Underreported: Inhalant Abuse-related Deaths

Posted May 5, 2016

Inhalant Abuse is a serious problem that can be hard to draw attention to because of its common unreported nature. The statistics available are useful, but it’s nearly impossible to determine the actual numbers of inhalant abuse-related deaths happening as they are not always documented properly. We’re here to tell you why exactly that is through some helpful FAQ’s.

1. How can inhalant abuse cause death?

Cause of death by inhalant abuse is typically Sudden Sniffing Death Syndrome, where the heart spontaneously stops. For more insight on the topic, we turned to George Rodgers. Dr. Rodgers holds an MD and PhD in Pediatrics and Medical Toxicology, he is the Humana Chair in International Pediatrics, as well as current Professor at the University of Louisville, Department of Pediatrics, Toxicology, and Hospitalist. Dr. Rodgers discussed with us how easily the chemicals can pass through the blood vessels in the lungs into the bloodstream, where they can immediately and detrimentally affect the brain and heart; “Inhaled chemicals increase the sensitivity of the heart, so even the slightest adrenaline responses can be lethal. The slightest startling of someone who has just huffed can be enough to send their heart into a fatal arrhythmia”.

Particularly as inhalants are most commonly tried by young people, likely afraid of getting in trouble for huffing chemicals, the risk of startling is high. Coupled with the sensitivity of a heart that has just been surged with inhaled chemicals, nerves and adrenaline create a perfect storm in a highly sensitive body. Sudden Sniffing Death Syndrome can happen the first time someone tries an inhalant, it can happen to someone who occasionally uses inhalants, or to someone who frequently abuses inhalants.

Ultimately, however, it occurs the last time they use an inhalant.

2. What happens in the human body when someone uses an inhalant?

Although some inhalants are commonly referred to as “canned air”, it is important to note that “canned air” is not simply air in a can. These products are useful when used for their intended purposes of cleaning, crafting, and automotive capacities, etc.; however, their immediate response in the body poses significant risk. Inhaled chemicals immediately surge the blood vessels clustered in the lungs, sending the chemicals directly to the bloodstream, heart, and brain. This chemical surge results in an instant high, but also risks immediate and long-term damage to the nervous system, lungs, and heart. Breathing in chemicals intended to get high can cause a lung to over-expand and pop, much like an overfilled balloon, can cause a lung to freeze, and ultimately, can cause breathing to stop.

If the lungs survive the chemicals being directly inhaled, a rush of chemicals heads to the brain. This can cause short-term damage, like headaches, muscle weakness, abdominal pain, severe mood swings, violent behavior, slurred speech, numbness, tingling of hands and feet, nausea, hearing loss, depressed reflexes, stupor, visual disturbances, and loss of consciousness; amongst many other effects. In users who repeatedly abuse inhalants, long-term damages like weight loss, inattentiveness, lack of coordination, irritability, depression, and permanent problems like hearing loss, limb spasms, bone marrow, and brain damage may occur.

Family members of inhalant abusers have also mentioned permanent behavioral and personality changes over time. Overall, intentionally breathing in chemicals causes the brain to shrink as fat cells which compose the brain deteriorate, affecting the rest of the body in a variety of negative ways.

3. Why do autopsy reports not list “inhalant abuse” as a cause of death?

While inhalant abuse can indirectly cause death by triggering organ failure and other problems, cause of death is specifically labeled as “cardiac arrest” or “respiratory arrest”, or a variety of other medical conditions that, while caused by inhalants, are the scientific explanation that cause the body to shut down. Inhalants are a contributing factor, but from a medical perspective the cause of death is a specific essential function (i.e. the heart beating, lungs breathing, etc.) breakdown, leading the body to stop functioning altogether. Cardiac arrest can happen through Sudden Sniffing Death Syndrome.

Respiratory problems triggered by huffing can be more distinct and destructive in people with asthma, but respiratory arrest can happen to anyone that inhales chemicals, regardless of age and health status.

The next few questions refer specifically to motor vehicle accidents. One way that ACE and partners are able to collect data on inhalant abuse cases is through key-word searches in the news, and self-reported instances. When inhalants are found and reported at the scene of an accident, there is often a causal link between the high from huffing and the accident. This is why it is hard to track inhalant abuse deaths in the US.

4. To find out more, we asked Police Officer Jeff Williams:

Can an officer deduce that an inhalant was a factor in an accident or death if there is not an inhalant present?

“The only way the inhalant would not be present is if someone removed it. Usually all would be injured in some manner so it should still be there, just hidden or thrown away from the accident. Unfortunately, if the responding Officers are not trained on inhalants, they would not know even if the inhalant was right next to them. Most are not trained in inhalants.”

What does a police officer look for to determine the cause of accident?

“There are many things that are looked at. The important thing here is that they look for what they are trained look for. Since very few are trained in inhalants, they might even pick up the inhalant and move it out of the way, never realizing that it was the cause.”

What education is given to police officers to identify inhalant abuse as a cause of accidents where the victim may be under the influence?

“Almost none. It is my belief that if most officers were trained in inhalant abuse and know that it can cause a person to black out or make their heart stop, causing an accident, the amount of deaths from inhalant abuse would decrease dramatically because officers would then know what to look for. Young people huff in cars for the same reason they drink in them, [they think] it's harder to get caught.”

Additionally and unfortunately, unless the type of inhalant abused is known, toxicologists would not know what chemicals to test for – especially when the inhalant abused is often not found at the scene.

Many of the immediate effects of inhalant abuse are similar to other substances, including alcohol. This makes it difficult to determine what the driver is under the influence of.

ACE works closely with the National Association for School Resource Officers to help get as many police officers as possible educated and trained on the subject.

5. Why are the numbers of deaths and injuries resulting from inhalants not better known?

We have seen how there is no easy way to test for inhalants at an accident, and they are not commonly labeled in causes of death. As a result of these two factors, much of data on inhalant abuse is self-reported. Particularly with Sudden Sniffing Death Syndrome, as the heart is extremely sensitive to adrenaline, the user could think that they are in normal health after huffing and put away the solvent; however, once they are startled and the arrhythmia occurs, there is no inhalant present, making it difficult to identify if the inhalant abuse contributed to death. With motor vehicle accidents, the driver may be able to throw away the inhalant or hide it if they are not incapacitated. Once emergency personnel arrives, they have no reason to suspect that inhalants are involved.

All of these issues compound, making it difficult to find concrete data. The data that we do have, however, suggests it’s the fourth most abused “drug”. Young adults are abusing inhalants and dying at alarming rates. Due to their easy access and legal status as household products, they are readily available to adults and children alike seeking an instant high. The effects of inhalants are indiscriminate, and can harm people of any age in otherwise perfect health. It’s important to remember that when used correctly, household products serve a purpose that improves daily life. But when abused or misused they can be deadly. Take action and talk to your kids about the dangers of abuse today. While the price of household products may not be high, the cost of abuse is.

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