Despite the dangers associated with inhalant abuse, no central system exists in the United States for reporting deaths and injuries from abusing inhalants. A study by Dr. James C. Garriott, the chief toxicologist in San Antonio and Bexar County, Texas, examined all deaths in the county between 1982 and 1988 that were attributed to inhalant abuse. Most of the thirty-nine inhalant-related deaths involved teenagers, with twenty-one deaths occurring among people less than twenty years old. Deaths of males outnumbered those of females thirty-four to five. Many of the abusers met with a violent death possibly related to but not directly caused by the use of volatile solvents. Eleven deaths were caused by suicide (ten by hanging), nine by homicide, and ten by accident, including falls, auto accidents, and overdoses.
Most of those people who died in Bexar County had used toluene-containing products, such as spray paints and lacquers, Dr. Garriott reported. The next most frequent cause of death in the Texas study was the use of a combination of chemicals found in typewriter correction fluids and other solvents. Other abused substances that resulted in death included gasoline, nitrous oxide, and refrigerants, such as fluorocarbons (Freon). Freon now has been replaced with butane or propane products in most aerosols.
As reported in the Texas study, the solvent toluene is identified frequently in inhalant-abuse deaths and injuries because it is a common component of many paints, lacquers, glues, inks, and cleaning fluids. A 1986 study of twenty chronic abusers of toluene-containing spray paints found that after one month of abstinence from sniffing the paint, 65 percent of the abusers had damage to the nervous system. Such damage can lead to impaired perception, reasoning, and memory, as well as defective muscular coordination and, eventually, dementia.
In England, where national statistics on inhalant deaths are recorded, the largest number of deaths in 1991 resulted from exposure to butane and propane, which are used as fuels or propellants. Many researchers believe that abuse of butane, which is readily available in cigarette lighters, is on the increase in the United States.
A recent report of this particular inhalant problem in the Cincinnati region indicates that butane gas is the cause of enough deaths to foster national concern about the abuse of fuel gases, whether or not it is a passing form of inhalant abuse. Sniffers seem to go out of their way to get their favorite product; in certain parts of the country, Texas 'shoeshine'—a shoe-shining spray containing toluene—and silver or gold spray paints are local or current favorites.
Since the banishing of fluorocarbons, the most common sniffing death hazards among U.S. students probably are due to butane and propane. Doctors and emergency room staffs need to be aware that the profile of the teenager who inhales volatile solvents is not limited to ethnic lower socioeconomic classes. Many sources lead us to believe that abuse of these readily available inhalants has reached epidemic proportions, indicating an urgent need for preventive efforts.
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