Health issues

Health effects of volatile substances include the following.

• A sensitization of the heart—so that cardiac arrhythmias may occur if VSA is followed by exertion or fright.

• Cooling of the throat tissues—this is caused by spraying substances directly into the mouth, which may causing swelling and suffocation.

• A risk of fire—many of these products are inflammable, especially when combined with smoking.

• Suffocation—this is a particular danger when large plastic bags are used.

• Most products are mixtures of chemicals, and manufacturers do not list constituents. Changing product formulations make the dangers unpredictable.

• Using on one's own in an isolated place presents special hazards.

• When combined with alcohol or other drugs, the effects can be unpredictable.

• Intoxication itself has potential dangers, for example greater recklessness, doing bizarre things in response to hallucinations, becoming unconscious, and choking on vomit.

Apart from the real risk of death, VSA rarely causes long-term damage. However, some products contain poisonous substances, such as lead in some petrols or n-hexane in some glues. Chronic abuse of toluene-containing products and of chlorinated solvents such as 1,1,1-trichloroethane sometimes causes damage to the liver and kidneys. Damage to the lungs, bone marrow, and nervous system is also known, but is uncommon and generally reversible. Some people are more vulnerable (genetically or otherwise) than others to certain harmful effects. However, the long-term effects of sniffing have not been thoroughly studied, and virtually all reports of chronic toxicity are case studies, so the actual morbidity from VSA is not known.

A review article looking at the possibility of cognitive impairments from volatile substance use concluded that: 'the possibility that permanent structural brain damage, with accompanying psychiatric manifestations, results from solvent abuse remains inconclusive'. (!4)

Users develop tolerance. Although no dependence syndrome exists, a few young people develop a more compulsive and long-term habit. The United Kingdom Advisory Council on the Misuse of Drugs suggested that: 'There are...pharmacological reasons for suspecting that persistent exposure to volatile substances might be able to induce a dependence of the so-called depressant type'.(15)

Many users of volatile substances are also users of other drugs, both legal and illegal. Using different drugs in combination may potentiate their effects. Polydrug use makes it difficult to assess the risks of individual substances.

VSA during pregnancy is associated with increased maternal and fetal morbidity.(16) Paternal exposure to volatile substances may also have deleterious effects on their offspring.(lZ) But the complexities of the chemicals involved—and the complexities of people's lives—make the identification of particular causes of fetal damage difficult.

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