From Chapter One of the book
How to Quit Drugs for Good

How to Quit Drugs for Good

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Inhalants

Through the wizardry of modern chemical science, we now have available dozens of substances that produce psychoactive vapors. There’s nothing natural here. These substances are purely the product of industry. Among the inhalants are three remarkably different types of substances: nitrous oxide and other anesthetic gases, nitrites, and solvents and aerosols.

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Nitrous oxide and other anesthetic gases. Nitrous oxide, also known as laughing gas, has a medical use as a dental anesthetic. It’s also used as the propellant in whipped-cream containers. It comes in small metal cylinders called “whippets” by those in the drug culture. Some users inhale this gas from balloons or from special pipes called “buzz bombs.” Other anesthetic gases that people sometimes abuse are ether, chloroform, and halothane. However, none of these is as common on the street.

Nitrites. The nitrites are yellow, flammable liquids that have a fruity odor. The best known of these, amyl nitrite, can be obtained by prescription for alleviating heart pain (angina). It comes in ampoules that, when broken, release the fumes (AKA: Poppers, Snappers, Amies, Pearls). Other nitrites include butyl nitrite (which until 1995 was sold legally as room deodorizers and liquid incense) and isobutyl nitrite. AKA for butyl nitrite: Rush, Kick, Locker Room, Locker Popper, Jock Aroma, Satan’s Scent, Toilet Water. AKA for isobutyl nitrite: Bolt, Bullets, Climax.

Solvents and aerosols. This group includes gasoline, lighter fluid, glues, refrigerants, paint, lacquers, paint thinners, paint sprays, degreasers, cleaning solutions, correction fluids, felt-tip marker fluid, fabric protector sprays, and hair or deodorant sprays. Users can inhale these chemicals directly or by using a soaked rag. Another method involves saturating a cotton ball or rag, placing it in a paper or plastic bag, and inhaling the contents. This is called “bagging.” AKA for breathing solvents and aerosols: Huffing.

How They’re Used

All these substances are inhaled through the nose or mouth. Users simply breathe the fumes.

Each substance in this category produces a brief high—lasting from two to five minutes with each inhalation. A deeper high, to the point of delirium or intoxication, comes from continuous inhalation over a short period of time. Nevertheless, once the user stops inhaling, the high begins to fade and usually ends within five minutes for nitrites and gaseous anesthetics and within 10 to 20 minutes for solvents and aerosols.

Popularity

About 5.6% of Americans have used one or more of the inhalants at some time in their lives. About 1.1% have used one or more during the past year, and 0.4% have used within the past month. That’s about 961,000 current users. Of these, 391,000 were aged 12 to 17, and 289,000 were aged 18 to 25.

The Joy of It

Nitrous oxide and the gaseous anesthetics. Nitrous oxide is the mildest of the gaseous anesthetics. It reduces pain and increases the sense of euphoria. It can also lower inhibitions while increasing mental exhilaration, so things often seem funnier than usual. At higher concentrations, it causes drowsiness. The other gaseous anesthetics produce these effects as well but at higher concentrations cause major sedation.

Nitrites. The nitrites relax the smooth muscles of the body—those that control blood vessels, the bladder, the anus, and other tissues. Users often feel as if their bodies go limp. They might also feel light-headed or faint. Indeed, after popping, some users collapse into a giddy heap on the floor.

Because the nitrites relax the muscles that regulate the blood vessels, they produce an increased heart rate along with a drop in blood pressure. Most users feel sensations of pleasure and warmth, and some take nitrites to boost the pleasure of sex. Some users report that when they’re high they feel that their orgasms last longer. The nitrites gained favor among gay men for this reason and for the added reason that these drugs relax the anal sphincter muscle, making penetration easier.

Solvents and aerosols. This group of chemicals produces an intoxication similar to that of alcohol. Users experience reduced inhibitions, increased mental energy or exhilaration, and feelings of physical calm. Continued huffing in a single session leads to drowsiness, numbness, and even unconsciousness. Continued use can also cause dizziness, disorientation, delusions, and hallucinations. Users might “see” shooting stars, ghosts, or angels and “hear” deafening explosions, unusual voices, or music from the center of the universe. Some of the reported delusions include feeling as if you can fly, feeling as if you’re a supremely powerful hero or villain, or feeling as if you can walk through walls.

The Problems It Causes

Nitrous oxide. Users sometimes experience injuries to the mouth, trachea, or lungs because of the cooling effects of expanding gas. Users also run the risk of death by asphyxiation if they don’t ensure a supply of oxygen-rich air. This happens occasionally when someone falls into unconsciousness and breathes only nitrous oxide. Long-term users have problems with vitamin B12 deficiency. Nitrous oxide inactivates B12, which causes the destruction of nerve fibers (neuropathy). Physical symptoms of this damage include weakness, tingling sensations, decreased sense of touch, abnormalities in gait, decreased ankle and knee reflexes, and bladder and bowel dysfunction. Psychological symptoms include loss of memory, depression, confusion, and delirium.

Nitrites. Side effects of using nitrites include headaches, flushing of the skin, cold sweats, dizziness, and the potential to drop briefly into unconsciousness. Some users get crusty lesions on the skin around the mouth, nose, penis, and scrotum. Some users get skin rashes or irritations of the throat and eyes. Nitrites also cause a decrease in the blood’s ability to carry oxygen (methemoglobinemia). This can be serious enough to cause coma or death. The early signs of methemoglobinemia are breathlessness combined with the lips, tongue, and hands turning blue. This condition becomes most serious when nitrites have been swallowed rather than inhaled.

Solvents and aerosols. Among all the drugs of abuse, solvents and aerosols might be the most dangerous. Once inside the body, these chemicals wreak destruction. They cause serious damage to the liver, kidneys, muscles, gastrointestinal system, and cardiovascular system and to the brain and nervous system. In long-term moderate users and short-term heavy users, damage to the kidneys, the nervous system, and the brain can be irreversible.

Studies show that these chemicals have caused thousands of deaths. The term “sudden sniffing death” (SSD) refers to death from cardiac arrest. Inhaling coolants (such as freon), propellants from hair spray or spray paint, and fuel gases (such as butane and propane) often lead to heart arrhythmias that can end in cardiac arrest. About 50% of all inhalant deaths are SSDs. Another significant percentage of sniffers die from suffocation. This occurs when a user becomes unconscious and falls on a rag containing one of the solvents or becomes unconscious when huffing from a plastic bag placed over the head. A small percentage who use aerosol products have died from freezing of the airways (laryngospasm). Another small percentage of sniffers and huffers have died from inhalation of vomit after falling into an unconscious or a semiconscious state. A large percentage of deaths from inhalant use can be attributed to accidents. One broad-based study of 1,239 inhalant deaths showed that 26% were due to accidents.

Withdrawal

There’s no documented abstinence syndrome for nitrous oxide and the nitrites. Some long-term heavy users of solvents and aerosols experience a withdrawal syndrome that includes stomach cramps, chills, hallucinations, and delirium tremens (DTs). However, this syndrome is rare.