Chapter 3 Drug-Specific Information 2024 PDF

Chapter 3 Drug-Specific Information Drugs on the Street Where You Live Learning Objectives Explain the current changes in marijuana use, including medical uses of marijuana Explain the dangers of energy drinks when they are consumed with alcohol. Define the following terms—physical depen...

Chapter 3 Drug-Specific Information Drugs on the Street Where You Live Learning Objectives Explain the current changes in marijuana use, including medical uses of marijuana Explain the dangers of energy drinks when they are consumed with alcohol. Define the following terms—physical dependence, withdrawal, psychological dependence, tolerance, cross-tolerance, synergism, and antagonism. Define and describe addiction, routes of administration, set and setting, drug absorption, distribution, and elimination. Define addiction using the three Cs of addiction. Identify and list the drugs for each of the classifications of drugs. List and describe the hazards in using alcohol and other sedative- hypnotics together. Defining Addiction 3C: Compulsion, control, and continued use Compulsion and obsession. Loss of control or inability to stop. Continued use despite known adverse consequences. Drugs in Society In the 60s and 70s, drugs became a major part of the hippie movement {Marijuana, hallucinogens (especially LSD)}.. In the 80s, cocaine and crack were popular. Rise of synthetically produced drugs. Celebrity deaths raised awareness of the drugs. In the 90s, ice, a purified form of the drug methamphetamine hydrochloride, was widely used. Definitions of Terms 1 Physical dependence: Altered state that develops when a person cannot stop taking a certain drug without suffering from withdrawal. Withdrawal symptoms: Physical symptoms resulting from stopping the use of a drug. Psychologically dependent: User with a profound emotional or mental need for the repetitive use of drug(s). Tolerance: Users require larger doses to achieve the same high produced previously by a smaller dose of the same drug. Cross-tolerance: Diminished or reduced response to the effect of a psychoactive drug. This response is due to prior use of other psychoactive drugs, usually in the same drug category. Definitions of Terms 2 Synergism: Combined effect of two or more drugs is greater than the effect of each agent added together Antagonism: Occurs when the combined effect of two drugs is less than the sum of the drugs’ effects acting separately Routes of administration: Method by which the alcohol/drug is ingested. May be oral, through the skin, by injection, by smoking, or through other openings. Definitions of Terms 3 Drug Action – Specific molecular changes produced by a drug when it binds to a target site of receptor Drug Effects – Alterations in physiological or psychological functions Therapeutic Effects – Drug-receptor interaction produces desired physical or behavioral changes Side Effects – All other effects; therapeutic and side effects can change, depending on desired outcome Specific Drug Effects – Based on the physical, biochemical interactions of a drug on a target site Nonspecific Drug Effects – Based on unique characteristics of the individual  Nonspecific Drug Responsiveness Set: Psychological makeup and the expectations of the person taking the drug Setting: Social and physical environment in which the drug is taken Biochemical makeup: Each individual has a unique biochemical makeup, some of which are dependent on genetic factors Definitions of Terms 4 Pharmacokinetics: The processes involved in the movement of drugs within the system with respect to absorption, distribution, binding or localization in tissues, metabolic alterations, and excretion from the body. What does the body do to the drug? Pharmacodynamics: The biochemical and physiological effects of drugs and their mechanisms of action. What does the drug do to the body? Pharmacokinetics and Pharmacodynamics Definitions of Terms 5 Duration of Action: The amount of time that the drug exists in its active form in the bloodstream, could be minutes or hours, depending on the drug Drug Half-Life: The amount of time required for the body to eliminate half of the drug; a longer half-life corresponds to a longer duration of action Pharmacokinetics Pharmacokinetics is broken down into four processes of drug activity: 1 Absorption 2 Distribution 3 Metabolism 4 Elimination/Excretion  1 Drug Absorption Entrance of drug into the bloodstream for transport throughout the body A drug taken orally must dissolve in and permeate the lining of the stomach or small intestine before it can be absorbed into the bloodstream First pass metabolism: Drugs taken orally must first go through GI tract, into hepatic system before getting into bloodstream that goes to brain – Makes oral dosing difficult to predict and control The same dose of drug will have different drug levels depending on the route of administration due to differences in absorption  Routes of Administration) How and where a drug is administered determines how quickly and completely a drug is absorbed into the blood 1. Enteral Routes 2. Parenteral Routes 3. Topical Routes 4. Inhalation Routes 1. Enteral Routes Oral: Swallowed and absorbed through the GI tract (safer, cheaper, self-administered, more comfortable). Sublingual: Absorbed under the tongue. Buccal: Absorbed between the gums and cheek. Rectal: Administered through the rectum (Alternate way to enter GI tract for drugs destroyed in stomach or small intestine). 2. Parenteral Routes Intravenous (IV): Directly into the bloodstream. Intramuscular (IM): Into a muscle. Subcutaneous: Under the skin. IV and IM Intravenous Injection (IV): Rapid onset of drug action; intense effects (more than the same drug via oral); little can be done about overdose; high incidence of allergic reaction, cardiovascular and other side effects; more accurate for dosing Intramuscular (IM) injection: More rapid absorption than via oral due to blood supply in muscles, more even absorption than IV Intracerebroventricular Some drugs cannot cross the blood-brain barrier. If these drugs are to reach the brain, they must be injected directly into the brain or into the cerebrospinal fluid of the brain's ventricular system. This route is used very rarely in humans--primarily to deliver antibiotics directly to the brain to treat certain types of infections. 3. Topical Routes Topical: Applied directly to the skin or mucous membranes. Transdermal: Through the skin using patches. 4. Inhalation Routes Inhalation: Administered through the respiratory system. Rapid onset of action and intense effects due to large surface area of lungs and proximity to blood vessels What Impacts Absorption? Route of administration Drug concentration: Age Sex Body size Solubility and ionization of the drug 2 Drug Distribution The absorbed drug now moves into the bloodstream and into other tissues and organs The main factor affecting distribution is blood flow, some areas of the body get more blood flow than others Heart, liver, brain, and kidneys have the largest blood supplies – these areas will have the highest concentration of drug Blood Brain Barrier The site of action of most drugs of abuse is the brain BBB is a feature of the physical structure of the capillaries supplying blood to the brain – less porous, more tightly packed than other capillaries in the body (e.g., less permeable) BBB limits entry of substances into the brain Protects brain against fluctuations in the body’s system & varying chemical levels in the blood The faster a drug penetrates the BBB the greater the likelihood of its being abused & producing dependence 3 Drug Metabolism Metabolism: Process resulting in chemical change in the drug in the body to promote excretion Also called biotransformation Drug can become more active, less active or unchanged during metabolism Sometimes a single drug can change in all three ways The liver is the primary organ responsible for metabolism – creates enzymes that attack the drug differently, depending on the chemistry of the drug Metabolism Many things can affect the rate of drug metabolism: Tobacco smoking (may enhance metabolism of psychotropics) Other drugs (Some drugs inhibit the metabolization of another drug because they share a common metabolic pathway) Amount of cytochrome enzymes in the body due to age, race E.g., older people may be at higher risk of drug toxicity due to loss of enzyme production Nutrition Disease Increasingly stronger doses of the drug produce increasingly larger effects until the maximum effect is reached. After that point, increments in the dose do not produce any increments in the drug's effect. However, the risk of adverse side effects increases.  4 Drug Elimination/Excretion Excretion is the removal of the drug from the body Some drugs are excreted intact, with minimal metabolic transformation (amanita muscaria mushroom) The most active tissues in metabolism are also involved in excretion: GI tract; liver; kidneys; lungs Primary form of excretion is through urine Primary organ of excretion is the kidney Drug must become more water soluble to facilitate excretion Other routes of excretion include – lungs, sweat, saliva, and breast milk Pharmacokinetix Journey of an asprin Pharmacodynamics The biochemical and physiologic effects of drugs. Pharmacodynamics is the study of how a drug affects an organism, whereas pharmacokinetics is the study of how the organism affects the drug. Effects of drugs on synaptic activity Agonist: Drug produces an effect Antagonist: Drugs produce no effect, as if it were blocking the site Partial Agonist: Demonstrate efficacy that is less than that of full agonists but more than that of an antagonist Inverse Agonist: Initiate an action that is opposite to that produced by an agonist Ways for Effecting Synaptic Activity Effects on Production of Neurotransmitters Effects on Storage and Release of Neurotransmitters Effects on Receptors Effects on Reuptake or Destruction of Neurotransmitters  Dose-Response Dose-response curve: Relationship between dose administered and response observed. The more drug – the greater the response, up to a point when there is no more therapeutic effect (ceiling effect) - side effects may still increase. Threshold dose: Smallest dose that produces a measurable effect Maximum response: Greatest degree of response that can be achieved with that drug ED50: Effective dose for the 50% of the population– dose that produces the maximal effect for the half of the group Most drugs have more than one effect. Opiates such as morphine, codeine, or oxycodone produce analgesia (reduced sensitivity to pain), but they also depress the activity of neurons in the medulla that control heart rate and respiration. A physician who prescribes an opiate to relieve a patient's pain wants to administer a dose that is large enough to produce analgesia but not large enough to depress heart rate and respiration--effects that could be fatal.  More on Dose-Response Potency: How much drug is needed to produce an effect Highly potent drugs produce effects at very low doses (e.g. micrograms for LSD) The same drug has different ED50 values for different effects LD 50 – “Lethal Dose” – Dose that causes death in 50% of the population Therapeutic Index: A drug’s relative margin of safety (drug’s LD50 relative to it’s ED50 – divide LD50 by ED50) – therapeutic index under 10 is considered hazardous – usually want TI of 100 Drug Interactions Physiological antagonism: When two drugs produce opposite effects and reduce each other’s effectiveness Additive effects: When the combined drug effect equals the sum of each drug alone Potentiation: When combined drug effects are greater than the sum of individual drug effects Pharmacodynamics  Drug Tolerance Tolerance: Occurs when there is a reduction in the potency or efficacy of a drug with repeated administration Larger amounts needed to yield same response Sometimes no amount will produce original effects Cross-tolerance: Development of tolerance to one type of drug results in decreased sensitivity to the effects of another type of drug  Characteristics of Tolerance Reversible when drug use stops Dependent on dose and frequency of drug use and drug-taking environment May occur rapidly, after long periods of chronic use, or never – varies from drug to drug Not all effects of a drug show the same degree of tolerance Several different mechanisms explain multiple forms of tolerance but we are not covering them in this course.  Sensitization Drug sensitization: Enhancement of drug effects with repeated administration of the same dose Also called reverse tolerance Same effect can be yielded with a lower dose in subsequent administrations  Psychological Dependence Psychological Dependence: A strong compulsion or desire to experience the effects of a drug (craving) because it produces pleasure or reduces emotional discomfort Consider context-specific tolerance and psychological dependence linked: e.g. reinforcement Some motives to use drugs/alcohol are more strongly linked to excessive drug use than others (e.g. coping motives are; social motives are not) If physical dependence exists, a psychological craving might be related to the fear or anxiety of experiencing an abstinence syndrome Physiological (Physical) Dependence Physiological Dependence: When the administration of a drug is suspended (or an antagonist is administered) an abstinence syndrome develops Abstinence Syndrome (AS): Physical disturbance when a drug is withdrawn; usually the opposite of the drug action Duration/intensity of AS are highly correlated with the duration/intensity of a drug’s effects  Dependence/Addiction Takeaways Many predisposing factors lead to initial drug use Many additional factors can lead to continued drugs use, once it has begun Psychological dependence plays a significant role in maintaining drug use; therefore, methods that only focus on physical dependence and withdrawal are not likely to have long term effectiveness  Strong Potential for Physical & Psychological Dependence Sedative-hypnotic properties: Alcohol Barbituates Nonbarbituate sedative-hypnotics Antianxiety drugs Narcotics/Opioids: Heroin Morphine Codeine Methadone Strong Potential for Psychological Dependence – Unclear Physical Dependence Psychostimulants: Cocaine Amphetamines Marijuana Rare Psychological Dependence & No Documented Physical Dependence Hallucinogens LSD Mescaline Psilocybin Classification of Drugs Nonpsychoactive drugs: Substances that in normal doses do not directly affect the brain. Such as vitamins, antibiotics, and topical skin preparations. Psychoactive drugs affect brain functions, mood, thoughts, and behavior. Subdivided primarily on the basis of physiological and psychological effects. Drug Classification Dilemma It is difficult to classify drugs : Drugs with similar molecular structures may induce different effects Drugs with different molecular structures may have similar effects Drugs may have different effects at different doses A specific effect of a drug may be desirable in some circumstances but not in others This has led to a variety of ways to classify drugs Classification - Therapeutic Action Common in psychopharmacology to describe a drug as belonging to a class based on the therapeutic action Advantage is that this conveys some meaning about the effects of newly developed drugs Disadvantage of this approach is that many drugs do not consistently yield the same effect (dose; multiple treatment uses, etc.) Some drugs do not easily fit into any one category Classification – Neurochemical Actions A drug induces a behavioral effect when it can alter the process of chemical transmission in the nervous system Neurotransmitters can also be affected by drugs When classification combines therapeutic action and neurochemical action, a clearer picture of the drugs’ overall effect is yielded Psychoactive Drug Classification Watch this video for your exam https://www.youtube.com/watch?v=HLcZFjsdyVQ Psychoactive Drug Classification Drugs Examples Narcotic analgesics Painkillers and designer drugs Central nervous system Sedative hypnotics, alcohol, tranquilizers, depressants and barbiturates Central nervous system Amphetamines, cocaine, nicotine, and stimulants caffeine Hallucinogens LSD and mescaline Cannabis sativa Marijuana and hashish Inhalants Volatile solvents The DSM-5-TR recognizes substance-related disorders resulting from the use of 10 separate classes of drugs: Alcohol Caffeine Cannabis Hallucinogens Inhalants Opioids Sedatives Hypnotics, or anxiolytics Stimulants (cocaine) Stimulants (amphetamine-type substances, and other stimulants) Tobacco Other or unspecified Major Effects of Narcotic Analgesics Pain relief. Euphoria. Cough suppressant. Respiratory depression. Sedation or drowsiness. Constriction of the pupils. Nausea and vomiting. Itching and decrease in gastrointestinal activity. Narcotic Analgesics Users may inject narcotics intravenously, subcutaneously, or deep within the muscle. Hazard: Overdose and risk of disease from sharing dirty needles. Tolerance: Develops rapidly depending on the route of administration. Withdrawal symptoms: Appetite suppression, nausea and vomiting, dilated pupils, gooseflesh, restlessness, chills, and irritability. Narcotic Analgesics Classification Natural Opioids Synthetic Semisynthetic Antagonistic Morphine Demerol Dilaudid Narcan Codeine Meperidine Percodan Naloxone Opium NA Talwin NA  Heroin It is an increasing trend. It is now much purer, and thus more potent, which enables the user to inhale it The fact that it does not have to be injected makes it more attractive by alleviating the aversion most people have to needles the widespread misbelief, and rationalization, that if one smokes or snorts heroin, it will be nonaddicting. it is also relatively inexpensive, especially compared with crack cocaine. Easy access OxyContin (Oxycodone) Abuse Semisynthetic opioid analgesic prescribed for chronic pain. Effective and beneficial for chronic pain sufferers. Long-acting medication that is time-released over 12 hours. Abusers seek a quick and powerful rush. Injected, snorted, or mixed in water. https://www.youtube.com/watch?v=Kmg45R9PMIo Central Nervous System Depressants: Sedative, Hypnotic and Anxiolytic drugs in DSM 5TR Alcohol Central Nervous System Depressants: Alcohol 1 Toxic drug with irritating and sedative properties. Effects. Amnesia, permanent loss of memory, and mental confusion. Pain and loss of sensation in legs and dimmed vision. Gastritis, esophagitis, peptic ulcer, and pancreatitis. Dilated peripheral blood vessels and emphysema. Energy drinks (E D) are potentially fatal when mixed with alcohol. Central Nervous System Depressants: Alcohol 2 Tolerance develops with frequent use. Withdrawal symptoms: Psychomotor agitation in stage 1 and hallucinations in stage 2. Related illnesses: Premature deaths, vitamin deficiencies, and sexual impotence. Fetal alcohol syndrome: Alcohol use and abuse by pregnant women.  Energy Drinks Energy drinks appear to be innocuous, but combined with alcohol they can be deadly. Energy drinks are very popular with college students and young adults, especially athletes and students who are physically active. https://www.youtube.com/watch?v=u704u8nKYIE Central Nervous System Depressants: Barbiturates & benzodiazepines Barbiturates have been more stringently controlled in the United States, and benzodiazepines are more frequently abused because of perceived greater safety. Relatively small doses may cause drowsiness, motor impairment and impaired judgement. Accident risk is greatest in the first weeks of benzodiazepine use. Intoxication, stupor, coma and respiratory depression are more common with barbiturates. Withdrawal involves autonomic overactivity, tremor, insomnia, psychomotor agitation or anxiety, hallucinations and convulsions after hours to days of abstinence. Central Nervous System Depressants: Barbiturates Induce sleep and reduce pre-menstrual tension and motion sickness. At higher doses, reduce the individual’s ability to react quickly and perform precise tasks. Withdrawal symptoms: Physical weakness, dizziness, anxiety, and hallucinations. Methaqualone: One of several nonbarbiturates that have barbiturate-like effects. Tranquilizers Used for treatment of tension, insomnia, behavioral excitement, and anxiety. Taken orally as tablets, capsules, or liquids. Effects: Drowsiness, disorientation and confusion, lethargy, and rage reactions. Withdrawal symptoms: Tremors, rapid pulse, fever, loss of appetite, nausea, and vomiting. Classification of Minor Tranquilizers (Antianxiety Agents) Benzodiazepines Meprobamate Sedating Antihistamines Valium (diazepam) Equanil Atarax, Vistaril (hydroyzine) Librium Miltown Benadryl (diphenhydramine) (chlordiazepoxide) Serax (oxazepam) NA Sleep-Eze, Sominex, Nytol Tranxene NA NA (chlorazepate) Ativan (lorazepam) NA NA Xanax (alprazolam) NA NA Halcion (triazolam) NA NA Classification of Major Tranquilizers (Antipsychotic Agents) Phenothiazines Butyrophenones Thioxanthenes Other Thorazine Haldol Navane Serpasil (chlorpromazine) (haloperidol) (thiothixene) (reserpine) Moban Mellaril Taractan NA (molindone (thioridazine (chlorprothixene) hydrochloride) Stelazine NA NA NA (trifluoperazine) Compazine NA NA Loxitane (prochlorperazine) Trailafon NA NA NA (perphenazine) Prolixin NA NA NA (fluphenazine) Central Nervous System Stimulants: Amphetamines Prescribed for obesity, depression, and narcolepsy. Taken orally or injected intravenously. Effects: Relieves sleepiness, decreases fatigue and boredom, agitation, confusion, and anxiety. Withdrawal symptoms: Fatigue, brain wave abnormalities, prolonged sleep, dehydration, and weight loss. Ephedrine is a substitute.  Crystal Methamphetamine This is a stimulant that does not occur in nature and thus must be synthesized in a laboratory. Street names for this drug include speed, crank, crystal, ice, meth, chalk, chicken powder, peanut butter-crank, go-fast, crystal meth, shabu-shabu, glass, go qip, chris, and christy, depending on the geographical area, the dealer, and the physical form, crystal versus powder. Methamphetamine enters the brain more rapidly than any other CNS stimulant, rapidly producing a "rush" of euphoria when injected or smoked. Impact: stimulated movement and increased speech, feelings of excitement and euphoria, and decreased appetite. A significant rise in pulse rate and blood pressure occurs. This may progress to irregularities in heart rhythm, a dramatic rise in body temperature, convulsions, cardiovascular collapse, and death. Chronic use leads to a state of paranoia, with individuals displaying behaviors strikingly resembling those of someone experiencing an acute episode of paranoid schizophrenia.  Ice Ice, the smokable form of methamphetamine, is of extremely high purity--greater than 90 percent--and can lead to "runs" of 4 to 5 days without any sleep and often without food or even fluids. Then, a "crash" of 4 days or so occurs, before the user begins another "run." The drug, regardless of form, is often used concurrently with alcohol, either to blunt some of the stimulant effect or to help the user "come down" after a protracted period of use. Classification of Stimulants Cocaine Amphetamines Other Stimulants (Benzoylmethylecognine) Benzedrine Ritalin (methylphenidate) NA (amphetamine) Preludin (phenmetrazine) Dexedrine Tenuate (diethylpropion) NA (dextroamphetamine) I N H (isoniazid) Methedrine, Desoxyn Coffee, colas, tea (caffeine) NA (methamphetamine) Tobacco (nicotine) Central Nervous System Stimulants: Cocaine Can be inhaled, injected, or smoked. Freebase cocaine is a smokable form of cocaine. Effects: Excitation, euphoria, depression, and anxiety. Kindling effect: Brain is sensitized to the effect of cocaine so that one additional dose may trigger firing, leading to sudden death. Cocaine Clinical Syndromes Cocaine Cocaine Dysphoria Cocaine Schizophreniform Euphoria Psychosis Euphoria Sadness Anhedonia (inability of feel pleasure from what from what would have normally given pleasure) Affective lability Melancholia NA Increased Apathy Disorientation intellectual function Hyperalertness Inability to Hallucinations concentrate Hyperactivity Painful delusions Concern with minutia Anorexia Anorexia Stereotyped Behavior Insomnia Insomnia Paranoid delusions (parasitosis) Hypersexuality NA Insomnia Proneness to NA Proneness to violence violence  MDMA (Ecstasy) MDMA was first synthesized and patented in 1914 as an appetite suppressant, and it became popular in the 1980s with college students. Prior to July 1985, when it became illegal to sell MDMA, or Ecstasy, the drug was legally sold in bars in Texas catering to college students. MDMA is related to both mescaline and amphetamines and could be best described as a "mood-enhancing stimulant." Negative effects include overdose potential, extreme fatigue with too much use, dilated pupils, dry mouth and throat, tension in the lower jaw, grinding of the teeth, and too much stimulation. Central Nervous System Stimulants: Tobacco Tobacco is the most widely abused drug. The numbers of tobacco-related deaths are far higher than those related to alcohol or other drugs. Diseases related to smoking tobacco. Heart disease. Peripheral vascular disease. Cerebrovascular disease. Cancer. Chronic obstructive lung disease and colds. Hallucinogens Capable of: Altering time and space perception. Changing feelings of self-awareness, emotion, and one’s sense of body image. LSD, mescaline, psilocin, and so on. Ingested orally, smoked, snorted, or injected. Effects: Mood and perceptual alterations, mild anxiety, paranoia, or severe panic. Phencyclidine (PCP) Cannot be classified properly as a hallucinogen, a stimulant, or a depressant. Smoked, ingested, or occasionally injected. Effects (similar to hallucinogen so together in DSM): Auditory, visual, time, and other sensory disturbances, loss of feeling, and inability to feel pain. Withdrawal symptoms: Depression that can lead to relapse and suicide. Cannabis Any product of the plant Cannabis sativa. Marijuana: Unprocessed, dried leaves, flowers, seeds, and stems of the plant. Uses: Spasm relief, asthma relief, anxiety reduction, and relief of alcohol withdrawal symptoms. Smoked in hand-rolled cigarettes, or joints. Hashish: Potent product processed from the resin of the herb. Major Effects of Cannabis Intensification of thoughts and feelings. Feelings of exhilaration and relaxation. Minor increase in heart rate. Drowsiness, dry mouth and throat, and bloodshot eyes. Impaired short-term memory, attention, and cognitive processing Altered states of time and space. Dilated pupils. Slow reaction time Effects of Chronic Use of Cannabis Strong psychological and physical dependence. Irritability, decreased appetite, restlessness, sleep disturbances, sweating, nausea, or diarrhea. Anxiety and panic reactions. Damage to the respiratory system. Suppression of body’s immune response. Decrease in sperm motility and serum testosterone. Interference with the menstrual cycle. Lethargy, apathy, and a general lack of involvement and motivation in growth and developmental activities. Impaired short-term memory and overall coordination and motor functioning. A New Era for Marijuana: Its Medical Usage The legalization of medical marijuana is the single most significant change in recent drug history. The federal government is leaving it up to the States to legalize medical marijuana and approve medical marijuana dispensaries. The problem is the limited research on medical marijuana. Marijuana research has some inherent problems because of marijuana's illicit status. There are also research difficulties because of variables that are hard to control (e.g., potency, method of ingestion, frequency of use, etc.). There is not enough evidence to recommend medical marijuana as a treatment for any psychiatric disorders. The psychiatric risks are well documented and include addiction, anxiety, and psychosis. Inhalants Use of solvents, aerosols, and other gases that people inhale to get high. Effects: Reduction of inhibitions, elevated mood, confusion, psycho-motor retardation, gastritis, and peptic ulcers. Withdrawal symptoms: Hallucinations, headaches, chills, delirium tremens, and stomach cramps. Can cause death Classification of Inhalants A wide variety of names apply to inhaled substances. Many liquids also contain alcohol and petroleum distillates. Name Substance Naphtha Fluorocarbon propellants Benzene Nitrous oxide Acetone Amyl nitrite, butyl nitrite Anesthetic gases (for example, ether Toluene and chloroform) Carbon tetrachloride Gasoline  Inhalants It is estimated that at least 10,000 common household products contain ingredients that can be abused. The most commonly used inhalants by young people are glue, shoe polish, and gasoline. The earlier children use inhalants, the more likely they will become dependent. Signs and Symptoms of Inhalant Use Slurred speech. Odor of the substance being used. Mental disorientation or confusion. Headaches, dizziness, and weakness. Muscle spasms in the neck, chest, or lower extremities. Euphoria, exaggerated feeling of well-being. Loss of balance and ataxia (uncoordinated walk). Nystagmus (eye movement from side to side).