Inhalants

How are inhalants used?

When inhaled, inhalant fumes enter the bloodstream very quickly and the effects are felt almost instantly. But the inhalant ‘high’ is short, so some people may keep using to maintain or extend this high.^{6, 7}

• Volatile solvents and aerosols are usually breathed in straight from the container, or after being soaked onto a cloth or sprayed into a bag before inhaling.¹
• Gases such as nitrous oxide are typically inhaled after the gas has been released from metal cannisters (often called bulbs or whippets) into another object, like a balloon. Sometimes people inhale directly into the mouth, however this method of use should be avoided as it is extremely dangerous and can be fatal.⁷
• Alkyl nitrites are inhaled (sniffed) directly from the bottle.⁶

Effects of inhalants

The use of any drug can have risks. It’s important to be careful when taking any type of drug.

Inhalants affect everyone differently, based on:

• size, weight and health
• whether the person is used to taking it
• whether other drugs are taken around the same time
• the amount taken
• the strength (varies from product to product)
• the environment (where it is taken).

There are many different types of inhalants. Each type contains unique chemicals; meaning they all have unique risks and effects.

Some of the shared immediate effects that can be experienced after using an inhalant include:

• rush of euphoria
• uncontrolled laughter
• confusion and disorientation
• lowered inhibitions
• hallucinations and delusions
• headaches, dizziness and/or light-headedness
• temporary reddening of the face caused by increased blood flow
• irritation to eyes, nose and throat
• reduced coordination
• muscle relaxation
• feeling unusually tired or weak
• numbness of the body
• increased skin sensitivity and irritation
• irregular heartbeat
• chest pain
• low blood pressure
• nausea
• vomiting
• diarrhoea.^{3, 4, 6-9}

Impact of mood and environment

Drugs that affect a person’s mental state (psychoactive drugs) can also have varied effects depending on a person’s mood (often called the ‘set’) or the environment they are in (the ‘setting’):

• Set: a person’s state of mind, previous encounters with the drug, and expectations of what’s going to happen. For example, feelings of stress or anxiety before using inhalants may result in an unpleasant experience and make those feelings worse.
• Setting: the physical and social environment where you use inhalants – whether it’s known and familiar, who you're with, if you're indoors or outdoors, the type of music or sounds, and lighting. The ideal setting to use inhalants will vary based on the individual and drug they’re using. For example, one person might enjoy using inhalants at a festival, while another may prefer being with friends at home.¹⁰

Being in a good state of mind, with trusted friends and a safe environment before using inhalants reduces the risk of having a bad experience.¹⁰

Overdose

If you inhale a large amount or inhale too frequently, you could overdose.

Your risk of overdose can also increase if you mix inhalants with other drugs, including medications.

Call triple zero (000) and request an ambulance if you or someone else has any of the following symptoms (emergency services are there to help and can provide more instructions).

• nausea, vomiting
• irregular, slow or no heartbeat and pulse
• chest pain
• cool or clammy (wet and sweaty) skin
• skin colour changes, especially lips and fingernails:
• typically, bluish-purple skin for people with lighter complexions
• or greyish or ashen skin for people with darker complexions
• seizures
• unconsciousness or non-responsive.^{8, 9}

Inhalants carry the risk of death. The three main causes are:

• Sudden sniffing death - refers to cardiac arrest or heart failure that can occur after using inhalants, such as volatile solvents or aerosol. The chemicals in these inhalants can cause a spike in adrenaline which the heart is sensitive to, resulting in cardiac arrest. The risk of sudden sniffing death increases if the person is stressed or does intense exercise after inhaling.
• Suffocation - can occur when an inhaled gas, like nitrous oxide, takes the place of oxygen in the lungs. This can happen when inhalants are used in enclosed spaces without fresh air, or through dangerous practices such as placing a plastic bag over the head. Suffocation can also occur if a person sprays some substances directly into the mouth as it can freeze the throat and airways.
• Swallowing alkyl nitrites - can interfere with the blood’s ability to carry oxygen through the body, leading to a condition called methemoglobinemia, which can be fatal. If alkyl nitrites are swallowed seek medical attention immediately.^{4, 9, 11}

Mixing inhalants with other drugs

Mixing inhalants with alcohol and other drugs can have unpredictable effects and increase the risk of harm. Mixing includes using more than one drug (including alcohol or medications) at the same time, or one after another. You should also consider what drugs you’ve taken in the last 24 hours.

• Inhalants and stimulants (such as amphetamine/dexamphetamine/methamphetamine): can increase stress and strain on the body and heart.
• Inhalants and depressants (such as alcohol/benzodiazepine/GHB): can increase the risk of losing consciousness.
• Alkyl nitrites and depressants (such as alcohol/benzodiazepine/GHB): can increase the risk of overdose and dangerously lower blood pressure and heart rate.
• Alkyl nitrites and other vasodilators (such as Viagra/Cialis): can cause cardiac arrest, stroke and death.^{3, 4, 6, 7, 12}

Using more than one drug or type of drug at the same time is called polydrug use.¹³

Reducing Harm

There are ways you can reduce the risk of harm when using inhalants:

• Start low, go slow – try a small amount first to see how you feel. Wait at least 30 minutes before deciding whether to take more.
• Avoid exercise or physical activity immediately after use to avoid risk of heart failure or lung injury.
• Never swallow, inject, spray directly into mouth or take any way other than inhaling to avoid risk of severe poisoning, suffocation, dangerously low blood pressure, and death.
• Never inhale nitrous oxide directly from bulbs or dispensers. Nitrous oxide gas is very cold (-40℃) and can cause frostbite to the nose, lips and throat. Releasing the nitrous oxide into a balloon helps to warm the gas and normalise the pressure before inhaling.
• Keep water handy to wash any affected areas, if you accidently spill it on yourself.
• Keep away from flames, including lit cigarettes, as inhalants can be highly flammable.
• Keep your face uncovered and make sure you can breathe freely – never put plastic bags over the head or block breathing in any way to avoid oxygen deprivation.
• Stay seated when using to prevent injury if you fall or lose consciousness.
• Take regular breaks and breathe in fresh air.
• Use in well-ventilated spaces with open doors/windows.
• Don’t use if you are anaemic, pregnant, have a heart condition, have abnormal blood pressure, or have increased pressure within the skull (head injury or brain haemorrhage), due to increased risk of harmful effects.
• Don’t operate machinery, drive, or swim.^{6, 7, 11}

Coming down

As the effects of inhalants begin to wear off, a person may experience symptoms such as headache, nausea and dizziness. These effects can last from a few minutes to several days.¹²

Long-term effects

Inhalants are among the most harmful and dangerous substances due to their long-term health effects, and risk of sudden death when using.

People who regularly use inhalants may experience:

• vitamin B12 deficiency (specific to nitrous oxide use)
• breathing problems e.g. cough, chest pain
• blurred vision or vision loss
• cognitive issues (e.g. memory, attention, decision making)
• tremors and other movement problems (e.g. difficulty walking) that could lead to accidents/falls
• damage to other parts of the body including the brain, bones, nerves, kidney, liver, heart and immune system.^{8, 9, 14, 15}

Most long-term effects are not permanent and can be reversed if use is stopped.

However, some inhalants such as cleaning products, correction fluid, aerosol sprays and petrol can cause permanent damage, especially if people use them heavily for a long period.

Inhalants and mental health

There are many different types of inhalants, and research on their specific impacts on mental health remains limited. But available evidence shows that regular use of some inhalants, like nitrous oxide, has been found to lead to depression and psychosis.¹⁶

There is no significant relationship between the use of alkyl nitrites and poor mental health.¹⁷

Tolerance

Regular use of some inhalants, such as nitrous oxide and nitrites, can lead to developing a tolerance – which means you need to take larger amounts to get the same effects.^{3, 4, 12}

Dependence

Evidence suggests that long-term use of certain inhalants can lead to dependence.⁹

People who regularly use nitrous oxide and petrol may become dependent. They may feel they need to use them to go about usual activities like working, studying and socialising, or just to get through the day.³

Alkyl nitrites are not known to cause dependence. However, some people report developing a psychological reliance on them, particularly in relation to sexual activity.⁴

People with existing mental health conditions may be at greater risk of developing dependence.

Withdrawal

Withdrawal refers to the symptoms that can occur when someone who is dependent on a drug, or who has been using it regularly over time, stops or reduces their use.¹⁸

Withdrawal can include physical symptoms (such as headaches, or nausea) and psychological symptoms (such as anxiety, or depressed mood).¹⁸

After a period of regular use, reducing or stopping the use of inhalants can lead to withdrawal symptoms as the body adjusts to functioning without them. Symptoms may include:

• headaches
• irritability
• sleep problems
• loss of appetite
• nausea
• tremors.^{9, 12}

Symptoms - including how strong they are and how long they last - will vary depending on the type of drug and a person’s history of use.¹⁸

Pregnancy and breastfeeding

Inhalants contain many toxic chemicals that can harm both you and your baby. Nearly all inhalants are believed to cross the placenta and enter the baby’s bloodstream. Because of this, it is important to stop using inhalants during pregnancy.¹⁹

Research in this area is limited, but known risks to the baby include:

• premature labour and early birth
• poor growth during pregnancy
• low birth weight
• ongoing growth problems in childhood
• reduced oxygen supply, which can affect brain development.¹⁹

Research on the impact of inhalants on breastmilk is limited. If you would like to breastfeed your baby and you are using inhalants, it is recommended that you speak with your doctor or midwife about how you can safely do this. It’s important to know that if you are using inhalants, you may not be alert enough to breastfeed safely or you may lose consciousness while breastfeeding, so it’s recommended to stop your use.¹⁹

Getting help

If your use of inhalants is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about someone else, you can find help and support.

Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs

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