special subjects
Volatile Solvents
Symptoms and Signs of Volatile Solvent Use
Acute symptoms of dizziness, drowsiness, slurred speech, and unsteady gait occur early. Impulsiveness, excitement, and irritability may occur. As effects on the central nervous system increase, illusions, hallucinations, and delusions develop. Users experience a euphoric, dreamy high, culminating in a short period of sleep. Delirium with confusion, psychomotor clumsiness, emotional lability, and impaired thinking develop. The intoxicated state may last from minutes to>1 hour. Sudden death can result from respiratory arrest or airway occlusion due to central nervous system depression or arrhythmias ("sudden sniffing death," perhaps due to myocardial sensitization). One chlorinated hydrocarbon, methylene chloride (dichloromethane), is metabolized to carbon monoxide and inhalation of this product can cause delayed onset of symptoms of Carbon Monoxide Poisoning ; symptoms may persist for a prolonged period. Methanol, a solvent that can be inhaled, may cause Metabolic Acidosis and retinal injury. Chronic inhalation of volatile hydrocarbons may irritate the skin around the mouth and nose (huffer's eczema). Complications of chronic use may result from the effect of the solvent or from other toxic ingredients (eg, lead in gasoline). Carbon tetrachloride may cause a syndrome of hepatic and renal failure. Toluene may cause degeneration of central nervous system white matter, Renal Tubular Acidosis , and Inhalant abuse during pregnancy can cause premature birth and fetal solvent syndrome, which has features similar to those of Fetal Alcohol Syndrome . 