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Inhalant Withdrawal Symptoms and Signs and Detoxification

The term “inhalants” covers a wide spectrum of substances that share the ability to produce chemical fumes or vapors. These substances have psychoactive, or mind-altering effects when sniffed, huffed, or inhaled.1

In 2016, there were about 600,000 people using inhalants to achieve a euphoric state.Despite their appeal (a quick and cheap high), inhalants can trigger adverse effects on the brain and the body when abused, as well as withdrawal symptoms when use ends. Although these symptoms can cause some discomfort and distress, getting clean and sober is essential to your physical, emotional, social, and spiritual health.

Many safe and effective inhalant withdrawal treatment options are available to help you with the process of safely ending your dependence on and addiction to inhalants.

Reasons to Quit Inhalants

Inhalants are consumed by: 1

  • Sniffing and snorting directly from containers.
  • Spraying aerosols into the nose and mouth.
  • Bagging – inhaling from substances sprayed or put in a bag.
  • Huffing vapors from a bag filled with vapors or directly from a chemical-soaked rag placed in the mouth.
  • Inhaling from balloons filled with gases.

When breathed in, the chemicals in inhalants quickly move from the lungs to the bloodstream before being distributed throughout the body.1 Once in the brain, volatile solvents, aerosols, and gases act on the central nervous system (CNS) and produce effects similar to those of alcohol and sedatives. Initially, these effects may be pleasurable and include:

  • A very short-lived feeling of euphoria.
  • An initial burst of excitation.

But while the high comes on quickly, so do the unwanted side effects:1

  • Drowsiness.
  • Lightheadedness.
  • Headache.
  • Lack of coordination.
  • Slurred speech.
  • Loss of self-control.

Solvent and gas inhalation can result in feelings of numbness and a loss of consciousness. Due to the very brief high, people using them may use them repeatedly, raising their risks of losing consciousness or even dying.1

Nitrites, specifically, affect the body somewhat differently than other inhalant substances. They relax smooth muscle tissue and dilate blood vessels, 1 and they are used frequently to enhance sexual encounters. Their use is associated with a high risk of spreading infectious diseases such as HIV/ AIDS and hepatitis.1

Inhalants not only impact a person’s physical health in negative ways, they are also detrimental to their mental health. Mental health side effects of inhalants may include:1

  • Anger and agitation.
  • Hallucinations – seeing, hearing, or feeling things that are not present.
  • Delusions – having irrational, odd, or paranoid thoughts.

Solvents and aerosols are linked to a frightening phenomenon called sudden sniffing death, which occurs when a rapid and irregular heartbeat leads to cardiac arrest shortly after inhalant use.1 The chemicals with the biggest risk of sudden sniffing death are:1

  • Butane.
  • Propane.
  • Aerosol chemicals.

The short duration of the high from inhalants might make them seem benign to some degree, but the dangers aren’t limited to the brief time span where a person feels intoxicated. With continued use of inhalants, the risk of the following issues increases:3

  • Organ injury (including the liver and kidneys).
  • Hearing and vision loss.
  • Damage to the bone marrow.
  • Nerve damage resulting in long-term loss of coordination and muscle spasticity.
  • Developmental delays in children or adolescents secondary to brain injury.
  • Anoxic brain damage (from lack of oxygen delivery to the brain).
4 Categories of Inhalants:1,4
Volatile solvents – liquids that become gases at room temperature. Includes cheap and easily accessible home, cleaning, and art supplies like:

  • Paint thinners.
  • Nail polish removers.
  • Degreasers.
  • Gasoline.
Aerosols – usually found in sprays cans like:

  • Spray paint.
  • Hair spray.
  • Spray deodorant.
Gases – includes medical gases and gases found around the home.

  • Medical gases are often anesthetics like:
    • Ether.
    • Chloroform.
    • Nitrous oxide – laughing gas – also found in whipped cream cans and N20 chargers.
  • Household gases like.
    • Butane lighter fluid.
    • Propane tanks.
Nitrites – Often called “poppers,” amyl, butyl, and cyclohexyl nitrites are used illicitly for the enhancement of sexual encounters. Now banned by the Consumer Product Safety Commission, nitrites may still be found in products labeled as:

  • Video head cleaner.
  • Room odorizer
  • Leather cleaner.
  • Liquid aroma.

Dependence and Addiction

There are some common misunderstandings when it comes to inhalants. Because these products are relatively easy to find and purchase, some people may believe that inhaling these substances is without the kinds of risks inherent to other drugs. These misconceptions about inhalants are dangerous, though, because consistent use over time often results in:5

  • Inhalant tolerance – the need for more of the inhalant to produce the desired level of intoxication or muscle relaxation.
  • Inhalant dependence – a physical adaptation where the body requires the substance to maintain normal functioning and avoid withdrawal.
  • Inhalant addiction – strong desire to keep using inhalants, even though doing so hurts you and those you love. About 20% of all adolescents who use inhalants will develop an inhalant use disorder.6

As someone uses a substance over time, they might experience less of an intoxicating effect from the drug, indicating a developing tolerance.7 Then, the person attempts to counteract tolerance by consuming larger quantities of the substance more often. As this continues, the person may come to only feel normal when the substance is in their system, which indicates they’ve become dependent on the inhalants.7

Without regular inhalant consumption, a dependent person will feel odd, uncomfortable, or even sick. The physical and psychological symptoms that come with cutting back or stopping is referred to as the withdrawal syndrome. 

Inhalant Withdrawal Symptoms

Withdrawal symptoms are distressing and potentially dangerous problems that emerge in the hours or days following the last use of a substance.7 In many cases, the use of any substance associated with dependence will lead to a relatively predictable set of withdrawal symptoms (i.e., an acute withdrawal syndrome).

There is some debate about inhalants, however, and whether they cause significant physiological dependence—and, therefore, a marked withdrawal syndrome. The American Psychiatric Association (APA) decided not to recognize the diagnosis of inhalant withdrawal in the newest version of their Diagnostic and Statistical Manual of Mental Disorders (DSM-5) because the group believed inhalant withdrawal symptoms to be too mild and too inconsistent to be included.6

Not everyone agrees with this conclusion, though, as significant inhalant withdrawal symptoms have been reported and observed. When a person ceases to use one of these substances, they may experience a variety of withdrawal symptoms that resemble some of those linked to alcohol withdrawal symptoms. They include:3,5

  • Excessive sweating.
  • Insomnia.
  • Restlessness.
  • Poor attention and concentration.
  • Runny nose and watery eyes.
  • Loss of appetite.
  • Nausea and vomiting.
  • Quickened heart rate.
  • Mood changes such as irritability and depression.
  • Increased anxiety.
  • Hallucinations.

One telling sign of drug withdrawal is an overwhelming desire for more of the substance. People who stop using inhalants often report cravings that are significant enough to disrupt their routines.5

The withdrawal symptoms timeline will vary depending on several facets of use including which specific inhalant substance has been used. There have been reports of withdrawal symptoms beginning soon after last use and persisting for a total of 7 days.5

Initially, it might not seem that these symptoms are very serious, but there are significant mental health risks related to inhalant withdrawal. Symptoms like hallucinations and worsening depression could lead to serious negative outcomes.

Withdrawing from Inhalants: Treatment Methods

With the proper support and dedication to the process, you can get through the withdrawal stage and achieve a clean and sober life. While some may wish to accomplish this at home, many seek recovery assistance from a treatment facility to better avoid relapse and receive any necessary medical care.

Often when you are seeking help for addiction, you’ll meet with a doctor or other addiction treatment professional who will help you develop a treatment plan that fits your specific needs. You may be asked about:8

  • Which inhalants you used.
  • How often and how much you used.
  • Any other substance abuse.
  • Whether you know of any other mental health or medical issues.
  • Any prior withdrawal experience or substance abuse treatment attempts.
  • The level of support you have from friends and family.
  • Stressors (e.g., strained relationships, substance-using family or friends, etc.)

For many individuals, their specific treatment plan will begin with a period of detox, which may or may not be available as part of a longer addiction rehab program. Detoxification, a set of professional interventions and strategies meant to ease your symptoms and improve your comfort during withdrawal, is a fantastic first step toward recovery.7 Different detox programs provide varying levels of treatment intensity and medical involvement.

In general, medical detox programs provide the most intensive forms of detox intervention, as they involve medical supervision and treatment from doctors and nurses.8 Though there are no medications specifically designed to manage inhalant dependence or withdrawal, certain medications may be given to help alleviate some of the withdrawal symptoms like insomnia.8

Depending on the severity of your inhalant dependence, your doctor or addiction treatment team may recommend a different type of detoxification protocol known as social detox. 8 In social detox, a treatment team works to decrease discomfort and relapse risk by providing support in a calm, relaxing environment where no inhalants are available.

Both medical and social styles of detox are available in inpatient and outpatient settings. Inpatient options require the individual to live at the center during their treatment. Inpatient treatments offer 24-hour support and care. These options may take place in hospitals, rehab centers, or freestanding detox centers in the community.8

Outpatient detox treatments are available at doctors’ offices, mental health facilities, and addiction treatment centers.8 The outpatient option may be appropriate for people who have a strong support network in place that can help them through the recovery process.

Detox should be followed up by a longer course of addiction treatment, as addressing chemical dependence is only the first step in overcoming addiction. Without therapy and other interventions, the unchecked compulsion to use is may be more likely to lead to relapse.

After Detox: Addiction Rehab and Recovery

Detox is incredibly valuable, but it is only a small part of someone’s overall treatment and recovery. 7 What detox does is ready the mind and body for recovery. You must be free of the influences of the substances in order to benefit from the therapeutic interventions you’ll need to overcome your compulsions to seek out and use inhalants.

The many treatment options for post-detox care allow you to find a service level that fits your needs. If you don’t know where to begin, consult with your detox center. After all, an important aspect of effective detox is linking patients to continuing care.8

Addiction treatment following detox fit into 2 general categories:

  • Inpatient/residential rehabilitation—Provides a higher, more intense level of care for people who are not yet ready to return to their normal home life. Just like with detox, inpatient rehabs provide 24-hour staff and require you to live at the facility.7 Residential rehabs can last for many months to establish stability and cement new skills and ways of thinking.
  • Outpatient treatment—A more flexible and somewhat less intensive form of treatment, this type of care allows for you to attend treatment for a set period of time each day or week before returning home each night.7

Outpatient treatment can range in terms of the required time commitment, with some standard outpatient programs requiring only a one-hour session each week. More intensive options include partial hospitalization programs (PHP) that conduct, on average, 6 hours of treatment per day for 5 days per week and intensive outpatient programs (IOP) that provide about 6 hours of treatment throughout the week.9

Whichever type of treatment you choose, you will attend therapy. This can take the form of one-on-one counseling with a qualified psychotherapist, group therapy at a treatment facility, or family therapy sessions. Therapy is an important part of the healing process because it helps you overcome the psychological and emotional reasons for using inhalants.

The same treatment program won’t work for everyone. For example, adolescents are more likely to abuse inhalants than other age groups, so the therapies used must match the needs, development, and learning styles of teens.9 A combination of individual, group, and family therapy can be helpful in addiction treatment, but adolescents may struggle in group settings due to a tendency to discuss the positive aspects of getting high instead of focusing on the negatives of inhalants and the benefits of recovery.9 Treatment professionals will monitor these issues, direct sessions, and offer other treatments for those who struggle in group settings.

Although enduring inhalant withdrawal symptoms at the start of your recovery from inhalant addiction can be a challenge, it is one you can overcome with the right support.

Questions and Answers (FAQ)

What are some street names/slang terms for Inhalants?

Different types of inhalants will go by different slang terms including:10

  • Nitrous oxide:
    • Laughing gas.
    • Whippits.
    • Hippie crack.
    • Buzz bomb.
  • Amyl nitrite:
    • Boppers.
    • Poppers.
    • Ames.
    • Amies/Amys.
    • Pearls.
    • Rush.
  • Isobutyl nitrite:
    • Hardware.
    • Bullet.
    • Climax.
    • Thrust.
    • Quicksilver.

Can using inhalants kill you?

Yes. Inhalants are deadly and can kill you in several different ways. As mentioned above, sudden sniffing death is the result of irregular heart rhythms produced by inhalants, but inhalants can also be deadly by way of:1

  • Asphyxiation. Chemical vapors in the lungs can impair normal blood oxygenation.
  • Suffocation. When someone “bags” (inhales vapors with a bag over their head), they could cut off their air supply.
  • Choking. Inhalant use can result in vomiting and subsequent aspiration—which occurs when stomach contents are breathed into the lungs.
  • Injuries. People may suffer injuries due to incoordination while walking or driving under the influence.

Inhalant use can also result in severe seizures, convulsions, coma, and death.

Are There any Home Remedies for Getting Clean Safely?

With any substance abuse, home remedy and alternative withdrawal methods can be risky. You are far better off seeking professional advice before you begin any sort of withdrawal or detox program.

References:

  1. National Institute on Drug Abuse. (2012). Research Report Series: Inhalants.
  2. Substance Abuse and Mental Health Services Administration. (2017). Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health.
  3. National Institute on Drug Abuse. (2017). DrugFacts: Inhalants.
  4. National Institute on Drug Abuse for Teens. (2017). Inhalants.
  5. Perron, B. E., Howard, M. O., Vaughn, M. G., & Jarman, C. N. (2009). Inhalant Withdrawal as a Clinically Significant Feature of Inhalant Dependence DisorderMedical Hypotheses73(6), 935–937
  6. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  7. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide.
  8. Substance Abuse and Mental Health Services Administration. (2015). Detoxification and Substance Abuse Treatment.
  9. National Institute on Drug Abuse. (2014). Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide.
  10. Center for Substance Abuse Research. (2013). Inhalants.
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