SOLVENT SNIFFING

Abstract
The vapors of a wide variety of organic solvents contained in such products as glues, paint thinner, fingernail polish removers, and cleaning and lighter fluids are being used by juveniles for the deliberate induction of intoxication. Such practices recently reached epidemic proportions in many areas of this country and, while the faddist aspect has now largely subsided, chronic "sniffing" appears to have emerged as a permanent and relatively common form of aberrant childhood behavior. Various observations of the problem suggest that sniffing provides a chemical escape from reality which is more adaptable, and therefore more readily accepted, by young children than are such other intoxicating practices as alcohol ingestion or the use of narcotic drugs. The greater adaptability of the former resides primarily in inexpensiveness, ease of concealment, and ease of procurement for supposedly legitimate purposes. The result is the development of dependence or habituation of youngsters at a far younger age than would otherwise be likely. The impression is gained that sniffing is the counterpart in the young child of the abuse of narcotics, alcohol, or LSD in older individuals. The pyschodynamics of this phenomenon, however, are not clear and there may be common factors underlying the widespread, recurrent use of or dependence on substances such as betel morsels, amphetamines, barbiturates, and even tobacco and caffeine (in coffee and tea). All of these result in a physiochemical modification of the sensorium, usually with a transient euphoric or stimulant effect. Attempts were made to characterize solvent sniffers and to assess the importance, potential dangers and the effectiveness of various control measures through original studies, a review of published data, and extensive discussion with others concerned with the problem. Among sniffers as among all juveniles apprehended by the police, there is a great preponderance of boys over girls, and the majority are in their early "teens," although some are as young as 7 to 8 years of age. In areas of large Spanish-American population, members of this ethnic group comprise a disproportionately large share of sniffers, but it is noteworthy that Negroes seem definitely to be under-represented among sniffers, even in areas of very high Negro population. Although sniffers usually had prior histories of scholastic under achievement, intelligence per se bore little positive relation to the adoption of the habit. There was a definite relationship, however, to other modes of delinquency, of which most sniffers had long records. Perhaps surprisingly, such records tended not to include addictive behavior involving alcohol on narcotics, but repeated histories of exploring various solvent vapors for their intoxicating effects were usual. Among various psychosocial factors which might be considered etiologic, emotional deprivation was one which seemed to be frequently and regularly present. The intoxicating effects desired by sniffers can be produced by most volatile organic Solvents which are lipid-soluble. The popularity of some solvents is limited, however, because of undesirable properties, expense or difficulty of obtaining. The effects of solvent inhalation may often resemble those produced by alcohol, but there is a tendency for sniffing to be associated with greater impairment of judgment and reality perception. Thus, solvent vapor inhalation may lead to accident, violence, and the perpetration of various bizarre and antisocial acts. Repeated inhalation of large concentrations of vapors is associated with the development of striking tolerance and dependence, the latter often being accompanied by compulsion. Serious withdrawal symptoms, however, have been absent or rare and not at all like the intensity on pensistence of those associated with opium derivatives. That it may be the forerunner of alcoholism or narcotic addiction is perhaps implicit in the nature of the practice, but there is yet little evidence that one leads per se to the other. The toxic potential of solvent sniffing depends, of course, upon the constituents of the products employed. Some extremely dangerous solvents (e.g., carbon tetrachloride) which would not be popular among confirmed sniffers may be selected by the exploring novice or during periods of forced deprivation. Such eventualities aside, it remains unclean to what extent the more popular types of solvent sniffing (e.g., involving toluene or naphtha) are medically dangerous. In some studies, but not in others, sniffers of toluene have been found to have an abnormal incidence of vague neurological signs, hepatomegaly, eosinophilia, and, rarely, acute intracranical hypertension. The most consistent findings have been urinary abnormalities which appear to he transient; their ultimate significance, if any, is unknown at this point. Whether such findings reflect a transient, irritating effect of the chemical on the kidneys or a more destructive process capable of evolving into chronic incapacity remains to be determined. Legislation has been adopted, or proposed, in many cities and in several major states ill an attempt to control the problem, but its effectiveness remains open to question. Statutes aimed at restricting distribution (rather than abuse) of solvents is made difficult by the ubiquitousness of substances which can produce such effects. Thus, while a particular product (such as plastic cement) may be the current favorite, legislation aimed at it alone is not only discriminatory but may actually be harmful by forcing the use of alternate substances which are potentially more dangerous. Statutes aimed at abuses of the solvents (i.e., prohibition of inhalation with the intent of intoxication) provide a mechanism whereby offenders can be apprehended and, hopefully, subjected to treatment and may have some deterrent value. However, if interpreted literally they could be difficult to enforce and could...