THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Transcripts: 491.1 to 491.3

Week: 491.1 Guest: Mike Gimbel Topic: Kids and Inhalants Part One Host: Richard Roeder Producer: Ed Graham

NEMA: This is a three part series on children and chemical inhalants and what you need to know about this deadly practice. My guest is Mike Gimbel, director of the Baltimore County Office of Substance Abuse in Baltimore, Maryland.

NEMA: Mr. Gimbel, inhalants seem to very visibly come and go as time moves on but I guess it's something that's always there but a lot of people don't even now what an inhalant is. Would you first explain what that is.

Gimbel: Basically, when you talk about inhalants, you talk about chemicals and these are literally chemicals rather than drugs. A lot of people think that when you think about drug use, they don't think about chemicals like inhalants so basically what you're looking at are substances, chemicals, which are inhaled. The vapors get into the body in a very quick period of time and it usually leads to a loss of control, it can lead to an individual passing out and what you're doing is you're literally eliminating the blood from getting to the brain and the chemicals are replacing the oxygen that gets to the brain and usually leads to some really serious short term and long term damage but when you think about inhalants, there are many different household products which can be inhaled and cause some serious damage. So it's not your traditional drugs like marijuana or cocaine but these are household products and chemicals which can be deadly.

NEMA: So part of the insidiousness of this is that they are so readily available then.

Gimbel: There's no question about it. You can look at everything in your household from hair sprays to paint to airplane glue, cement, gasolines, lighter fluid, I mean there's hundreds of products that if an individual were to put into a plastic bag or into a rag, they could inhale the fumes and find themselves under the influence of a chemical.

NEMA: How widespread a problem is this because I know a lot of people I've talked to about this they know about marijuana or they know about LSD but they really are very unaware of inhalants. How common and how widespread is this problem?

Gimbel: It's one of the fastest growing problems we have, especially among school age children. As you mentioned earlier there has always been a population that has inhaled chemicals because it was always known as a cheap high, something that was a poor person's high. Now it's become a little more chic. It's become a little more middle class so you're seeing the use go up in middle class America and usually about 10% to 15% of the student population are involved with inhalants and that can go up and it can go down but somewhere between 10% and 15% so you're looking at somewhere you know, maybe 400,000 young people in this country have admitted to inhaling some kind of chemical so it's a big problem, much bigger than I think most people would actually want to admit but it is something very serious among our young people.

NEMA: And when you say young people, is there an age in which this seems to be the most common substance abuse?

Gimbel: What we're finding is that the age has gotten younger. We're looking now at 7th and 8th graders. You're looking at that 13 14 year old range, very early use of drugs in which inhalants have become popular.

NEMA: Join me for part two on kids and inhalants.

Week: 491.2, September 1995 Guest: Mike Gimbel Topic: Kids and Inhalants Part Two Host: Richard Roeder Producer: Ed Graham

NEMA: This is part two in a three part series on children and chemical inhalants. My guest is Mike Gimbel, director of the Baltimore County Office of Substance Abuse in Baltimore, Maryland.

Gimbel: We're looking now at 7th and 8th graders. You know, you're looking at that 13 14 year old range, very early use of drugs in which inhalants have become popular. Then we also see a big increase in high school inhalant use of a particular inhalant called nitrous oxide which we've all heard of as laughing gas and that has become very popular with the older teen agers in parties, rock concerts where they actually can buy a balloon that is filled with this nitrous oxide gas and they inhale it right at the rock concert. So you've got the younger kids starting with sniffing glue and paint and the older teen agers are using the nitrous oxide.

NEMA: Are these substances addictive in the sense that we would think of drugs like heroin or tobacco being addictive?

Gimbel: Well, they don't usually have the physical addictive properties of heroin or alcohol that you actually have to have the drug physically but when you find somebody who's really into inhaling, they are psychologically so dependent on the drug because they want that feeling over and over again that you end up with a lot of chronic users of inhalants who end up with long term damage because they do use it over and over and over again so I'm always one that's always believed that there's a fine line between the psychological and physical addiction of any drug and we all know we can be psychologically addicted to just about anything and any kind of drug so it's not as physical but there's definite addiction when you talk about the use of these kids.

NEMA: Now are these inhalants used by both genders?

Gimbel: I would say in the numbers that I've looked at it seemed to be mostly boys doing it but then again in the state of Maryland we had a young lady who died less that two years ago inhaling butane lighter fluid so I think it is something that has kind of increased but it seemed to be something that was geared toward boys because it was more of a risk taking drug than other drugs but I think that's probably closing now and we're seeing a little more of everyone doing it as we are with all drugs.

NEMA: Part of the difficulty again of this being that these things are so readily available at hardware stores or grocery stores or in somebody's kitchen, what are the symptoms that someone who has gotten into this would start to manifest that a parent could recognize?

Gimbel: Parents should start looking first of all for possible stains, paint stains on the body or on clothing. They start seeing lots of paint sprays or glue stains over the clothing or even around the mouth of a child when they come home, sore spots around the mouth because the inhalant is drying out the skin, runny nose, red nose, red eyes, runny nose, some of the standard things you might want to look for. A chemical breath odor in the child's mouth might tell you that they're inhaling something. They end up acting kind of drunk, a little dazed when they're around when they're under the influence. They might feel nauseous all the time, a loss of appetite, and then some of the longer term concerns become the anxiety, the irritability of a child, and what we call excitability.

NEMA: Join me for part three on kids and inhalants with Mike Gimbel.

Week: 491.3 Guest: Mike Gimbel Topic: Kids and Inhalants Part Three Host: Richard Roeder Producer: Ed Graham

NEMA: This is the third part in a three part series on kids and chemical inhalants. My guest is Mike Gimbel, director of the Baltimore County Office of Substance Abuse in Baltimore, Maryland. I asked Mr. Gimbel to describe the symptoms of inhalants use.

Gimbel: They might feel nauseous all the time, a loss of appetite, and then some of the longer term concerns become the anxiety, the irritability of a child and what we call excitability that he over reacts. Those are some real classic symptoms, the ones when you actually find a product, when you find a paint or glue stains on the body or on the clothes, I mean they're telling you that something's going on and the chemical breath odor is another one that is very common among inhalant users that the parent can look for.

NEMA: Just how dangerous are these inhalants?

Gimbel: There are so many problems with inhalants. For instance, a death could occur instantly from cardiac arrhythmia, respiratory failure. The other thing the drug does is it releases large amounts of adrenaline very quickly which also could cause some kind of death so it's almost a death from suffocation. You know, you have long term problems here with heart failure, you're having long term problems with brain damage. Remember again, you're inhaling a very powerful chemical. It's not a mild drug. It's a chemical and it is very very dangerous and there could be long term permanent damage to the memory and cognitive type of functions. It is very very dangerous.

NEMA: This is certainly an example of something that brings up the classic argument about education versus enforcement. If you're dealing with something like marijuana or heroin, enforcement is obviously something that can be part of the picture but how do you enforce the sale of over the counter substances from hardware stores?

Gimbel: Exactly. Very very difficult. The things that parents need to do I mean this really is an education and prevention solution to inhalant abuse, parents have got to look at what's in their home. They need to do what I call an inventory of the products in their house. They need to know do they have cans of lighter fluid and spray paint and gasoline and other toxic chemicals that are in the house. If they do, they should inventory and check that inventory every week, make sure nothing's missing. As far as stopping the sale from stores, one of the things that have happened in some communities in this country is that parents have gotten together and have gone to the local hardware store or the local supply house and said "Look, we don't want you selling inhalant products to our children," and maybe at some point in this country we'll see an age at which you can and can't buy certain products like we do with alcohol but parents can take control and do the best prevention they can, certainly in their own home.

NEMA: What course of treatment does a parent have an option to use if they find out their child is using inhalants?

Gimbel: The way we treat most alcohol and drug abusers is pretty much the same process as far as treatment. If a parent were to suspect that their child was using inhalants, they should follow the same kinds of procedures they would if they thought their child was smoking marijuana which is usually call for some professional help, a local drug abuse program within their community and let them know what the parent suspects.