Inhalation of volatile substances: an emerging threat to readiness?

Volatile substance abuse is the deliberate inhalation of volatile substances to achieve intoxication. We discuss the history and pathophysiological effects of commonly abused volatile substances. We explore three deaths and one serious accident in active duty military settings. The causes for abuse in the military environment are numerous and include remote duty, peer influence, low cost, rapid onset, limitation of ethanol use, difficult detection/screening for use, and lack of knowledge among users and authorities. The lethality of these substances and their casual use can constitute a threat to military readiness. Our experience suggests an increase in the use of these substances in the military paralleling their increasing use in the general population. Education and awareness training could limit fatalities and decrease the threat in military and civilian populations.