Magazine article Clinical Psychiatry News

'Huffing' Causing Methanol Toxicity

Magazine article Clinical Psychiatry News

'Huffing' Causing Methanol Toxicity

Article excerpt

NEW ORLEANS -- The intentional inhalation of products containing methanol, such as carburetor cleaner and windshield washer fluid, can cause significant toxicity--and emergency physicians must keep that in mind when a suspected inhaler, or "huffer," comes into the emergency department.

Ingesting these products is a well-known cause of serious and fatal poisoning that requires aggressive treatment, but inhaling them can be just as serious, Dr. Kristine A. Kalbfleisch said in a poster session at the annual meeting of the American College of Emergency Physicians.

An analysis of the Texas Poison Center Network database, "Toxicall," from January 2003 to May 2005 found 87 cases of methanol inhalation poisoning and 81 cases of methanol ingestion poisoning. Carburetor cleaner was the culprit substance in 97% of inhalation cases, while ingestions involved mostly windshield washer fluid (48%) and carburetor cleaner (25%).

The finding is in contrast to previous literature suggesting that inhalation toxicity was rare, said Dr. Kalbfleisch of the University of Washington Madigan Army Emergency Medicine Residency Program, Seattle.

"It is well known that carburetor cleaner contains other solvents that are toxic, such as toluene, butane, and methylene chloride. All of those can produce significant clinical effects, such as CNS depression and GI disturbances, and people think they are getting sick from these things," she said. "Perhaps this is true, but at the same time, methanol is in there as well, and we are getting data that show that there are measurable levels of methanol in the blood of these patients."

Most (76%) of the inhalation-al exposures in the Texas database were intentional; that is, users wanted to get high. …

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