Inhalant use and anabolic-androgenic steroid misuse

Disorder

Inhalants are household vapours sniffed for a brief high, sometimes fatal on first use; anabolic steroids build muscle but harm mood, heart and hormones.

Updated Nov 13, 2026

Key points

Sudden sniffing death: a fatal heart event while sniffing, especially if the person is startled; it can happen even on first use.
Chronic solvent use damages the brain and the myelin around nerve fibres, with cognitive deficits, ataxia, and loss of vision and hearing.
Other inhalant harms: distal renal tubular acidosis, hepatitis, and damage to the heart, lungs, liver and kidneys.
Clues to inhalant use: chemical smell on the breath or clothes, paint or stains on the face, hands or clothes, and a rash around the mouth and nose (huffer's rash).
AAS psychiatric effects: irritability, aggression and mania during use; depression during withdrawal, which can lead to suicide attempts.
AAS medical effects: shrinking testes, low sperm production and breast growth in men; deeper voice and excess body hair in women; stunted growth in teens; high blood pressure, heart attack, stroke and liver tumours.

What it is

Inhalants are volatile substances breathed in to get high: solvents (glue, thinner, fuel, correction fluid), aerosols, gases such as nitrous oxide and butane, and nitrites. They are cheap household products, so they are most commonly used by adolescents, especially younger adolescents, and also by homeless young people. Anabolic-androgenic steroids (AAS) are synthetic relatives of testosterone used to build muscle or improve appearance or performance. AAS do not usually cause a high, but about a third of people who misuse them (roughly 32%) become dependent.

Key facts

Inhalant intoxication resembles alcohol drunkenness: brief euphoria, dizziness, slurred speech, ataxia, then drowsiness; inhalants can also cause cardiac arrest or suffocation.
Bagging (inhaling from a bag) adds the risk of suffocation; deaths also come from aspiration, burns, falls and drowning.
No effective specific treatment exists for acute inhalant intoxication; care is supportive, and sympathomimetic drugs are avoided.
Muscle dysmorphia, a preoccupation with seeming not muscular enough, is often linked to AAS use.
AAS can cause a substance use disorder; withdrawal brings fatigue, insomnia, reduced sex drive, craving and depression.
Injecting AAS with shared needles carries risk of HIV and hepatitis B and C.

Inhalants and steroids: groups and their main harms

Group	Examples	Main harms
Volatile solvents	Glue, paint thinner, fuel, correction fluid (toluene, other hydrocarbons)	Sudden sniffing death, brain and nerve damage, kidney and liver damage
Aerosols	Spray paint, hair spray, deodorant, computer duster	Arrhythmia, frostbite of the airway, suffocation
Gases	Nitrous oxide, butane, propane	Suffocation, burns, freezing injury of the face and airway
Nitrites	Poppers (alkyl nitrites)	Low blood pressure, methaemoglobin; also used during sex
Anabolic-androgenic steroids	Testosterone and synthetic derivatives, by injection or by mouth	Aggression, mania, withdrawal depression, shrinking testes, heart attack and stroke, liver tumours

Clinical notes

Ask adolescents directly and confidentially about sniffing; inhalant use often comes with school failure, family conflict and other drug use.
Treatment of inhalant use disorder is psychosocial: family therapy, school and community programmes, and extended treatment periods, which improve outcomes.
In people who train intensely, ask about AAS, other performance drugs and body image; screen for muscle dysmorphia and depression.
AAS withdrawal depression is the most dangerous phase: assess suicide risk; endocrine (hormone) therapy can be part of treatment.
Approach without judgement and with harm reduction (never sharing needles), since many users distrust health services.

Test yourself

Think of the answer, then tap the question to see it.

What is sudden sniffing death?

A fatal heart event while inhaling solvents, especially when the user is startled; it can happen even on first use.

What brain damage follows long-term solvent use?

Damage to the brain and the myelin around nerve fibres, with cognitive deficits, ataxia and loss of vision and hearing.

When is suicide risk highest in anabolic steroid misuse?

During withdrawal, when depression is the most dangerous symptom.

Which body image disorder is linked to anabolic steroid misuse?

Muscle dysmorphia, a preoccupation with the belief that one's muscles are too small.

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Educational content on behavior and the clinical relationship; not a diagnostic or treatment guide and no substitute for assessment by a health professional. If you or someone near you is at risk, seek help now from an emergency service or a mental-health helpline.

Sources: Inhalants (National Institute on Drug Abuse (NIDA), 2024); Inhalant abuse (Paediatrics & Child Health (PubMed Central), 2010); Anabolic Steroids and Other Appearance and Performance Enhancing Drugs (APEDs) (National Institute on Drug Abuse (NIDA), 2024).

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