A volatile substance is a compound which gives off a vapour or fumes at room
temperature. The recreational sniffing of gases and solvents has become relatively common,
particularly among adolescents in Australia, with the mean age of solvent abusers being 12
to 15 years. Petrol sniffing is a particularly common practice among the youth of
Aboriginal settlements in the outback.
Volatile substances include petroleum fuels, propellants from aerosol products,
chlorinated hydrocarbons, glue, nail polish remover, antifreeze, paint thinners and
anaesthetic products.
All of these substances are fat soluble and are stored in the fat deposits within the
body, particularly in the brain. This leads to a prolonged effect on the level of
consciousness even hours after the inhalation has stopped. This is an extremely dangerous
practice and sudden death may occur even during the first usage.
The most important problem of volatile solvent use is the occurrence of potentially
fatal cardiac arrhythmias due to intoxication. Respiratory depression can also occur.
Pathological changes occurring in solvent abuse include myocardial damage and cerebral
oedema.
Another major concern with petrol sniffing is lead poisoning (except with the use of
unleaded petrol). At this time there is no generally accepted means of treating organic
lead poisoning, and the neurological and other manifestations of tetra-ethyl lead
poisoning (TEL) absorption must be deemed to be effectively irreversible.
There is general agreement that repeated exposure to solvents induces tolerance, though
there are doubts about physical addiction; however, psychological dependence is common.
The effects of a single use, whilst potentially very dangerous, usually wear off after
a few hours and the cardiovascular symptoms predominate. The most common toxic effects are
cardiac arrhythmias and asphyxia from enhancement of inhalation of volatile substances via
the use of plastic bags etc. Chronic headache, sinusitis, diminished cognitive function,
ataxia and peripheral neuropathy all accompany chronic use. The neurological sequelae
convey the most long-term morbidity and disability. Other symptoms include:
- chronic or frequent cough
- tinnitus
- chest pain or angina
- nosebleeds
- extreme tiredness or weakness
- increased nasal secretions
- red, watery eyes
- a dreamlike state with hallucinations
- depression and/or anxiety
- shortness of breath
- indigestion
- dizziness
- stomach ulcers
- deep inhalation over short periods of time may cause disorientation, unconsciousness or
seizures
- the sniffing of some petrols may cause a particular type of lead poisoning, features of
which are:
- liver damage
- acute and chronic inflammation of the kidneys and multiple abscesses
- cerebellar hemisphere degeneration
- inorganic lead poisoning causing anaemia and other effects on the blood.
As mentioned previously most users of volatile substances are young adolescents (12-15
years). While most abusers are recreational users and generally cease use of their own
volition, in some groups there is predominantly chronic or dependent use, eg among
Aboriginal youths.
Management of abuse of volatile substances is extremely complex and calls for a
multidisciplinary approach. The general practitioner plays a pivotal role through
assessment, management and referral of the young user to appropriate counselling services.
Community centres which provide drug counsellors in specific treatment areas should be
found in the region in which the GP practices. Individual and group counselling can be
provided which helps to develop some sharing of the problem with therapists, parents and
others in the family.
Health education explaining the dangers and the possible complications is important,
and should be followed by other forms of therapy such as vocational counselling. The
development of social skills is also important.
In some cases the use of computer games as a means of stimulating recreational activity
has been found useful in those young people who are seeking and achieving abstinence from
solvents.
A video role-play approach has also been found to be helpful by using the role-play in
discussions involving resolution of crisis and difficulties in relationships with parents
or other members of the family. These films can be used in the education of other abusers
of volatile substances.
Hypnotherapy can be helpful, particularly for those who have developed excitability and
emotional volatility, and who are difficult to handle because of the continuing abuse.
However, hypnotherapy should be used only in conjunction with other techniques in aiming
to change the behaviour and the personal and emotional background in which the solvent
abuser lives.
