Inhalants
Inhalants may produce a stupefying or intoxicating effect. They may, less often, cause psychedelic effects. They typically are fast acting (within 7-10 min) and produce an intense effect that is short in duration (generally no more than 10-30 min). The effects often include strange, erratic behaviour and poor judgement. They are generally inexpensive and readily available, making their abuse widespread.
Adverse effects of the use of inhalants include disorientation, hallucinations, and drunken-like effects that may lead to accident. Chronic use may cause muscle, organ (especially liver), and brain damage, including hearing and visual disturbances, loss of coordination, memory lapses, and learning disability.
Their abuse is most prevalent among adolescents, probably because of their price and accessibility. They are more commonly abused by young women, relative to young men. The most frequently abused substances include typewriter correction fluid, glue, gasoline, and spray paints.
Methods of Inhalation
Huffing -- breathing in the inhalant from a piece of cloth (sock, glove, cuff) or tissue that has been soaked with the inhalant. This procedure may sometimes include placing the rag in the mouth and inhaling
Bagging -- breathing in the inhalant from a plastic or paper bag, into which the substance has been sprayed or poured
Spraying -- breathing in the inhalant by spraying it directly into the nose or mouth
Balloon and cracker -- breathing in the inhalant from a balloon that has been filled with the substance, either by spraying it into the balloon or by puncturing the can and filling the balloon with the pressurised contents
A variation on bagging -- the abuser places a bag over their head and introduces the inhalant, breathing in
Variations on all the above method -- sometimes the abuse may heat the inhalant, to make it more volatile -- this can prove dangerous since some of the substances or their vehicles (the chemicals they are placed in) may be flammable
NOTE that many of these methods are designed to concentrate the inhalant, so that the abuse is getting a larger dose. This may lead to an increase risk of toxicity from the agent, including direct caustic damage to the mouth or nose. ALSO NOTE that many of these methods limit the amount of oxygen that the abuser is breathing in, increasing the chance for dangerous hypoxia (inadequate oxygen).
Trichloroethylene (typewriter correction fluid) -- Similar to toluene, but may also cause hallucinations.
Gasoline -- In addition to the hydrocarbons, toxicity by gasoline includes metals and other chemicals in the gasoline. Symptoms of gasoline abuse include insomnia, tremors, anorexia, and paralysis.
Warning signs of volatile solvent abuse --
Volatile Nitrates and Nitrites
Another aspect of the abuse of these substances is their purported ability to enhance sexual performance.
One unique danger of inhaling nitrous oxide is when the substance in used directly from the storage tank. The gas is pressurised and often at a temperature much lower than room temperature. Inhalation directly from the take may fast-freeze tips of the nose, vocal cords, and lung tissue.
Chronic use may damage nerves both in the CNS and the body in general due to lack of oxygen, leading to permanent loss of nerve function.
The use of various substances by athletes is not a new problem. Ancient Greeks used herbs at the original Olympics. Wines spiked with cocaine (vin mariani) were specifically marketed for athletes during the 19th century. Anabolic-androgenic steroids were first used to enhance athletic ability by the Eastern Bloc countries at the Olympics during the 1950s. Their use spread to American professional athletes. During the past 40 years, their use has filtred from professional abuse through collegiate use and to abuse by high and junior high school students.
Therapeutic Drugs
Patterns of Use -- Many times steroid use is cycled. The person may take steroids for a period of time (i.e. during training) and then stop for a period, allowing their own hormonal system to recover from use, prior to starting another cycle of steroid administration.
Another pattern of use is stacking. Many users will administer more that one drug at a time, stacking one drug on another. This is often in the form of daily ingestion or oral steroids and weekly or monthly injections of parenteral steroids.
Physical Side Effects of steroids include in both the male and female bloatedness, due to water retention, male pattern baldness for those persons caring the gene for male pattern baldness, acne, thickened skin, and organ damage (the most common organ involved with steroid toxicity is the liver, however damage may also occur to the heart, kidney, and other organs). In men, other effects include testicular atrophy and gynecomastia (breast development). In women, other effects include decreases in breast size, deepening of the voice, and clitoral enlargement. Increased aggressiveness and libido may also occur in both genders, as well as an initial euphoria or sense of well being.
Withdrawal symptoms of steroids include fatigue, depression, restlessness, insomnia, anorexia, and decreased libido.
One reason that steroids are so widely abused is that they do provide the desired results. However, increased muscle growth and strength ONLY occur if the person also exercises and has a high protein diet. All three components are necessary for muscle growth.
Commonly used steroids include testosterone, nandrolone (Durabolin®, Deca-Durabolin®), stanozolol (Winstrol®), and methandrostenolone (Dianabol®).
Erythropoietin -- This drug is used to stimulate red blood cell production. It is abused with the same goal as blood doping. The adverse effects to competition are also similar to blood doping.
Other drugs previously discussed are often abused by athletes as well. The uppers, downers, and psychedelics (especially marijuana) may be used for any of the number of reasons discussed in those sections. ALSO, recall that a person who exhibits a tendency to abuse one class of drugs (even a non-addictive drug such as a diuretic or beta blocker), will have a higher chance of abusing other drugs.
C-4 Explosive -- Some plastic explosives may produce a psychedelic effect. Their abuse is often limited to members of the military. Tremors and seizures are the general adverse reactions.
Toad Secretions -- As already discussed in previous sections, some toads produce a psychedelic substance. These toad toxins may be collected and smoked.
Embalming Fluid -- Formaldehyde may be inhaled (often in combination with marijuana) to produce a depressant and psychedelic effect. The combination often gives a PCP like experience. Formaldehyde is a know carcinogen (cancer-causing substance).
Gasoline -- In addition to being inhaled for its deliriant effects, gasoline may be mixed with orange juice and drank ("Montana gin").
Kava Kava -- A natural product of South America, this drug contains several components that produce an ethanol-like state of drunkenness.
Smart Drugs -- A newer form of substance abuse is the use of vitamins, minerals, herbal extracts, and drugs (such as those used for Alzheimer's disease) that are supposed to increase mental ability, learning, and retention.
Of particular interest to the genetic contributors of compulsive behaviour (whether it be drug abuse or one of the behaviours discussed below) is the genetic predisposition known as REWARD DEFICIENCY SYNDROME. The presence of a particular gene has been correlated with numerous types of addicted behaviour. It is present in 45% of persons who are compulsive overeaters, 48% of smokers, 51% of compulsive gamblers, 52% of cocaine addicts, 69% of alcoholics, and 76% of gamblers who also have drug addictions. In those persons who possess this gene, there appears to be a lack of receptors for dopamine in the reward center of the brain. In other words, it is much harder for these people to experience reward. They therefore seek artificial means to stimulate this centre of the brain, through either compulsive behaviours or drugs. The gene is present in only 20% of persons who do not exhibit nonalcoholic, nonaddictive, noncompulsive behaviours.
Compulsive Gambling
Bulimia refers to a compulsive behaviour characterised by binge eating followed by purges (either self-induced vomiting or laxatives).
Compulsive overeating is the opposite of the above two, in which persons compulsively overeat and do not care about the weight gain that results.
Treatment of any eating disorder is usually a combination of psychological counselling, changes in life style, education on the effects of the disease and the importance of proper nutrition, and occasionally, the use of psychotherapeutic drugs to increase appetite to adjust the moods of the patient (especially when there is accompanying depression).