of different products that may

have different pharmacological

effects. As a result, precise 

categorization of inhalants is 

difficult. One classification system lists four general categories

of inhalants—volatile solvents,

aerosols, gases, and nitrites—

based on the form in which they

are often found in household,

industrial, and medical products.

Volatile solvents are liquids

that vaporize at room temperatures. They are found in a 

multitude of inexpensive, easily

available products used for 

common

household

and industrial

purposes.

These include

paint thinners

and removers,

dry-cleaning

fluids,

degreasers,

gasoline,

glues, correction fluids,

and felt-tip

marker fluids.

INHALANT

Abuse

from the director

Although many parents are 

appropriately concerned about illicit

drugs such as marijuana, cocaine,

and LSD, they often ignore the dangers

posed to their children from common

household products that contain

volatile solvents or aerosols. Products

such as glues, nail polish remover,

lighter fluid, spray paints, deodorant

and hair sprays, whipped cream 

canisters, and cleaning fluids are

widely available. Many young people

inhale the vapors from these sources 

in search of quick intoxication without

being aware of the serious health 

consequences that can result.

National surveys indicate that more

than 22.9 million Americans have

abused inhalants at least once in their

lives. NIDA's Monitoring the Future

study reveals that approximately 17.3

percent of eighth-graders have abused

inhalants. Parents and children need

to know that experimentation with

these substances should not be taken

lightly. Even a single session of repeated

inhalant abuse can disrupt heart

rhythms and cause death from cardiac

arrest or lower oxygen levels enough to

cause asphyxiation. Regular abuse of

these substances can result in serious

harm to vital organs including the

brain, heart, kidneys, and liver.

Through scientific research, we

have learned much about the nature

and extent of inhalant abuse, its 

pharmacology, and its consequences.

This research has brought the picture

of inhalant abuse in our Nation into

focus and pointed to the dangers 

and the warning signs for parents,

educators, and clinicians. We hope 

this compilation of the latest scientific

information will help alert readers 

to inhalant abuse and its harmful

effects and aid efforts to deal with this 

problem effectively.

Nora D.Volkow, M.D.

Director

National Institute on Drug Abuse

U . S . Department of Health and Human Services • National Institutes of Health

ResearchReport

NATIONAL INSTITUTE ON DRUG ABUSE

SERIES

What are

inhalants?

I

nhalants are volatile substances that produce chemical

vapors that can be inhaled 

to induce a psychoactive, or

mind-altering, effect. Although

other abused substances can be

inhaled, the term “inhalants” is

used to describe a variety of 

substances whose main common

characteristic is that they are

rarely, if ever, taken by any route

other than inhalation. This definition encompasses a broad range

of chemicals found in hundreds
Aerosols are sprays that 

contain propellants and solvents.

They include spray paints,

deodorant and hair sprays, 

vegetable oil sprays for cooking,

and fabric protector sprays.

Gases include medical anesthetics as well as gases used in

household or commercial products. Medical anesthetic gases

include ether, chloroform,

halothane, and nitrous oxide,

commonly called “laughing gas.”

Nitrous oxide is the most abused

of these gases and can be found

in whipped cream dispensers

and products that boost octane

levels in racing cars. Household

or commercial products containing gases include butane lighters,

propane tanks, whipped cream

dispensers, and refrigerants.

Nitrites often are considered a

special class of inhalants. Unlike

most other inhalants, which act

directly on the central nervous

system (CNS), nitrites act primarily

to dilate blood vessels and relax

the muscles. While other inhalants

are used to alter mood, nitrites

are used primarily as sexual

enhancers. Nitrites include cyclohexyl nitrite, isoamyl (amyl)

nitrite, and isobutyl (butyl) nitrite,

and are commonly known as

“poppers” or “snappers.” Amyl

nitrite is used in certain diagnostic

procedures and was prescribed

in the past to treat some patients

for heart pain. Nitrites are now

prohibited by the Consumer

Product Safety Commission, but

can still be found, sold in small

bottles, often labeled as “video

head cleaner,” “room odorizer,”

“leather cleaner,” or “liquid

aroma.”

What are the 

patterns of

inhalant abuse?

I

nhalants—particularly 

volatile solvents, gases, and

aerosols—are often among 

the first drugs that young children

use. One national survey indicates

that about 3.0 percent of U.S.

children have tried inhalants 

by the time they reach fourth

grade. Inhalant abuse can

become chronic and extend 

into adulthood.

Generally, inhalant abusers

will abuse any available substance. However, effects produced by individual inhalants

vary, and some individuals will

go out of their way to obtain

their favorite inhalant. For 

example, in certain parts of the

country, “Texas shoe-shine,” a

shoe-shining spray containing

the chemical toluene, is a local

favorite. Silver and gold spray

paints, which contain more

toluene than other spray colors,

also are popular inhalants.

Data from national and State

surveys suggest inhalant abuse

reaches its peak at some point

during the seventh through ninth

grades. In the Monitoring the

Future (MTF) study, an annual

NIDA-supported survey of the

Nation’s secondary school students, 8th-graders also regularly

report the highest rate of current,

past year, and lifetime inhalant

abuse; 10th- and 12th-graders

report less abuse.

Gender differences in inhalant

abuse have been identified at 

different points in childhood. The

2004 MTF indicates that 10.5 percent of 8th grade females reported

2NIDA RESEARCH REPORT SERIES

Students who have ever used inhalants 

versus other commonly abused drugs, percent

Marijuana

Cocaine

LSD

Inhalants

8th

10th

12th

Grade

Percentage

Source: Monitoring the Future Survey, 2004

0 10 20 30 40 50
using inhalants in the past year,

compared with 8.8 percent of 

8th grade males. Among 12thgraders, 3.4 percent of females

and 4.8 percent of males reported

using inhalants in the past year.

The National Survey on Drug

Use and Health (NSDUH), 

an annual survey of drug use

among the Nation’s noninstitutionalized civilians, reports that

similar percentages of 12- to 17-

year-old boys and girls abused

inhalants in 2003. However, the

percentage of 18- to 25-year-old

males who abused inhalants

within the past month was more

than twice that of females in 

that age group, suggesting that 

sustained abuse of inhalants is

more common among males.

People who abuse inhalants

are found in both urban and

rural settings. Research on factors

contributing to inhalant abuse

suggests that adverse socioeconomic conditions, a history of

childhood abuse, poor grades,

and dropping out of school all

are associated with inhalant

abuse. 

What is the 

scope of 

inhalant abuse?

I

nhalant abuse was up 

significantly for the second

year in a row among 

8th-graders, according to the 

latest MTF data, while use

among 10th- and 12th-graders

continued to decline.

■ The rate of high school 

seniors who abused

inhalants in the past year

was 4.2 percent in 2004,

down from the peak of 

8.0 percent in 1995. 

■ Annual abuse of inhalants

among 10th-graders was 

5.9 percent in 2004, also

down from a high in 1995

(9.6 percent).

■ Among 8th-graders, 2004

abuse figures, at 9.6 percent,

were down overall from the

1995 peak of 12.8 percent,

but were up from the 2002

rate of 7.7 percent.

According to the 2003 NSDUH,

lifetime, past year, and past

month inhalant use among 

persons aged 12 to 17 were 

10.7 percent, 4.5 percent, and 

1.3 percent, respectively. The

number of new inhalant users

increased from 627,000 new

users in 1994 to 1 million in

2002. Inhalant initiates were 

predominantly under age 18 

(78 percent in 2002).

NIDA RESEARCH REPORT SERIES3

Percent of 8th-Graders Reporting Lifetime Use of Inhalants Increased

*P<.05 Source: University of Michigan, 2004 Monitoring the Future Survey

0

5

10

15

20

25

91 92 93 94 95 96 97 98 99 00 01 02 03 04

Percent

■

▲

●

8th-graders

10th-graders

12th-graders

*
MTF’s lifetime prevalence 

figures indicate that the percentages of students who have tried

inhalants continue to decrease

steadily for 10th- and 12thgraders. In 2004, 12.4 percent 

of 10th-graders and 11.9 percent

of 12th-graders said they have

abused inhalants at least once 

in their lives. Although lifetime

prevalence peaked for 8thgraders in 1995 (21.6 percent),

rates of inhalant use among 

this group are still high. In fact, 

8th-graders reported a significant

increase in lifetime use from

15.8 percent in 2003 to 17.3 percent in 2004. For 10th-graders,

the peak was 19.3 percent in

1996. For seniors, rates were

highest in 1994 at 17.7 percent.

These data raise a question: 

How can fewer 12th-graders than

8th-graders consistently report

they have ever abused inhalants?

Possibly, many 12th-graders fail

to recall their much earlier use

of inhalants or, more troubling,

many 8th-grade inhalant abusers

may have dropped out of school

by the 12th grade and are no

longer included in the survey

population. 

How are 

inhalants used?

I

nhalants can be breathed 

in through the nose or the

mouth in a variety of ways,

such as:

■ “Sniffing” or “snorting”

fumes from containers;

■ Spraying aerosols directly

into the nose or mouth;

■ “Bagging”—sniffing or inhaling fumes from substances

sprayed or deposited inside

a plastic or paper bag;

■ “Huffing” from an inhalantsoaked rag stuffed in the

mouth; and

■ Inhaling from balloons filled

with nitrous oxide.

Inhaled chemicals are rapidly

absorbed through the lungs into

the bloodstream and quickly 

distributed to the brain and 

other organs. Within seconds of

inhalation, the user experiences

intoxication along with other

effects similar to those produced

by alcohol. Alcohol-like effects

may include slurred speech, an

inability to coordinate movements, euphoria, and dizziness.

In addition, users may experience

lightheadedness, hallucinations,

and delusions.

Because intoxication lasts 

only a few minutes, abusers 

frequently seek to prolong the

high by continuing to inhale

repeatedly over the course of

several hours, a very dangerous

practice. With successive 

inhalations, abusers can suffer

loss of consciousness and death.

At the least, they will feel less

inhibited and less in control.

After heavy use of inhalants,

abusers may feel drowsy for 

several hours and experience a

lingering headache.

4NIDA RESEARCH REPORT SERIES

How can inhalant abuse be recognized?

Early identification and intervention are the best ways to stop

inhalant abuse before it causes serious health consequences.

Parents, educators, family physicians, and other health care

practitioners should be alert to the following signs of a serious

inhalant abuse problem:

■ Chemical odors on breath

or clothing

■ Paint or other stains on

face, hands, or clothes

■ Hidden empty spray paint

or solvent containers and

chemical-soaked rags or

clothing

■ Drunk or disoriented

appearance

■ Slurred speech

■ Nausea or loss of 

appetite

■ Inattentiveness, lack of

coordination, irritability,

and depression
How do inhalants

produce their

effects?

Many brain systems may

be involved in the anesthetic, intoxicating, and

reinforcing effects of different

inhalants. Nearly all abused

inhalants (other than nitrites)

produce a pleasurable effect by

depressing the CNS. Evidence

from animal studies suggests that

a number of commonly abused

volatile solvents and anesthetic

gases have neurobehavioral

effects and mechanisms of action

similar to those produced by

CNS depressants, which include

alcohol and medications such as

sedatives and anesthetics.

A recent study indicates

that toluene, a solvent

found in many commonly

abused inhalants, including

model airplane glue, paint

sprays, and paint and nail

polish removers, activates

the brain’s dopamine system. The dopamine system

has been shown to play 

a role in the rewarding

effects of many drugs of

abuse. Nitrites, in contrast,

dilate and relax blood 

vessels rather than acting

as anesthetic agents.

What are 

the shortand long-term

effects of

inhalant use?

Although the chemical substances found

in inhalants may

produce various pharmacological effects, most

inhalants produce a rapid

high that resembles alcohol

intoxication with initial

excitation, then drowsiness,

disinhibition, lightheadedness, and agitation. If 

sufficient amounts are inhaled,

nearly all solvents and gases 

produce anesthesia, a loss of sensation, and even unconsciousness.

The chemicals found in solvents, aerosol sprays, and gases

can produce a variety of additional effects during or shortly

after use. These effects are 

related to inhalant intoxication

and may include belligerence,

apathy, impaired judgment, and

impaired functioning in work 

or social situations. Dizziness,

drowsiness, slurred speech,

lethargy, depressed reflexes, 

general muscle weakness, and

stupor are other possible effects.

For example, research shows 

that toluene can produce

headache, euphoria, giddy feelings, and inability to coordinate

movements. Exposure to high

doses can cause confusion and

delirium. Nausea and vomiting

are other common side effects.

Inhaled nitrites dilate blood

vessels, increase heart rate, and

produce a sensation of heat 

and excitement that can last for

several minutes. Other effects

can include flush, dizziness, and

headache. Unlike other inhalants,

which are abused mainly for

their intoxicating effects, nitrites

are abused primarily because

they are believed to enhance

sexual pleasure and performance.

A strong need to continue

using inhalants has been reported among many individuals, 

particularly those who abuse

inhalants for prolonged periods

over many days. Compulsive 

use and a mild withdrawal syndrome can occur with long-term

NIDA RESEARCH REPORT SERIES5

Brain damage in a 

toluene abuser

Brain images show marked atrophy (shrinkage)

of brain tissue in a toluene abuser (B) compared

to a nonabusing individual (A). Note the smaller

size and the larger empty (dark) space within

the toluene abuser's brain. (The white outer 

circle in each image is the skull.)

Courtesy of Neil Rosenberg, M.D.
inhalant abuse. Additional 

symptoms exhibited by longterm inhalant abusers include

weight loss, muscle weakness,

disorientation, inattentiveness,

lack of coordination, irritability,

and depression.

What are 

the medical 

consequences of

inhalant abuse?

I

nhalant abusers risk an array

of devastating medical consequences. Prolonged sniffing of

the highly concentrated chemicals in solvents or aerosol sprays

can induce irregular and rapid

heart rhythms and lead to heart

failure and death within minutes

of a session of prolonged sniffing. This syndrome, known as

“sudden sniffing death,” can

result from a single session of

inhalant use by an otherwise

healthy young person. Sudden

sniffing death is particularly 

associated with the abuse of

butane, propane, and chemicals

in aerosols. Inhalant abuse also

can cause death by:

■ Asphyxiation—from repeated

inhalations, which lead to

high concentrations of

inhaled fumes displacing 

the available oxygen in

the lungs;

■ Suffocation—from blocking

air from entering the lungs

when inhaling fumes from 

a plastic bag placed over 

the head;

■ Convulsions or seizures—

caused by abnormal 

electrical discharges in the

brain;

■ Coma—the brain shuts

down all but the most vital

functions;

■ Choking—from inhalation of

vomit after inhalant use; or

■ Fatal injury—from accidents,

including motor vehicle

fatalities, suffered while

intoxicated.

Animal and human research

shows that most inhalants are

extremely toxic. Perhaps the

most significant toxic effect of

chronic exposure to inhalants is

widespread and

long-lasting 

damage to the

brain and other

parts of the 

nervous system. 

For example, both

animal research 

and human 

pathological 

studies indicate 

that chronic abuse

of volatile solvents

such as toluene

damages the 

protective sheath

around certain

nerve fibers in 

the brain and

peripheral nervous

system. This extensive destruction 

of nerve fibers is

clinically similar 

to that seen with

neurological 

diseases such as

multiple sclerosis.

The neurotoxic effects of 

prolonged inhalant abuse include

neurological syndromes that

reflect damage to parts of the

brain involved in controlling

cognition, movement, vision, and

hearing. Cognitive abnormalities

can range from mild impairment

to severe dementia. Other effects

can include difficulty coordinating

movement, limb spasms, and loss

of feeling, hearing, and vision.

Inhalants also are highly 

toxic to other organs. Chronic

exposure can produce significant

damage to the heart, lungs, liver,

and kidneys. Although some

inhalant-induced damage to the

nervous and other organ systems

6NIDA RESEARCH REPORT SERIES

Nerve fiber deterioration in an

inhalant abuser

Dark-stained patches show areas where nerve fibers have

lost their protective sheath in a specimen of brain tissue

removed from a deceased inhalant abuser.

Reproduced with permission from the Journal of Neuropathology & Experimental Neurology.
may be at least partially reversible

when inhalant abuse is stopped,

many syndromes caused by

repeated or prolonged abuse 

are irreversible.

Abuse of inhalants during

pregnancy also may place infants

and children at increased risk of

developmental harm. Animal

studies designed to simulate

human patterns of inhalant abuse

suggest that prenatal exposure 

to toluene or trichlorethylene

(TCE) can result in reduced birth

weights, occasional skeletal

abnormalities, and delayed 

neurobehavioral development. 

A number of case reports note

abnormalities in newborns of

mothers who chronically abuse

solvents, and there is evidence 

of subsequent developmental

impairment in some of these

children. However, no wellcontrolled, prospective study of

the effects of prenatal exposure

to inhalants in humans has been

conducted, and it is not possible

to link prenatal exposure to a

specific chemical to a specific

birth defect or developmental

problem.

What are the 

special risks for

nitrite abusers?

Nitrites are abused mainly

by older adolescents and

adults. Typically, individuals who abuse nitrites are seeking to enhance sexual function

and pleasure. Research shows

that abuse of these drugs in this

context is associated with unsafe

sexual practices that greatly

increase the risk of contracting

and spreading such infectious

diseases as HIV/AIDS and 

hepatitis.

Animal research raises the 

possibility that there may be a

link between abuse of nitrite

inhalants and the development

and progression of infectious 

diseases and tumors. The

research indicates that inhaling

nitrites depletes many cells in 

the immune system and impairs

immune system mechanisms that

fight infectious diseases. A recent

study found that even a relatively

small number of exposures to

butyl nitrite can produce dramatic

increases in tumor incidence and

growth rates in animals.

Where can I get

further scientific

information about

inhalant abuse?

T

o learn more about

inhalants and other drugs of

abuse, contact the National

Clearinghouse for Alcohol and

Drug Information (NCADI) at 

1-800-729-6686. Information 

NIDA RESEARCH REPORT SERIES7

Hazards of chemicals found in commonly abused inhalants

amyl nitrite, butyl nitrite

(“poppers,” “video head cleaner”)

sudden sniffing death syndrome, suppressed immunologic

function, injury to red blood cells (interfering with oxygen

supply to vital tissues)

benzene (found in gasoline)

bone marrow injury, impaired immunologic function,

increased risk of leukemia, reproductive system toxicity

butane, propane

(found in lighter fluid, hair and paint sprays)

sudden sniffing death syndrome via cardiac effects, 

serious burn injuries (because of flammability)

freon (used as a refrigerant and aerosol propellant)

sudden sniffing death syndrome, respiratory obstruction 

and death (from sudden cooling/cold injury to airways), 

liver damage

methylene chloride

(found in paint thinners and removers, degreasers)

reduction of oxygen-carrying capacity of blood, changes to the

heart muscle and heartbeat

nitrous oxide (“laughing gas”), hexane

death from lack of oxygen to the brain, altered perception and motor

coordination, loss of sensation, limb spasms, blackouts caused by

blood pressure changes, depression of heart muscle functioning

toluene

(found in gasoline, paint thinners and removers, correction fluid)

brain damage (loss of brain tissue mass, impaired cognition, gait

disturbance, loss of coordination, loss of equilibrium, limb spasms,

hearing and vision loss), liver and kidney damage

trichlorethylene (found in spot removers, degreasers)

sudden sniffing death syndrome, cirrhosis of the liver, reproductive

complications, hearing and vision damage
Access information 

on the Internet

• What’s new on the NIDA Web site

• Information on drugs of abuse

• Publications and communications

(including NIDA NOTES)

• Calendar of events

• Links to NIDA organizational units

• Funding information 

(including program announcements 

and deadlines)

• International activities

• Links to related Web sites 

(access to Web sites of many other

organizations in the field)

specialists are available to help

you locate information and

resources.

Fact sheets, including InfoFacts,

on the health effects of inhalants,

other drugs of abuse, and 

other drug abuse topics are

available on the NIDA Web site

(www.drugabuse.gov), and can

be ordered free of charge in

English and Spanish from the

National Clearinghouse for

Alcohol and Drug Information

(NCADI) at www.health.org.

References

Balster, R.L. Neural basis of inhalant abuse. Drug and

Alcohol Dependence 51(1-2):207-214, 1998.

Bowen, S.E.; Wiley, J.L.; Evans, E.B.; Tokarz, M.E.; 

and Balster, R.L. Functional observational battery

comparing effects of ethanol, 1,1,1-trichlorethane,

ether, and flurothyl. Neurotoxicology and Teratology

18(5):577-585, 1996.

Edwards, R.W., and Oetting, E.R. Inhalant use in the

United States. In: Kozel, N.; Sloboda, Z.; and De La

Rosa, M. (eds.), Epidemiology of Inhalant Abuse:

An International Perspective. National Institute on

Drug Abuse Research Monograph 148. DHHS

Publication No. NIH 95-3831. Washington, DC:

U.S. Government Printing Office, 8-28, 1995.

Fendrich, M.; Mackesy-Amiti, M.E.; Wislar, J.S.; and

Goldstein, P.J. Childhood abuse and the use of

inhalants: Differences by degree of use. American

Journal of Public Health 87(5):765-769, 1997.

Jones, H.E., and Balster, R.L. Inhalant abuse in 

pregnancy. Obstetrics and Gynecology Clinics of

North America 25(1):153-167, 1998.

National Institute on Drug Abuse. National Survey

Results on Drug Use From the Monitoring the Future

Study, 2004 (www.monitoringthefuture.org).

National Institute on Drug Abuse. NIDA InfoFacts,

Inhalants, 2004.

PRIDE Surveys National Summary for Grades 4 thru 6,

2002-2003.

Riegel, A.C., and French, E.D. Acute toluene induces

biphasic changes in rat spontaneous locomotor 

activity which are blocked by remoxipride.

Pharmacology, Biochemistry and Behavior

62(3):399-402, 1999.

Sharp, C.W., and Rosenberg, N.L. Inhalants. In:

Lowinson, J.H.; Ruiz, P.; Millman, R.B.; and

Langrod, J.G. (eds.), Substance Abuse: A

Comprehensive Textbook, 3d. ed. Baltimore:

Williams and Wilkins, 246-264, 1996.

Sharp, C.W., and Rosenberg, N. Inhalant-related 

disorders. In: Tasman, A.; Kay, J.; and Lieberman,

J.A. (eds.), Psychiatry, Vol. 1. Philadelphia: 

W.B. Saunders, 835-852, 1997.

Substance Abuse and Mental Health Services

Administration. National Findings From the 

2003 National Survey on Drug Use and Health.

SAMHSA, 2003.

Soderberg, L.S. Immunomodulation by nitrite inhalants

may predispose abusers to AIDS and Kaposi’s 

sarcoma. Journal of Neuroimmunology 

83(1-2):157-161, 1998.

Soderberg, L.S. Increased tumor growth in mice

exposed to inhaled isobutyl nitrite. Toxicology

Letters 104(1-2):35-41, 1999.

Woody, G.E.; Donnell, D.; Seage, G.R.; et al. 

Non-injection substance use correlates with risky 

sex among men having sex with men: Data 

from HIV/NET. Drug and Alcohol Dependence

53(3):197-205, 1999. NIDA Web Sites

www.drugabuse.gov

www.inhalants.drugabuse.gov

www.steroidabuse.org

www.clubdrugs.org

NCADI

Web Site: www.health.org

Phone No.: 1-800-729-6686

NIH Publication Number 05-3818

Printed 1994, Reprinted 1996, 1999, Revised July 2000,

Revised March 2004, Revised March 2005

Feel free to reprint this publication.

8NIDA RESEARCH REPORT SERIES

Glossary

Anesthetic: An agent that causes insensitivity to pain.

Central nervous system: The brain and spinal cord.

Dementia: A condition of deteriorated mental function.

Dopamine: A neurotransmitter present in regions of

the brain that regulate movement, emotion, motivation,

and feeling of pleasure.

Epidemiology: The sum of the factors controlling the

presence or absence of a disease or condition.

Toxic: Causing temporary or permanent effects that

are detrimental to the functioning of a body organ or

group of organs.

Withdrawal: A variety of symptoms that occur after

use of an addictive drug is reduced or stopped.