recorded level in 2003. NSDUH data show past year rates of inhalant abuse were relatively stable from 2002 to 2003 for adults aged 18 to 25 (2.2% to 2.1%) and 26 or older (0.2% in both years).
Analysis of long-term trends in inhalant use among adolescents indicates that abuse has declined overall. According to MTF, past year rates of inhalant abuse among adolescents decreased overall between 1995 and 2004. In 2003, however, as rates among tenth and twelfth grade students continued to decline, rates increased significantly among eighth graders and, from 2003 to 2004, rates of use trended upward for eighth, tenth, and twelfth graders (see Figure 59). According to NSDUH data, rates of past year inhalant abuse for adolescents aged 12 to 17 were 4.4 percent in 2002 and 4.5 percent in 2003.
The prevalence of abuse of specific inhalant types appears to vary among age groups. NSDUH 2003 data indicate that among persons aged 12 or older, nitrous oxide--sometimes purchased in balloons or small, sealed vials called whippets--is the most commonly abused inhalant type. In fact, those aged 18 or older most often abused nitrous oxide in the past year. However, glue, shoe polish, and toluene were the most commonly abused inhalants among those aged 12 to 17.
Perceptions of Use
MTF data indicate that the perceived harmfulness of inhalant use has remained relatively stable among eighth and tenth graders (the only surveyed age groups) since the mid-1990s (see Figure 60). PATS data show that the percentage of teens believing that inhalant abuse can cause brain damage decreased overall since 1999--the earliest year recorded (see Figure 61).
Trends in Consequences of Use
The consequences of inhalant use have increased overall since 1995. DAWN data show that ED mentions for inhalants steadily increased from 736 in 1995 to 1,735 in 1998--the highest total for any recorded year. Thereafter, ED mentions for inhalants decreased dramatically in 1999 but have since fluctuated greatly from year to year. Between 2001 and 2002, ED mentions for inhalants nearly tripled, increasing from 522 to 1,496 (see Figure 62).
According to data from the Toxic Exposure Surveillance System (TESS) of the American Association of Poison Control Systems, most inhalant deaths between 1996 and 2001 were attributed to three types of inhalants: gasoline (and other hydrocarbons), air fresheners, and propane/butane (and other gases). These inhalants composed 53 percent of the inhalation cases reported to TESS during these years yet were responsible for 82 percent of all reported inhalant deaths. Gasoline accounted for the greatest percentage of reported inhalant deaths (45%), followed by air fresheners (26%), and propane/ butane (11%).
Inhalant abuse will remain concentrated among adolescents because of the widespread availability, easy accessibility, and low cost of commonly abused products. Adolescents aged 12 to 17 will likely continue to be the primary users of inhalants. Moreover, inhalant abuse among adolescents may increase, given increases in the prevalence of use among some age groups and decreases in the proportions of adolescents who associate risk or harm with inhalant abuse. These factors combined with rising inhalant-related emergency department visits suggest that inhalant abuse will become an increasing problem among the younger population in the near future.
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