Inhalant misuse management. The experience in Mexico and a literature review

ABSTRACT

Inhalant misuse (volatile substance misuse or VSM) is associated with severe harms, including sudden sniffing death. No specific pharmacological treatment exists, but there are consensus-based practices, case series, and reports that provide valuable information concerning inhalant misuse management. This paper analyzes examples of inhalant misuse treatment in Mexico, specifically in Hospital de Especialidades Toxicológicas Venustiano Carranza (HETVC, a specialized hospital that provides treatment for intoxication emergencies) and Centros de Integración Juvenil (CIJ, Centers of Juvenile Integration; an addiction treatment network with eleven residential centers and 106 ambulatory centers) and reviews relevant literature addressing clinical practices to treat inhalant intoxication, dependence, and withdrawal. The results show that toluene-based products are the main substances inhaled in Mexico and internationally. The most common cause of emergency is toluene-induced hypokalemia, which can be treated with parenteral potassium replacement. Malnutrition is common among chronic inhalant users and this point needs to be addressed in detoxification programs. The review of the literature shows that there is consensus on how to identify and manage several symptoms of acute inhalant intoxication. Main guidelines are summarized in this paper along with comments of challenges associated with this phenomenon.

KEYWORDS:

• Solvents
• treatment
• intoxication
• hypokalemia
• inhalants

Acknowledgements

Special thanks to Dr. Raúl Fernández-Joffre (former General Director, HETVC); Dr. Laura Margarita León (Treatment Director, CIJ); Mr. Enrique Hernández-Aguilar and Mr. Gerardo Rodríguez-Rivera (El Caracol) for providing first-hand information and helpful advice during the preparation of this work, Dr. Juan Carlos Molina for reviewing the manuscript, and Araceli Molina for designing Figure 1.

Funding

This work was partially supported by grant CB-239192 from Conacyt, Mexico.

Additional information

Funding

This work was partially supported by grant CB-239192 from Conacyt, Mexico.