More than half a million American teens are using inhalants. A doctor explains the dangers

By Katia Hetter, CNN

(CNN) — Social media trends are fueling a dangerous form of substance use among teenagers in the United States involving common household and commercial products, including inhaling nitrous oxide, or laughing gas.

More than 500,000 American adolescents reported inhalant use in the past year, according to an estimate based on findings in a new study published in the journal Preventive Medicine.

I spoke with CNN wellness expert Dr. Leana Wen to learn more about inhalants and why they appeal to so many teens. Wen is an emergency physician and adjunct associate professor at George Washington University. She previously was Baltimore’s health commissioner.

CNN: What are inhalants, and what substances are teenagers using?

Dr. Leana Wen: Inhalants are chemicals that produce mind-altering effects when people breathe in their fumes. The substances are often common products found in homes, schools, garages and stores. Teenagers may inhale gases, sprays or solvents to experience a brief high that can include euphoria and hallucinations.

These products include glue, shoe polish, paint thinner, aerosol sprays, gasoline and nitrous oxide, also known as laughing gas. Nitrous oxide has legitimate medical and commercial uses. In medicine, it is used for sedation and pain control, including in dentistry and in operating rooms. Commercially, nitrous oxide is sold in cartridges that can be used in whipped cream dispensers. Increasingly, though, these products are being marketed and discussed online as recreational substances.

One reason inhalants are especially concerning is that they are inexpensive, widely available and often legal to purchase. Adolescents may wrongly assume that because these products are common household items, they are relatively safe. And parents and caregivers may not be aware that these items are being misused in this way.

CNN: What did this new study find about inhalant use among adolescents in the US? Are certain populations more at risk than others?

Wen: This study analyzed nationally representative survey data collected between 2021 and 2023 from over 33,700 adolescents. Researchers found that 2.2% of adolescents reported using inhalants in the past year. That may sound like a small percentage, but when applied nationally, it represents well over a half million teenagers. About 0.7% reported inhalant use in the past month, and 0.3% met criteria for inhalant use disorder, which means that their use had become severe enough to cause clinically significant impairment or distress.

One important finding was that younger adolescents ages 12 to 13 actually had higher rates of inhalant use compared with those ages 14 to 17.

I found this to be surprising when I first saw the results, but, as the authors explained, this finding aligns with prior research showing that inhalants are often among the first substances experimented with by young teenagers because of how commonplace they are.

Another important finding was that there were strong links between inhalant use and other risky behaviors. Adolescents who used tobacco, got into physical fights or engaged in stealing had substantially higher odds of inhalant use and inhalant use disorder. The researchers concluded that inhalant misuse often does not occur in isolation but instead clusters with other behavioral concerns and substance-use risks.

Boys and girls had similar overall rates of inhalant use, but females had substantially higher odds of developing inhalant use disorder, which the researchers suggested could be related to prior findings that girls may progress more quickly from experimentation to problematic substance use. Black adolescents had lower odds of past-year inhalant use compared with White adolescents, while Native American and Alaska Native adolescents had higher odds of inhalant use disorder, and Asian adolescents had lower odds of inhalant use disorder.

The authors noted that broader social and structural factors likely contribute to some of these differences, though inhalant misuse can affect adolescents across many different backgrounds. Parents should not assume their children aren’t at risk just because they are doing well academically or are involved in structured activities.

CNN: What are the short-term and long-term health risks of inhalant use?

Wen: The short-term effects can include dizziness, slurred speech, poor coordination, nausea and impaired judgment. Some individuals may experience hallucinations or lose consciousness. Because the high is brief, users may repeatedly inhale the substance over a short period of time, which increases the risk of toxicity.

The long-term risks are far more serious. Inhalants can damage the brain, nerves, liver, kidneys and heart. Some effects may be irreversible, including neurological injury and hearing loss. Chronic use can also lead to dependence.

One of the most alarming dangers is something called sudden sniffing death syndrome. This is a fatal heart rhythm disturbance that can occur even after a single episode of inhalant use. Certain substances, including butane and propane, are especially associated with this risk.

CNN: Why has nitrous oxide become a problem?

Wen: Nitrous oxide is often perceived as safer because it has legitimate medical uses, but that perception can be misleading. In medical settings, it is administered carefully with oxygen and under supervision. Recreational use is very different.

In recent years, social media has fueled renewed interest in nitrous oxide, with some videos portraying it as funny and trendy. More than 13 million Americans have misused nitrous oxide, according a 2023 national survey. Earlier this year, the US Food and Drug Administration warned consumers against nitrous oxide misuse.

The potential impacts of abusing nitrous oxide cannot be overemphasized. Nitrous oxide can impair judgment and coordination, increasing the risk of accidents. Inhaling directly from pressurized canisters can cause frostbite injuries to the mouth and airway. Repeated nitrous oxide exposure can interfere with vitamin B12 activity in the body, which is essential for nerve function and blood cell production. Heavy use has been linked to numbness, tingling, difficulty walking and even spinal cord injury. Some people develop permanent neurological damage.

CNN: What warning signs should parents and caregivers watch for?

Wen: Parents may notice chemical odors on clothing or breath, empty spray cans or cartridges, stains on the face or hands, headaches, nausea or unexplained mood changes. Some adolescents may appear dizzy, disoriented or unusually fatigued.

Behavioral changes can also be important clues. Sudden declines in school performance, secrecy, irritability or new risk-taking behaviors may warrant closer attention. Because inhalants are often stored in ordinary household products, missing items from garages, bathrooms or kitchens can also be a sign.

CNN: What should parents say to teenagers about inhalants and social media trends involving these substances?

Wen: Parents should approach these conversations directly. Many adolescents are encountering videos or online discussions that normalize inhalant use. It’s important to explain clearly that “legal” or “household” does not mean safe.

I would also encourage parents to be specific about the risks. Teenagers often respond better to concrete information than vague warnings. Explaining that inhalants can cause permanent brain and nerve damage, and in some cases sudden death, may carry more weight than simply saying substances are dangerous.

Finally, families should create an environment where teenagers feel comfortable discussing what they are seeing online and what pressures they may be experiencing. Open communication remains a crucial protective factor against substance misuse.

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