Blogger 1: "I was first introduced to computer duster when some friends of mine were inhaling it one night while I was driving them around. I'd never done a drug in my entire life, but this made me very curious. I've gotten a throat infection from it and my friend has nosebleeds. We also experience headaches. I've had a friend crash his car while on it. I have another friend who has seizures when he does it." "We are trying to stop, it's just hard. I have a doctor's appointment coming up and I know they're going to do blood work. How long does it take the chemicals to work their way out of your bloodstream?"

 

Blogger: "Your last question made me sad; 'how long does it take for this stuff to be out of your system?" 

 

Respondent: "Sounds like you're worried about getting caught. No comment.[1]"

 

Inhalants are breathable chemical vapors that users "huff" to get a psychoactive high that produce mind-altering effects. A variety of products in the household and the workplace are easily accessible and often used by young people as a substitute for alcohol. Huffing has been a manner of drug use and addiction for generations. In the 50s and 60s the huffing of gasoline, paint and glue was widespread. In the 70s following the proliferation of potent marijuana, huffing became less popular. But over time, the search for quick and cheap drug highs has kept huffing around. Huffing is easy, dangerously easy. Volatile solvents have played a starring role in huffing, particularly toluene. Gasoline was and still is a reliable agent for huffing. The chemicals of the past are being eclipsed by the use of a new genre of inhalant. The inhalants of the new millennium are not volatile, not regulated and they're legal to possess. 

 

A new trend in huffing is quickly on the rise; a practice known as "dusting." Dusting is the dangerous abuse of computer dust-off cleaning products. Most dusters contain one of the following chemicals: tetrafluoroethane (HFC-134a) or difluoroethane (HFC-152a). Dusting products are commonly found in department stores such as Wal-Mart and Target. Users often shop to compare prices in stores and online. Abusers sometimes share cans of product at social events like dances and concerts. Frequent clearance sales on electronic parts cleaners at office supply chain stores make these types of inhalants a cheap and easy way to get high.

 
Effects of dusting resemble alcohol intoxication including mild stimulation, loss of inhibitions, and distorted perceptions. Physical signs of abuse include the following: glassy eyes, slurred speech, loss of appetite, problems in school, sores around the nose and mouth, and chemical odors on the breath or clothing. It's important to notice material signs of abuse because 

 
Young children and adolescents are the most likely to abuse inhalants. Because inhalants are so easily accessible, they tend to be a first drug of abuse. Although huffing usually begins around age 10 or 11, children as young as 6 begin experimenting with inhalants. Recent studies tend to indicate the practice of dusting also extends into young adulthood.

 
Over 2.1 million children ages 12-17 have used an inhalant to get high. Approximately 1 school-aged child out of 5 in America has intentionally abused a common household product to get high by the time they reach the 8th grade. According to a 2008 report of The National Survey on Drug Use and Health, (www.oas.samhsa.gov/2k8/inhalants/inhalants.htm) inhalants were the most frequently reported class of illicit drugs used in the preceding year among adolescents aged 12 and 13[2].

High blood concentrations of inhalants can cause death from suffocation by displacing oxygen in the lungs and in the central nervous system so that breathing ceases. Ironically, it is the sensation caused by oxygen starvation that is euphoric to the "duster." By inhaling these products, abusers push themselves to the limits of suffocation. As an abuser tips over into unconsciousness, it is possible for a slumping body to inadvertently depress a can's spray button down and open it. As a result, gas continues to stream into the person's airway.

 

This phenomenon has led to the discovery of children who were found dead sitting upright with a tube dangling from their lips. Some inhalant abusers have taken to the use of PAM (kitchen spray) and hair spray in order to experience similar effects. Oftentimes, this sort of abuser will aim the plastic straw attachment down their throat for a more direct spray of gas. All of these practices are inherently dangerous and can lead to sudden death. Heart failure is often the cause of what doctors call "sudden sniffing death" which can occur within minutes of a single session of inhalant use, even by an otherwise healthy young person. Lack of oxygen to parts of the brain can lead to memory disturbances.

 

Some users have remarked that they couldn't remember when or where they last used a dusting product, but they had the evidence in their bedroom or car of expended cans and discarded plastic tubes that led them to believe that they had in fact gotten high sometime in the recent past. In fact, inappropriate numbers of discarded dusting canisters, red plastic tubes, (straws) and packaging are blatant signs to parents that a child may be engaging in this drug abuse. Trashcans, book bags, and dresser drawers that contain used and unused canisters are clear signs that a child is engaged in inhalant abuse.

 

A single session of repeated inhalations can cause permanent damage to a variety of systems. Organs affected by use include the following: lungs, brain, liver, heart, and kidneys. Harmful, irreversible effects may result, such as hearing loss, peripheral neuropathies or limb spasms, and central nervous system or brain damage. For the periodic or social user of these drugs, lesions in the mouth and throat can occur. The propellants in the cans may dry out the throat and nasal passages. Abusers commonly report sudden nosebleeds. A non-productive dry hacking cough may also ensue from the use of these drugs; dry mouth and a raspy voice may also be experienced. Parents may even notice a change in the pitch of a child's voice as a result of chronic use. Depending on how often a product is used and how and where the gas is directed into the oral cavity, damage may be done to a user's vocal chords.

Blogger 2: "I know people who do it so much they can't remember the year, when sober. Or they don't remember how to spell simple words. Or are dead [1]."

 

Research has shown inhalant use is linked to depression. Depressed teens are three times more likely to engage in this drug use than kids who are not depressed[3]. A recent federal government report reports that adolescents who used inhalants were more likely to have a co-occurring mental health problem. 45% of inhalant abusers had a concurrent psychiatric disorder.
 
Dusting can become an addictive disorder. Although physical dependency is unlikely to occur with the abuse of these drugs, serious addictive behaviors may ensue following a period of chronic use. Because the effects of these drugs are short-lived, users will engage in patterns of use where they may spray up to 10 times an hour. A fatigue develops with frequent use of the drug. Some dusters report, "crashing" following a period of concentrated activity. An inhalant abuser may even exhibit some of the signs seen with abusers of methamphetamine and central nervous stimulant drugs. Weight loss, apathy, social isolation, and paranoia may occur in some cases.

 

 The DAR medical staff conferred with the caller and assured her that the utilization of gabapentin in treatment of methamphetamine addiction is not new. Gabapentin is a prescription medicine. Gabapentin is in a class of drugs that are used to treat seizure disorders and neuropathic pain. Gabapentin is a close chemical cousin to the inhibitory amino acid transmitter gamma amino butyric acid. A pro-drug relative called pre-gabalin is also available by prescription; it's regularly sold under the product name of Gabatril. Gabapentin's potency stems from its chemical similarity to the neurotransmitter gamma amino butyric acid. Gabapentin has had notable success in the treatment of various forms of chronic pain. It seems that gabapentin reduces the spurious firing of pain messages that emanate from nerve-damaged areas of the body. By reducing the frequency of electrical activity in certain types of nerve cells, overall levels of pain can be reduced or in some cases eliminated. This chemical corralling action of gabapentin makes it useful in fighting addiction.
 
For those people in recovery, drug cravings are substantially controlled by the amount of excitability in neurotransmitter systems that were targeted or damaged by their drug of abuse. In methamphetamine abuse, the neurotransmitter dopamine is the chemical that mediates the euphoria and energy that the drug generates. The various components of the nervous system that contain dopamine nerve cells remain in a hyper-excited state even after sobriety is attained. A chemical state of chronic agitation creates a visceral sense of need for the drug. These feelings for the addict are uncomfortable. From an addict's point of view and experience, the discomfort can only be relieved by a return to the original culprit. When this happens, relapse is just around the corner.
 
Like other membrane stabilizing drugs (Tegretol, Tripeptal) and calcium-channel blocking drugs (metoprolol), gabapentin works to slow down the rate of electrical firing in agitated transmitter systems. In doing so, gabapentin can reduce overall levels of drug cravings. To date, scientific study indicates that gabapentin is effective in this role. More research and inquiry needs to take place though. But going for now, it appears likely that gabapentin will continue to be used as an adjunct in the treatment of drug cravings, especially those experienced in recovery from methamphetamine addiction. Given their shared impacts on dopaminergic components of the central nervous system, it appears that gabapentin can be effective in treatment of cocaine and alcohol related cravings as well. It may be that some readers have clients or patients who have been prescribed the drug to treat cravings associated with those addictions.
 
As to the caller's concerns that gabapentin may be a drug of abuse in its own right, the evidence and experiences to date tend to discount that fear. Although there have been clusters of gabapentin abuse in parts of the country, the drug has not evolved into a street drug threat. There is no underground market for gabapentin. To be clinically effective, gabapentin must be taken in substantial doses (1000 mg or more daily) and must be taken regularly in order for it to reach significant levels in the blood. The drug's central effects are mildly sedating. Patients taking the drug to control drug cravings may be told to do so only during an acute period of withdrawal experienced in detoxification. Others may be prescribed the drug for a year or more according to the degree and persistence of their cravings.
 
The caller in this Hotline inquiry chose to allow the residents in question to proceed with their gabapentin treatment regimen. She called back several days later to inform us that she discovered that another resident in an unrelated facility had been prescribed the drug to treat a resistant form of bi-polar disorder. The caller was concerned that the patient had been prescribed too much of the drug and wanted to know if she should call the resident's psychiatrist. The resident was taking 3000 mg daily. The DAR medical team advised her that 3000 mg is a modest amount of gabapentin and that it probably was not worth her time to contact the doctor.
 
Gabapentin is eliminated from the bloodstream unchanged. The drug will not interfere with onsite (instant) drug testing kits. The drug is not a benzodiazepine, nor is it a controlled substance. Claims that gabapentin is a facilitator of false positive drug tests for THC and/or benzodiazepines are unfounded. 
  
The MEDTOX Hotline receives frequent calls from clients who inquire about the use of psychotropic and anti-seizure drugs in the use of detoxification and management of cravings. Although there is a short list of drugs prescribed for this purpose, there are dozens of possible alternative drugs that physicians can turn to should a patient show sensitivity or a lack of response to a first choice. MEDTOX clients can obtain more information about these drugs by emailing the DARS Hotline at DARSProgram@mac.com