Inhalants: Difference between revisions

>David Hedlund
https://www.cdc.gov/niosh/docs/81-123/pdfs/0124.pdf?id=10.26616/NIOSHPUB81123
>David Hedlund
Undo revision 167549 by Blackhole (talk)
 
(24 intermediate revisions by 4 users not shown)
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Inhalants do not include substances that are breathed in after they have been heated through vaporization or burned. For example, [[poppers|amyl nitrite]] (poppers), [[nitrous oxide]] and [[toluene]] are considered to be inhalants because they are volatile at room temperature and need no other heat source to transform from liquid to gaseous state. [[Tobacco]], [[cannabis]], [[cocaine|crack-cocaine]], or any other [[:category:psychoactive substance|psychoactive substance]] that requires an external heat source is not considered to be a member of the inhalant category of substances, even though once heated the resulting fumes are inhaled into the lungs.
Inhalants do not include substances that are breathed in after they have been heated through vaporization or burned. For example, [[poppers|amyl nitrite]] (poppers), [[nitrous oxide]] and [[toluene]] are considered to be inhalants because they are volatile at room temperature and need no other heat source to transform from liquid to gaseous state. [[Tobacco]], [[cannabis]], [[cocaine|crack-cocaine]], or any other [[:category:psychoactive substance|psychoactive substance]] that requires an external heat source is not considered to be a member of the inhalant category of substances, even though once heated the resulting fumes are inhaled into the lungs.
==Overview==
{| class="wikitable sortable" style="width: auto; text-align: center;"
|-
! Safety
! Category
! Sub category
! Psychoactive effect
! Examples<ref>{{cite journal |last1=Radparvar |first1=S |title=The Clinical Assessment and Treatment of Inhalant Abuse. |journal=The Permanente journal |date=15 June 2023 |volume=27 |issue=2 |pages=99-109 |doi=10.7812/TPP/22.164 |pmid=37078126 |pmc=10266853}}</ref>
! Example image
|-
! rowspan="2" | [https://en.wikipedia.org/wiki/List_of_medical_inhalants Medical inhalants]
| [[Nitrite]]s
|
| [[Dissociative]]
| [[Alkyl nitrites]] ([[poppers]] such as [[amyl nitrite]])
| [[Image:Nitrite-group-2D.svg|frameless|center|90x50px]]
|-
| [[NOx]]
|
| [[Dissociative]]
| [[Nitrous oxide]] (found in whipped cream canisters)
| [[Image:Nitrous-oxide-2D-VB.svg|frameless|center|150x50px]]
|-
! rowspan="7" | [https://en.wikipedia.org/wiki/List_of_medical_inhalants#Historical Medical (historical)]
|-
| [[Ether]]s
|
| [[Depressant]]
| [[Diethyl ether]] (liquid): Fuel, aerosol propellant, refrigerant, “freeze” sprays, fuel
|
|-
| rowspan="5" | Hydrocarbons
| rowspan="5" | [[Chloroalkane]]s
| rowspan="5" | [[Depressant]]
|-
| [[Carbon tetrachloride]] (liquid): Cleaning solutions, aerosol propellants
|
|-
| [[Chloroethane]] (liquid): Topical anesthetic
|
|-
| [[Chloroform]] (liquid): Cleanser for plastic compounds, adhesive, spot remover
| [[Image:Chloroform displayed.svg|frameless|center|60x50px]]
|-
| [[1,1,1-Trichloroethane]] (liquid): Typewriter correction fluid
|
|-
! rowspan="19" | Toxic
|-
| [[Ether]]s
|
| [[Depressant]]
| [[Dimethyl ether]] (liquid): See "ethyl ether" for sources
|
|-
| rowspan="16" | Hydrocarbons
|-
| rowspan="4" | [[Chloroalkane]]s
| rowspan="4" | [[Depressant]]
|-
| [[Methylene chloride]] (liquid): Paint thinners, varnish removers, degreasing agent
|
|-
| [[Tetrachloroethylene]] (liquid): Dry cleaning agents, degreaser
|
|-
| [[Trichloroethylene]] (liquid): Dry cleaning agent, spot remover, degreaser
|-
| rowspan="7" | [[Aliphatic hydrocarbon]]s
| rowspan="7" | [[Dissociative]]
|-
| [[Butane]], [[propane]], [[methane]] (gas): Lighter fluid, bottled fuel, aerosol propellants (hair spray, spray paint, deodorants, room fresheners, cooking oil sprays)
| [[Image:Butane simple.svg|frameless|center|90x60px]]
|-
| [[n-Hexane]] (liquid): Adhesive, gasoline, industrial solvents, rubber cement
|
|-
| [[Isooctane]] (liquid): Automotive fuel
|
|-
| [[Kerosene]] (liquid): Lighter fluid
|
|-
| [[Naphtha]] (liquid): Shoe polish, adhesive
|
|-
| [[Turpentine]] (liquid): Paint thinner, solvent
|
|-
| rowspan="3" | [[Aromatic hydrocarbon]]s
| rowspan="3" | [[Dissociative]]
| [[Benzene]] (liquid): Gasoline, rubber cement
|
|-
| [[Toluene]] (liquid): Adhesives, paint thinner, spray paint, rubber cement, nail polish remover
| [[Image:Toluol.svg|frameless|center|60x50px]]
|-
| [[Xylene]] (liquid) Paint thinner, adhesive, degreaser
|
|-
| [[Fluorocarbon]]s
|
| Chlorofluorocarbons (gas): (freons: difluoroethane, dichlorofluoromethane, tetrafluoroethane, bromochlorodifluoromethane) Refrigerants, various aerosol propellants (hair spray, spray paint, computer spray or duster, deodorants, room fresheners, fire extinguisher)
|
|-
| [[Ketone]]s
|
| [[Depressant]]
| [[Acetone]] (used in [[nail polish remover]])
| [[Image:Acetone-2D-skeletal.svg|frameless|center|60x50px]]
|}


==Medical inhalants==
==Medical inhalants==


===Anesthetics===
===Antidote to cyanide poisoning===
 
====Alkyl nitrites (poppers)====
[[Alkyl nitrites]] (also known as poppers) are a class of volatile liquid substances whose fumes are inhaled for recreational purposes, particularly in preparation for sexual activities.<ref name="MerckManuals">{{Citation | title=Volatile Nitrites - Special Subjects | url=https://www.merckmanuals.com/professional/special-subjects/recreational-drugs-and-intoxicants/volatile-nitrites?ruleredirectid=249&qt=&sc=&alt=}}</ref> They are known for producing intense but short-lived muscle relaxing effects that start after about 15 seconds and last for up to 3 minutes.The substance is often sold under the name 'Rush'.
 
===General anesthetics===
For a full list of medical inhalational anesthetic agents, see: [https://en.wikipedia.org/wiki/List_of_medical_inhalants#Inhalational_anesthetic_agents List of medical inhalants#Inhalational anesthetic agents]
For a full list of medical inhalational anesthetic agents, see: [https://en.wikipedia.org/wiki/List_of_medical_inhalants#Inhalational_anesthetic_agents List of medical inhalants#Inhalational anesthetic agents]


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======Food grade cream chargers compared to medical nitrous oxide======
======Food grade cream chargers compared to medical nitrous oxide======
*Medical grade contains 50% nitrous oxide, and 50% oxygen.
*Medical grade contains 50% nitrous oxide, and 50% oxygen.
*The gas from "cream chargers" contains food grade, not medical grade nitrous oxide. Thus, they can contain a range of impurities, such as industrial grease left over from manufacturing, and tiny particles of steel from the pierced metal. Users can filter them through a piece of cotton, cloth, or clothing to reduce the amount of impurities inhaled.<ref>https://www.dancewizensw.org.au/filtering-nangs</ref><ref>http://www.erowid.org/chemicals/nitrous/nitrous_article2.shtml</ref> Regular cleaning of nitrous dispensing devices can also reduce the harm posed by impurities.<!-- Added to: Inhalants, Nitrous -->
*The gas from "cream chargers" contains food grade, not medical grade nitrous oxide. Thus, they can contain a range of impurities, such as industrial grease left over from manufacturing, and tiny particles of steel from the pierced metal. Users can filter them through a piece of cotton, cloth, or clothing to reduce the amount of impurities inhaled.<ref>https://www.dancewizensw.org.au/filtering-nangs</ref><ref>http://www.erowid.org/chemicals/nitrous/nitrous_article2.shtml</ref> Regular cleaning of nitrous dispensing devices can also reduce the harm posed by impurities.<!-- Added to: Inhalants, Nitrous -->
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*[https://erowid.org/experiences/subs/exp_Xenon.shtml Erowid Experience Vaults: Xenon]
*[https://erowid.org/experiences/subs/exp_Xenon.shtml Erowid Experience Vaults: Xenon]


====Historical agents====
====Historical general anesthetics====
 
Obscure compounds:
* [https://en.wikipedia.org/wiki/1,1,1-Trichloroethane 1,1,1-Trichloroethane] (Wikipedia)
* [https://en.wikipedia.org/wiki/Carbon_tetrachloride Carbon tetrachloride] (Wikipedia)


======Chloroethane======
======Chloroethane======
It was commonly used to induce general anaesthesia before continuing with di-ethyl ether, which had a very much slower up-take.  
It was commonly used to induce general anaesthesia before continuing with di-ethyl ether, which had a much slower up-take.  


In Brazil, [[chloroethane]] is a major component of a traditional (though illegal) drug taken during Carnaval, known locally as "lança-perfume"<ref>{{Cite magazine | url=http://healthland.time.com/2010/12/02/whats-lanca-perfume-the-biggest-drug-in-rio-youve-never-heard-of/ |title = What's Lança-Perfume? The Drug from Rio's Bust You've Never Heard of|magazine = Time|last1 = Melnick|first1 = Meredith|date = 2 December 2010}}</ref> (lit. ''perfume launcher'' or ''sprayer'').
Albeit not used an inhalant in modern times it is still worth to note that: In Brazil, [[chloroethane]] is a major component of a traditional (though illegal) drug taken during Carnaval, known locally as "lança-perfume"<ref>{{Cite magazine | url=http://healthland.time.com/2010/12/02/whats-lanca-perfume-the-biggest-drug-in-rio-youve-never-heard-of/ |title = What's Lança-Perfume? The Drug from Rio's Bust You've Never Heard of|magazine = Time|last1 = Melnick|first1 = Meredith|date = 2 December 2010}}</ref> (lit. ''perfume launcher'' or ''sprayer'').


======Chloroform======
======Chloroform======
'''Chloroform''', or '''trichloromethane''', is an organic compound with formula CHCl<sub>3</sub>. It is a colorless, strong-smelling, dense liquid. It is a volatile solvent that was used as a medical anesthetic during the late 19th and early 20th centuries. It is one of the four chloromethanes and a trihalomethane. It is a powerful anesthetic, euphoriant, anxiolytic and sedative when inhaled or ingested.<ref>{{cite book | veditors=((Deutsche Forschungsgemeinschaft, Commission for the Investigation of Health Hazards of Chemical Compounds in the Work Area)) | date=31 January 2012 | chapter=The MAK-Collection for Occupational Health and Safety | title=Chloroform [MAK Value Documentation, 2000] | publisher=Wiley-VCH Verlag GmbH & Co. KGaA | pages=20–58 | url=https://onlinelibrary.wiley.com/doi/10.1002/3527600418.mb6766e0014 | doi=10.1002/3527600418.mb6766e0014 | isbn=9783527600410}}</ref>
'''Chloroform''', or '''trichloromethane''', is an organic compound with formula CHCl<sub>3</sub>. It is a colorless, strong-smelling, dense liquid. It is a volatile solvent that was used as a medical anesthetic during the late 19th and early 20th centuries. It is one of the four chloromethanes and a trihalomethane. It is a powerful anesthetic, euphoriant, anxiolytic and sedative when inhaled or ingested.<ref>{{cite book | veditors=((Deutsche Forschungsgemeinschaft, Commission for the Investigation of Health Hazards of Chemical Compounds in the Work Area)) | date=31 January 2012 | chapter=The MAK-Collection for Occupational Health and Safety | title=Chloroform [MAK Value Documentation, 2000] | publisher=Wiley-VCH Verlag GmbH & Co. KGaA | pages=20–58 | url=https://onlinelibrary.wiley.com/doi/10.1002/3527600418.mb6766e0014 | doi=10.1002/3527600418.mb6766e0014 | isbn=9783527600410}}</ref>


The anaesthetic qualities of chloroform were first described in 1842 in a thesis by Robert Mortimer Glover, which won the Gold Medal of the Harveian Society for that year. Glover also undertook practical experiments on dogs to prove his theories. Glover further refined his theories and presented them in the thesis for his doctorate at the University of Edinburgh in the summer of 1847. The Scottish obstetrician James Young Simpson was one of the persons required to read the thesis, but later claimed to have never read the thesis and to have come to his conclusions independently.
The anesthetic qualities of chloroform were first described in 1842 in a thesis by Robert Mortimer Glover, which won the Gold Medal of the Harveian Society for that year. Glover also undertook practical experiments on dogs to prove his theories. Glover further refined his theories and presented them in the thesis for his doctorate at the University of Edinburgh in the summer of 1847. The Scottish obstetrician James Young Simpson was one of the persons required to read the thesis, but later claimed to have never read the thesis and to have come to his conclusions independently.


The use of chloroform during surgery expanded rapidly thereafter in Europe. In the 1850s, chloroform was used by the physician John Snow during the birth of Queen Victoria's last two children. In the United States, chloroform began to replace ether as an anesthetic at the beginning of the 20th century; however, it was quickly abandoned in favor of ether upon discovery of its toxicity, especially its tendency to cause fatal cardiac arrhythmia analogous to what is now termed "sudden sniffer's death". Some people used chloroform as a recreational drug or to attempt suicide.<ref>{{cite journal | vauthors=((Martin, W.)) | journal=British Medical Journal | title=A Case of Chloroform Poisoning; Recovery | volume=2 | issue=1331 | pages=16–17 | date=3 July 1886 | issn=0007-1447 | doi=10.1136/bmj.2.1331.16-a}}</ref>
The use of chloroform during surgery expanded rapidly thereafter in Europe. In the 1850s, chloroform was used by the physician John Snow during the birth of Queen Victoria's last two children. In the United States, chloroform began to replace ether as an anesthetic at the beginning of the 20th century; however, it was quickly abandoned in favor of ether upon discovery of its toxicity, especially its tendency to cause fatal cardiac arrhythmia analogous to what is now termed "sudden sniffer's death". Some people used chloroform as a recreational drug or to attempt suicide.<ref>{{cite journal | vauthors=((Martin, W.)) | journal=British Medical Journal | title=A Case of Chloroform Poisoning; Recovery | volume=2 | issue=1331 | pages=16–17 | date=3 July 1886 | issn=0007-1447 | doi=10.1136/bmj.2.1331.16-a}}</ref>
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*[https://erowid.org/experiences/subs/exp_Ether.shtml Erowid Experience Vaults: Ether]
*[https://erowid.org/experiences/subs/exp_Ether.shtml Erowid Experience Vaults: Ether]


===Vasodilators===
==Non-medical inhalants==
Ethanol (the [[alcohol]] which is normally drunk) is [https://en.wikipedia.org/wiki/Alcohol_inhalation sometimes inhaled], but this cannot be done at room temperature.


====Historical====
==Toxic inhalants==
{{GenericPanel/warning
| title=Toxic inhalants can cause sudden death and should never be inhaled!
}}


=====Poppers=====
[[Alkyl nitrites]] (also known as poppers) are a class of volatile liquid substances whose fumes are inhaled for recreational purposes, particularly in preparation for sexual activities.<ref name="MerckManuals">{{Citation | title=Volatile Nitrites - Special Subjects | url=https://www.merckmanuals.com/professional/special-subjects/recreational-drugs-and-intoxicants/volatile-nitrites?ruleredirectid=249&qt=&sc=&alt=}}</ref> They are known for producing intense but short-lived muscle relaxing effects that start after about 15 seconds and last for up to 3 minutes.
==Dangerous inhalants==
Most users tend to be "... adolescents (between the ages of 12 and 17)."{{refn|1=For example, studies on inhalant use in New Zealand showed that "... most of the inhalant abusers are within the 14- to 18-year-old age group"; in the Philippines, the mean age of sniffers was 15; in Korea, a 1992 study showed "86 percent are male and are below the age of 20"; about 3/4 of Singapore inhalant users in a 1987 study were 19 or younger.<ref name="autogenerated1"/>}}
Most users tend to be "... adolescents (between the ages of 12 and 17)."{{refn|1=For example, studies on inhalant use in New Zealand showed that "... most of the inhalant abusers are within the 14- to 18-year-old age group"; in the Philippines, the mean age of sniffers was 15; in Korea, a 1992 study showed "86 percent are male and are below the age of 20"; about 3/4 of Singapore inhalant users in a 1987 study were 19 or younger.<ref name="autogenerated1"/>}}


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=====Liquid=====
=====Liquid=====


======Petrol/gasoline======
======Gasoline/petrol======
{{GenericPanel/warning
{{GenericPanel/warning
| title=''Medical gasoline'' is designed for topical use, for example to make it easy to remove adhesive residues from plaster and band-aid. It is not safe to inhale medical gasoline, just because the purification from lead eliminates lead toxicity. Medical gasoline still consists of aliphatic hydrocarbons and can cause sudden death though hydrocarbon toxicity.
| title=Gasoline is never safe to inhale. ''Medical gasoline'' is designed for topical use, for example to make it easy to remove adhesive residues from plaster and band-aid. It is not safe to inhale medical gasoline, just because the purification from lead eliminates lead toxicity. Medical gasoline still consists of aliphatic hydrocarbons and can cause sudden death though hydrocarbon toxicity.
}}
}}


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======Freon======
======Freon======
Freon is a trademark name for fluorinated hydrocarbons. Freon is an odorless gas commonly used as refrigerants and as aerosol propellants, also found in air conditioning units. They are stable, nonflammable, low toxicity gases or liquids.
Freon is a trademark name for fluorinated hydrocarbons. Freon is an odorless gas commonly used as refrigerants and aerosol propellants, it's also found in air conditioning units. They are stable, nonflammable, low toxicity gases or liquids.


Use of this inhalant can cause sudden death upon inhalation and is not advisable from a harm reduction perspective.  
Use of this inhalant can cause sudden death upon inhalation and is not advisable from a harm reduction perspective.  
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</center>
</center>


===Toxicity and harm potential for dangerous inhalants===
===Toxicity and harm potential for toxic inhalants===
'''There is no safe way to consume aerosol sprays, or solvents, as sudden death upon inhalation is always a present risk.'''
'''There is no safe way to consume aerosol sprays, or solvents, as sudden death upon inhalation is always a present risk.'''


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==Toxicity and harm potential==
==Toxicity and harm potential==
'''This section covers risks general risks for both medical and nonmedical inhalants. For specific risks with nonmedical inhalants, see [[#Toxicity and harm potential for dangerous inhalants|Toxicity and harm potential for dangerous inhalants]]'''
[[File:HarmCausedByDrugsTable.svg|thumb|upright=1.35|Table from the 2010 ISCD study ranking various drugs (legal and illegal) based on statements by drug-harm experts. Butane was found to be the 14th overall most dangerous drug.<ref name="Nutt_2010">{{cite journal | vauthors = Nutt DJ, King LA, Phillips LD | title = Drug harms in the UK: a multicriteria decision analysis | journal = Lancet | volume = 376 | issue = 9752 | pages = 1558–1565 | date = November 2010 | pmid = 21036393 | doi = 10.1016/S0140-6736(10)61462-6 | s2cid = 5667719 | citeseerx = 10.1.1.690.1283 }}</ref>]]
 
'''This section covers risks general risks for both medical and nonmedical inhalants. For specific risks with nonmedical inhalants, see [[#Toxicity and harm potential for dangerous inhalants|Toxicity and harm potential for toxic inhalants]]'''


It is strongly recommended that one use [[responsible use|harm reduction practices]] when using this class of substances.
It is strongly recommended that one use [[responsible use|harm reduction practices]] when using this class of substances.


Both medical and nonmedical inhalants should be avoided by:
Both medical and nonmedical inhalants should be avoided by:
* Inhaling large quantities continuously with a strap-on mask connected to a gas canister. Because it will eventually cause oxygen deprivation. In some cases, users have died from a lack of oxygen, also known as hypoxia{{citation needed}}.  
 
* Inhaling compressed gas directly from a container. Because it can cause aerosol burn and frostbite.
*Inhaling large quantities continuously with a strap-on mask connected to a gas canister. Because it will eventually cause oxygen deprivation. In some cases, users have died from a lack of oxygen, also known as hypoxia{{citation needed}}.
*Inhaling compressed gas directly from a container. Because it can cause aerosol burn and frostbite.


===Addiction potential===
===Addiction potential===
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*[[Responsible use]]
*[[Responsible use]]
*[[Nitrous oxide]]
*[[Poppers]]


==External links==
==External links==