CNS CNS DEPRESSANTSDEPRESSANTS

::SEDATIVE-SEDATIVE-HYPNOTICSHYPNOTICS

CHAPTER 6CHAPTER 6

WOULD YOU RATHER: WOULD YOU RATHER:

A.A. Be on a deserted island Be on a deserted island

alone ORalone OR

B.B. Be on a deserted island Be on a deserted island

with a person you hatewith a person you hate

HAPPY MONDAYHAPPY MONDAYHOW WAS YOUR WEEKEND?HOW WAS YOUR WEEKEND?

AAAA

B.B. :/:/

AAAA

INTRODUCTION TO CNS INTRODUCTION TO CNS DEPRESSANTSDEPRESSANTS

•Why are CNS depressants problematic?Why are CNS depressants problematic?

•Usually prescribed under physician’s Usually prescribed under physician’s directiondirection• Second most frequently abused prescription Second most frequently abused prescription

drug and sometimes contributes to death due drug and sometimes contributes to death due to accidental overdosesto accidental overdoses•Can cause very alarming and dangerous Can cause very alarming and dangerous

behavior if not closely monitoredbehavior if not closely monitored• Most problems associated with these drugs Most problems associated with these drugs

due to inadequate professional supervisiondue to inadequate professional supervision

INTRODUCTION TO CNS INTRODUCTION TO CNS DEPRESSANTS (CONTINUED)DEPRESSANTS (CONTINUED)

• Why are CNS depressants problematic? Why are CNS depressants problematic?

• Seemingly unrelated drug groups Seemingly unrelated drug groups can cause CNS depressioncan cause CNS depression• Combination use can cause Combination use can cause

dangerous drug interactionsdangerous drug interactions• Can cause disruptive personality Can cause disruptive personality

changeschanges

THE HISTORY OF CNS THE HISTORY OF CNS DEPRESSANTSDEPRESSANTS

• Attempts to find CNS depressants other than alcohol began in the Attempts to find CNS depressants other than alcohol began in the

1800s.1800s.

• Bromides were introduced to treat nervousness and anxiety in the Bromides were introduced to treat nervousness and anxiety in the

1800s.1800s.

• Very popular but toxicVery popular but toxic• In the early 1900s, bromides were replaced by barbiturates.In the early 1900s, bromides were replaced by barbiturates.

• Initially heralded as safe and effectiveInitially heralded as safe and effective

• Apparent problems with tolerance, Apparent problems with tolerance,

dependence, and safetydependence, and safety

THE HISTORY OF CNS THE HISTORY OF CNS DEPRESSANTS (CONTINUED)DEPRESSANTS (CONTINUED)

• In the 1950s the first benzodiazepines were marketed as substitutes In the 1950s the first benzodiazepines were marketed as substitutes

for barbiturates.for barbiturates.

• Relatively safe when used for short Relatively safe when used for short

periodsperiods

• Long-term use can cause dependence Long-term use can cause dependence

and withdrawal problemsand withdrawal problems

THE THE HISTORY OF CNS HISTORY OF CNS DEPRESSANTS (CONTINUED)DEPRESSANTS (CONTINUED)

• Benzodiazepines were routinely prescribed for stress, anxiety, or Benzodiazepines were routinely prescribed for stress, anxiety, or apprehension.apprehension.

• In 1973, 100 million prescriptions were In 1973, 100 million prescriptions were written for benzodiazepines.written for benzodiazepines.• Twice as many women as men taking Twice as many women as men taking

them.them.• As medical community became aware of the problem, use of As medical community became aware of the problem, use of

depressants declined, but benzodiazepines remained still very depressants declined, but benzodiazepines remained still very popular.popular.

• Classified as Schedule V drugsClassified as Schedule V drugs

SEDATIVE-HYPNOTIC DRUGS SEDATIVE-HYPNOTIC DRUGS (DEPRESSANTS)(DEPRESSANTS)

• Drugs that slow activity in the central nervous systemDrugs that slow activity in the central nervous system

• Include prescription drugsInclude prescription drugs• To treat anxiety: sedativesTo treat anxiety: sedatives

• To treat insomnia: hypnoticsTo treat insomnia: hypnotics

• Alcohol is the most widely used depressantAlcohol is the most widely used depressant

• Benzodiazepines are the most widely prescribed Benzodiazepines are the most widely prescribed

depressantsdepressants

THE EFFECTS OF CNS THE EFFECTS OF CNS DEPRESSANTSDEPRESSANTS

• CNS depressants reduce CNS activity and CNS depressants reduce CNS activity and diminish the brain’s level of awareness.diminish the brain’s level of awareness.

• Depressant drugs include:Depressant drugs include:

• BenzodiazepinesBenzodiazepines• Barbiturate-like drugsBarbiturate-like drugs• AlcoholAlcohol• AntihistaminesAntihistamines• Opioid narcotics like heroinOpioid narcotics like heroin

THE EFFECTS OF CNS THE EFFECTS OF CNS DEPRESSANTS (CONTINUED)DEPRESSANTS (CONTINUED)

• Depressants are usually classified according to the degree of their Depressants are usually classified according to the degree of their medical effects on the body. For example:medical effects on the body. For example:

• SedativesSedatives cause mild depression and cause mild depression and relaxationrelaxation• AnxiolyticAnxiolytic—drugs that relieve anxiety—drugs that relieve anxiety

• HypnoticsHypnotics induce drowsiness and induce drowsiness and encourage sleepencourage sleep• AmnesiacAmnesiac effects can cause the loss of effects can cause the loss of

memory memory

THE EFFECTS OF CNS THE EFFECTS OF CNS DEPRESSANTS (CONTINUED)DEPRESSANTS (CONTINUED)

•The same drug can cause different effects depending on dose.The same drug can cause different effects depending on dose.

•Low dose (sedatives—relieve anxiety Low dose (sedatives—relieve anxiety

and promote relaxation)and promote relaxation)

•Higher doses (hypnotics—can cause Higher doses (hypnotics—can cause

drowsiness and promote sleep)drowsiness and promote sleep)

•Even higher doses (anesthetics can Even higher doses (anesthetics can

cause anesthesia and are used for cause anesthesia and are used for

patient management during surgery)patient management during surgery)

EFFECTSEFFECTS• Produce a depressed, mood-altering action Produce a depressed, mood-altering action

on the central nervous system – act on GABAon the central nervous system – act on GABA

• Slow activity of the cardiovascular, muscular Slow activity of the cardiovascular, muscular

and respiratory systemsand respiratory systems

• Can cause confusion, inadequate emotional Can cause confusion, inadequate emotional

control, slurred speech, poor judgment, and control, slurred speech, poor judgment, and

intoxicationintoxication

TYPES OF CNS TYPES OF CNS DEPRESSANTSDEPRESSANTS

•Benzodiazepines: Valium-Type DrugsBenzodiazepines: Valium-Type Drugs• Prescribed for anxiety, relaxation and sleepPrescribed for anxiety, relaxation and sleep

• Medical usesMedical uses

• Relief from anxiety, treatment of neurosis, Relief from anxiety, treatment of neurosis, relaxation of muscles, alleviation of lower-back relaxation of muscles, alleviation of lower-back pain, treatment of convulsive disorders, pain, treatment of convulsive disorders, induction of sleep, relief from withdrawal induction of sleep, relief from withdrawal symptoms, induction of amnesiasymptoms, induction of amnesia

TYPES OF CNS DEPRESSANTS TYPES OF CNS DEPRESSANTS (CONTINUED)(CONTINUED)

• Mechanisms of action for benzodiazepineMechanisms of action for benzodiazepine

• Affect neurons that have receptors Affect neurons that have receptors for the neurotransmitter for the neurotransmitter GABAGABA

• GABA: GABA: most common inhibitory transmitter in brain regionsmost common inhibitory transmitter in brain regions

• Limbic system (alter mood)Limbic system (alter mood)• RAS (cause drowsiness)RAS (cause drowsiness)• Motor cortex (relax muscles)Motor cortex (relax muscles)

TYPES OF CNS DEPRESSANTS TYPES OF CNS DEPRESSANTS (CONTINUED) (CONTINUED)

• Types of benzodiazepinesTypes of benzodiazepines

• Many benzodiazepine compounds Many benzodiazepine compounds

available in the United Statesavailable in the United States

• Distinguished primarily by their Distinguished primarily by their

duration of action: duration of action: short-acting short-acting

(hypnotics), (hypnotics), long-actinglong-acting (sedatives)(sedatives)• Side effects include drowsiness to paradoxical effects (e.g. Side effects include drowsiness to paradoxical effects (e.g.

increased restlessness), tolerance, dependence, withdrawal, and increased restlessness), tolerance, dependence, withdrawal, and

abuseabuse

TYPES OF CNS DEPRESSANTS TYPES OF CNS DEPRESSANTS (CONTINUED)(CONTINUED)

• BarbituratesBarbiturates played an important played an important

historical role as sedative-hypnotic agents.historical role as sedative-hypnotic agents.• However, due to their narrow margin of safety and their abuse However, due to their narrow margin of safety and their abuse

liability, they were replaced by benzodiazepines.liability, they were replaced by benzodiazepines.

• Caused many negative side effects, from Caused many negative side effects, from

nausea to death, from respiratory or nausea to death, from respiratory or

cardiovascular depressioncardiovascular depression

OTHER TYPES OF CNS OTHER TYPES OF CNS DEPRESSANTSDEPRESSANTS

• Drugs with barbiturate-like properties:Drugs with barbiturate-like properties:

• Chloral hydrateChloral hydrate

• GlutethimideGlutethimide

• MethyprylonMethyprylon

• MethaqualoneMethaqualone• AntihistaminesAntihistamines

• Propofol (abused general anesthetic)Propofol (abused general anesthetic)

• GHB (gamma hydroxybutyrate)GHB (gamma hydroxybutyrate)

MEDICAL USESMEDICAL USES

• Used primarily to treatUsed primarily to treat

• AnxietyAnxiety

• InsomniaInsomnia

• Convulsive disordersConvulsive disorders

• Short-acting barbiturates Short-acting barbiturates

continue to be used for continue to be used for

anesthetic purposesanesthetic purposes

MECHANISMS OF ACTIONMECHANISMS OF ACTION

• Benzodiazepines and Benzodiazepines and barbituratesbarbiturates• Enhance inhibitory effects of GABAEnhance inhibitory effects of GABA

• Non-benzodiazepine Non-benzodiazepine hypnoticshypnotics• Selectively target the GABA-A receptorSelectively target the GABA-A receptor

• Work better as sleep aids rather than anti-Work better as sleep aids rather than anti-

anxiety medicationsanxiety medications

• Zolpidem (Ambien), zaleplon (Sonata), Zolpidem (Ambien), zaleplon (Sonata),

eszopiclone (Lunesta)eszopiclone (Lunesta)

MEDICAL USES FOR MEDICAL USES FOR BARBITURATES DO NOT INCLUDE:BARBITURATES DO NOT INCLUDE:

A.A. Treating Treating

depressiondepression

B.B. Reducing anxietyReducing anxiety

C.C. Controlling Controlling

seizuresseizures

D.D. Inducing sleepInducing sleepTre

ating d

epress

ion

Reducing an

xiety

Controllin

g seizu

res

Inducing sl

eep

63%

7%

30%

0%

DANGERSDANGERS

• ToleranceTolerance

• Lethal in combination with alcohol (synergistic Lethal in combination with alcohol (synergistic

effect)effect)

• Withdrawal severe, can be fatalWithdrawal severe, can be fatal

IN COMPARISON TO IN COMPARISON TO BARBITURATES, BARBITURATES,

BENZODIAZEPINES BENZODIAZEPINES A.A. Have more severe Have more severe

side effects side effects

B.B. Are not addictiveAre not addictive

C.C. Do not cause Do not cause withdrawal withdrawal symptomssymptoms

D.D. Have a wider Have a wider safety marginsafety margin

Have more

seve

re si

de ef...

Are not a

ddictive

Do not cause

with

drawal...

Have a wider s

afety m

argin

15%

73%

12%

0%

PATTERNS OF ABUSE PATTERNS OF ABUSE WITH CNS DEPRESSANTSWITH CNS DEPRESSANTS

• The American Psychiatric Association The American Psychiatric Association

considers dependence on CNS depressants considers dependence on CNS depressants

a psychiatric disorder.a psychiatric disorder.

PATTERNS OF ABUSE WITH PATTERNS OF ABUSE WITH CNS DEPRESSANTS CNS DEPRESSANTS

(CONTINUED)(CONTINUED)•People most likely to abuse CNS depressants include individuals who:People most likely to abuse CNS depressants include individuals who:

•Use drugs to relieve continual stressUse drugs to relieve continual stress

• Paradoxically feel euphoria and stimulation Paradoxically feel euphoria and stimulation

from depressantsfrom depressants

•Use depressants to counteract the Use depressants to counteract the

unpleasant effects of other drugs of abuseunpleasant effects of other drugs of abuse

•Combine depressants with alcohol and Combine depressants with alcohol and

heroin to potentiate the effectsheroin to potentiate the effects

PATTERNS OF ABUSE WITH PATTERNS OF ABUSE WITH CNS DEPRESSANTS CNS DEPRESSANTS

(CONTINUED)(CONTINUED)•Detoxification:Detoxification: The elimination of a toxic substance, such as a drug, and The elimination of a toxic substance, such as a drug, and

its effectsits effects

•With CNS depressants, this is achieved by With CNS depressants, this is achieved by

substituting a longer-acting barbiturate for substituting a longer-acting barbiturate for

the offending CNS depressant and gradually the offending CNS depressant and gradually

reducing the dose to avoid unpleasant reducing the dose to avoid unpleasant

withdrawal effects. Withdrawal from CNS withdrawal effects. Withdrawal from CNS

depressants, if not managed properly, can depressants, if not managed properly, can

be very dangerous, or even fatal.be very dangerous, or even fatal.

DO YOU KNOW SOMEONE WHO DO YOU KNOW SOMEONE WHO HAS HAD THEIR DRINK SPIKED HAS HAD THEIR DRINK SPIKED

WITH GHB OR ROOFIES?WITH GHB OR ROOFIES?

A.A. I think soI think so

B.B. I don’t think soI don’t think so

I think s

o

I don’t t

hink s

o

52%48%

DO YOU KNOW SOMEONE WHO DO YOU KNOW SOMEONE WHO HAS DRUGGED SOMEONE ELSE BY HAS DRUGGED SOMEONE ELSE BY

SPIKING THEIR DRINK?SPIKING THEIR DRINK?

A.A. I think soI think so

B.B. I don’t think soI don’t think so

I think s

o

I don’t t

hink s

o

77%

23%

GAMMA HYDROXYBUTYRIC ACIDGAMMA HYDROXYBUTYRIC ACID• Naturally occurring chemical found in brain and bodyNaturally occurring chemical found in brain and body

• Similar to GABASimilar to GABA

• Causes CNS depressionCauses CNS depression

• Has been used as an anestheticHas been used as an anesthetic

• Considered a date-rape drugConsidered a date-rape drug• Along with Rohypnol and KetamineAlong with Rohypnol and Ketamine

• GHB is listed on Schedule IGHB is listed on Schedule Ihttps://www.youtube.com/watch?v=LPtcU_8yvR4 https://www.youtube.com/watch?v=YwtBEkFXBjQhttps://www.youtube.com/watch?v=2udrpuNxcmM

WHEN IT IS USED IN CONJUNCTION WHEN IT IS USED IN CONJUNCTION WITH ALCOHOL, THE EFFECTS OF WITH ALCOHOL, THE EFFECTS OF

ROHYPNOL CAN BE FATAL.ROHYPNOL CAN BE FATAL.

A.A. TrueTrue

B.B. FalseFalse

True

False

50%50%

WED 4/26WED 4/26DO YOU HAVE A TATTOO?DO YOU HAVE A TATTOO?

A.A. Yes, more than oneYes, more than one

B.B. Yes, oneYes, one

C.C. No way! Never!No way! Never!

D.D. No, but considering one.No, but considering one.

INHALANTSINHALANTS

CHAPTER 14CHAPTER 14

HAVE YOU USED INHALANTSHAVE YOU USED INHALANTSEVER?EVER?

A.A. YesYes

B.B. NoNo

INTRODUCTIONINTRODUCTION

• Volatile substances introduced via the lungs.Volatile substances introduced via the lungs.

• Most cause intoxicating and/or euphorigenic Most cause intoxicating and/or euphorigenic

effects. effects.

• Many of these substances were never intended Many of these substances were never intended

to be used by humans as drugs; consequently, to be used by humans as drugs; consequently,

they are not often thought of as having abuse they are not often thought of as having abuse

potential. potential.

INTRODUCTION INTRODUCTION (CONTINUED)(CONTINUED)

• Inhalants are among the most commonly Inhalants are among the most commonly used drugs by adolescents.used drugs by adolescents.

• A widespread misconception is that A widespread misconception is that inhalant abuse is a harmless phase that inhalant abuse is a harmless phase that occurs commonly during normal childhood occurs commonly during normal childhood and teenage development and as such is and teenage development and as such is not worthy of significant concern. not worthy of significant concern.

POTENTIAL POTENTIAL CONSEQUENCESCONSEQUENCES

• ““Sudden Sniffing Death Syndrome” (SSDS): A Sudden Sniffing Death Syndrome” (SSDS): A condition characterized by serious cardiac condition characterized by serious cardiac arrhythmia occurring during or immediately arrhythmia occurring during or immediately after inhalingafter inhaling

• Brain damageBrain damage

• Damage to heart, kidney, liver, and bone Damage to heart, kidney, liver, and bone marrowmarrow

HISTORYHISTORY

• In 1776, British chemist Joseph Priestley In 1776, British chemist Joseph Priestley synthesized nitrous oxide, a colorless gas with a synthesized nitrous oxide, a colorless gas with a slightly sweet odor and no noticeable taste. slightly sweet odor and no noticeable taste.

• Priestly and Humphry Davy suggested correctly Priestly and Humphry Davy suggested correctly that the gas might be useful as an anesthetic, and that the gas might be useful as an anesthetic, and experiments were conducted to test this experiments were conducted to test this possibility.possibility.

HISTORY (CONTINUED)HISTORY (CONTINUED)

• Abuse of inhalants came to public attention in Abuse of inhalants came to public attention in

the 1950s when the news media reported that the 1950s when the news media reported that

young people were getting high from sniffing young people were getting high from sniffing

glue. glue.

LEGISLATIONLEGISLATION

• Inhalants are generally Inhalants are generally not regulated not regulated as as are other drugs of abuse.are other drugs of abuse.

• Some states have adopted laws Some states have adopted laws preventing the use, sale, and/or preventing the use, sale, and/or distribution to minors of various distribution to minors of various products abused commonly as inhalants.products abused commonly as inhalants.

TYPES OF INHALANTSTYPES OF INHALANTS

•Volatile substancesVolatile substances

•AnestheticsAnesthetics

•NitritesNitrites

VOLATILE SUBSTANCESVOLATILE SUBSTANCES

• Includes aerosols, art or office supplies, Includes aerosols, art or office supplies, adhesives, fuels, and industrial or household adhesives, fuels, and industrial or household solvents.solvents.

• Some abusers inhale vapors directly from their Some abusers inhale vapors directly from their original containers (called sniffing or snorting). original containers (called sniffing or snorting).

• Some abusers inhale volatile solvents from plastic Some abusers inhale volatile solvents from plastic bags (called bagging) or from old rags or bags (called bagging) or from old rags or bandannas soaked in the solvent fluid and held bandannas soaked in the solvent fluid and held over the mouth (called huffing).over the mouth (called huffing).

POTENTIAL EFFECTS OF POTENTIAL EFFECTS OF INHALING VOLATILE INHALING VOLATILE

SUBSTANCESSUBSTANCES• Can cause irritation of airways causing coughing Can cause irritation of airways causing coughing

and sneezing. and sneezing.

• Low doses often bring a brief feeling of Low doses often bring a brief feeling of lightheadedness, mild stimulation followed by a lightheadedness, mild stimulation followed by a loss of control, lack of coordination, and loss of control, lack of coordination, and disorientation accompanied by dizziness and disorientation accompanied by dizziness and possible hallucinations. possible hallucinations.

• In some instances, higher doses can produce In some instances, higher doses can produce relaxation, sleep or even coma.relaxation, sleep or even coma.

POTENTIAL EFFECTS OF POTENTIAL EFFECTS OF INHALING VOLATILE INHALING VOLATILE

SUBSTANCES (CONTINUED)SUBSTANCES (CONTINUED)• If inhalation is continued, dangerous hypoxia may If inhalation is continued, dangerous hypoxia may

occur and cause brain damage or deathoccur and cause brain damage or death..• Other effects include hypertension and damage to Other effects include hypertension and damage to

the cardiac muscle, peripheral nerves, brain, and the cardiac muscle, peripheral nerves, brain, and kidneys. kidneys.

• Chronic abusers of inhalants frequently lose their Chronic abusers of inhalants frequently lose their appetite, are continually tired, and experience appetite, are continually tired, and experience

nosebleeds.nosebleeds.

AEROSOLSAEROSOLS

• Include spray paints, deodorant and hair sprays, Include spray paints, deodorant and hair sprays, vegetable oil sprays for cooking, and fabric protector vegetable oil sprays for cooking, and fabric protector sprays sprays

• Often abused not because of the effects produced by Often abused not because of the effects produced by their principal ingredients but rather because of the their principal ingredients but rather because of the effects of their propellant gaseseffects of their propellant gases

• Can be dangerous because these devices are capable of Can be dangerous because these devices are capable of generating very high concentrations of the inhaled generating very high concentrations of the inhaled chemicalschemicals

TOLUENETOLUENE

• Found in some glues, paints, thinners, nail polishes, and Found in some glues, paints, thinners, nail polishes, and typewriter correction fluidtypewriter correction fluid

• A principal ingredient in “Texas shoe shine”A principal ingredient in “Texas shoe shine”

• Detectable in the arterial blood within 10 seconds of Detectable in the arterial blood within 10 seconds of inhalation exposureinhalation exposure

• Highly lipid solubleHighly lipid soluble

• Can cause brain damage, impaired cognition and gait Can cause brain damage, impaired cognition and gait disturbancesdisturbances

• Liver and kidney damage have been reportedLiver and kidney damage have been reported

BUTANE AND PROPANEBUTANE AND PROPANE

• Found commonly in found in lighter fluid, hair Found commonly in found in lighter fluid, hair

and paint sprays. and paint sprays.

• SSDS, and serious burn injuries (because of SSDS, and serious burn injuries (because of

flammability) have resulted from abuse flammability) have resulted from abuse

GASOLINEGASOLINE

• A mixture of volatile chemicals, including A mixture of volatile chemicals, including toluene, benzene, and triorthocresyl toluene, benzene, and triorthocresyl phosphate (TCP)phosphate (TCP)

• Because of its widespread availability, young Because of its widespread availability, young people, particularly in rural settings, people, particularly in rural settings, sometimes abuse gasolinesometimes abuse gasoline

GASOLINE (CONTINUED)GASOLINE (CONTINUED)

• As a mixture of chemicals, its intentional inhalation can be especially As a mixture of chemicals, its intentional inhalation can be especially dangerous.dangerous.

• Benzene is an organic compound that causes Benzene is an organic compound that causes impaired immunologic function, bone impaired immunologic function, bone marrow injury, increased risk of leukemia, marrow injury, increased risk of leukemia, and reproductive system toxicity.and reproductive system toxicity.• TCP is a fuel additive that causes TCP is a fuel additive that causes

degeneration of motor neurons. degeneration of motor neurons.

FREONSFREONS

• Freons and other related agents are used in Freons and other related agents are used in

refrigerators, air conditioners, and airbrushes.refrigerators, air conditioners, and airbrushes.

• Inhalation can cause not only serious liver Inhalation can cause not only serious liver

damage but also SSDS.damage but also SSDS.

• Inhalation can cause freeze injuries.Inhalation can cause freeze injuries.

ANESTHETICS (E.G. ANESTHETICS (E.G. NITROUS OXIDE)NITROUS OXIDE)

• ““Laughing gas”: frequently used in Laughing gas”: frequently used in

outpatient proceduresoutpatient procedures

• Can also be sold in large balloons or Can also be sold in large balloons or

small cylindrical cartridges used as small cylindrical cartridges used as

charges for whipped cream dispenserscharges for whipped cream dispensers

NITROUS OXIDENITROUS OXIDE

• Significant abuse problems of nitrous oxide are Significant abuse problems of nitrous oxide are

infrequent, but there are occasional reports of infrequent, but there are occasional reports of

severe hypoxia or death due to acute overdosessevere hypoxia or death due to acute overdoses

• Can cause loss of sensation, limb spasms, altered Can cause loss of sensation, limb spasms, altered

perception and motor coordination, blackouts perception and motor coordination, blackouts

resulting from blood pressure changes and resulting from blood pressure changes and

reduced cardiac function.reduced cardiac function.

NITRITESNITRITES

• Cause vasodilationCause vasodilation

• Prototype, amyl nitrite, has been used Prototype, amyl nitrite, has been used

in the past to treat anginain the past to treat angina

• Abuse has decreased dramaticallyAbuse has decreased dramatically

WHY ABUSED?WHY ABUSED?

• Legally obtainedLegally obtained

• Readily availableReadily available

• InexpensiveInexpensive

• Easy to concealEasy to conceal

• Lack of information about potential dangersLack of information about potential dangers

WHO ABUSES?WHO ABUSES?

• Primarily adolescentsPrimarily adolescents, but even small children., but even small children.

• More adolescent males than females.More adolescent males than females.

• Chronic inhalant users frequently have a profile Chronic inhalant users frequently have a profile like that associated with other substance abusers. like that associated with other substance abusers. That is, often they live in unhappy surroundings That is, often they live in unhappy surroundings with severe family or school problems, they have with severe family or school problems, they have poor self-images, and sniffing gives them an poor self-images, and sniffing gives them an accessible escape. accessible escape.

• http://www.youtube.com/watch?v=3g99h4qaCio http://www.youtube.com/watch?v=3g99h4qaCio

SIGNS OF INHALANT ABUSESIGNS OF INHALANT ABUSE

• Often collect an unusual assortment of Often collect an unusual assortment of chemicals (such as glues, paints, thinners and chemicals (such as glues, paints, thinners and solvents, nail polish, liquid eraser, and cleaning solvents, nail polish, liquid eraser, and cleaning fluids) in bedrooms or with belongingsfluids) in bedrooms or with belongings

• Have breath that occasionally smells of solventsHave breath that occasionally smells of solvents

• Often have the sniffles similar to a cold but Often have the sniffles similar to a cold but without other symptoms of the ailmentwithout other symptoms of the ailment

SIGNS OF INHALANT ABUSE SIGNS OF INHALANT ABUSE (CONTINUED)(CONTINUED)

• Appear drunk for short periods of time (15 to Appear drunk for short periods of time (15 to

60 minutes) but recover quickly60 minutes) but recover quickly

• Do not do well in school and are usually Do not do well in school and are usually

unkemptunkempt

• Sitting with a pen or marker near noseSitting with a pen or marker near nose

• Constantly smelling clothing sleevesConstantly smelling clothing sleeves

SIGNS OF INHALANT ABUSE SIGNS OF INHALANT ABUSE (CONTINUED)(CONTINUED)

• Hiding rags, clothes, or empty Hiding rags, clothes, or empty containers of the potentially containers of the potentially abused products in closets, abused products in closets, boxes, and other placesboxes, and other places

• Possessing chemical-soaked Possessing chemical-soaked rags, bags, or socksrags, bags, or socks

• Abusable household items Abusable household items missingmissing

DANGERS OF INHALANTSDANGERS OF INHALANTS

• Sudden sniffing death Sudden sniffing death

syndromesyndrome

• Damage to brain, liver, Damage to brain, liver,

kidney, heartkidney, heart

• Choking on vomitChoking on vomit

• Accidents associated with Accidents associated with

“intoxication” and fires“intoxication” and fires

THE HIGHEST RATE THE HIGHEST RATE OF INHALANT USE BY OF INHALANT USE BY

YOUTHS OCCURS YOUTHS OCCURS AMONG ASIANS.AMONG ASIANS.

A.A. TrueTrue

B.B. FalseFalse

True

False

0%0%

MORE PEOPLE DIE FROM MORE PEOPLE DIE FROM INHALING AIR INHALING AIR

FRESHENERS THAN FRESHENERS THAN FROM INHALING FROM INHALING

GASOLINE.GASOLINE.

A.A. TrueTrue

B.B. FalseFalse

True

False

0%0%

NITROUS OXIDE HAS BEEN NITROUS OXIDE HAS BEEN USED AS AN ANESTHETIC BY USED AS AN ANESTHETIC BY

DENTISTS.DENTISTS.

A.A. TrueTrue

B.B. FalseFalse

True

False

0%0%