Explore the vast range of titles available.

Educational campaigns and legislative actions may have led to an overall decrease in the prevalence of volatile substance misuse (VSM) in many countries; however, it is still a common practice throughout the world. Studies currently suggest that girls are misusing volatile substances more than before and at a prevalence rate equal to or exceeding that of boys in several countries. Products that may be misused are ubiquitous and relatively easy to acquire. The most commonly misused substances in recent studies are fuels such as butane or petrol and compressed gas dusters and deodorants that may contain fluorocarbons and/or butane. Detection of VSM is challenging, therefore physicians must maintain a high level of suspicion based on history and clinical presentation. Clues to misuse are often subtle and may include the patient's proximity to a volatile substance or paraphernalia when found intoxicated, dermal burns, blisters, pigments, or rashes, and chemical odors. The primary targets of toxicity are the brain and the heart. The leading cause of death from VSM is from ventricular dysrhythmias. Treatment of toxicity begins with support of airway, breathing, and circulation. Exogenous catecholamines should be avoided if possible due to the theoretical “sensitized” and irritable myocardium. In the case of ventricular dysrhythmias, direct current defibrillation and/or beta-adrenergic receptor antagonism should be used. New evidence demonstrates the addictive potential of VSM yet effective therapy remains uncertain. Further research is needed in developing methods for preventing, detecting, and treating the harmful effects of VSM.

•Three cases of butane sniffing death were reported.•Concentrations of n-butane metabolites in blood and tissues were determined.•n-Butane metabolites were detected only in cases with a history of chronic misuse.•n-Butane metabolite detection could be useful to understand the case history. Butane is an addictive volatile substance like toluene. We report three forensic autopsy cases of sudden death that occurred while sniffing n-butane and isobutane from portable gas cartridges. n-Butane and isobutane were detected in all three cases. In cases 1–3, n-butane concentrations in heart blood were 54.3, 25.5, and 30.7μg/mL, respectively. These concentrations were considered fatal according to the previous reports. In addition, n-butane metabolites (2-butanol and 2-butanone) were detected in cases 1 and 3 but not in case 2. Blood levels of 2-butanol and 2-butanone were 6.5 and 1.8μg/mL, respectively, in case 1, and 6.3 and 5.6μg/mL, respectively, in case 3. According to the police investigation, the decedent in case 1 had misused butane gas for more than 6 months in the period leading up to death. The decedent in case 3 also had a history of chronic misuse of butane gas. There was no history of chronic misuse of butane gas by the decedent in case 2. It was suspected that he attempted suicide via inhalation of butane gas using a plastic bag, leading to a rapid death. The presence or absence of n-butane metabolites might reflect the way of butane inhalation, such as the frequency and duration. Although additional experimental and case studies are necessary to establish the forensic applications of n-butane metabolite detection, it may be a useful method to understand the decedents’ pattern of butane sniffing before death.

The use of recreational drugs of abuse continues to expand without limitations to national boundaries, social status, race, or education. Beyond the prevalence of illicit drug use and dependence, their contribution to the global burden of disease and death are large and troubling. All medical providers should be aware of the evolving drugs of abuse and their medical and social consequences. In addition to heroin and stimulants such as cocaine and methamphetamine, new designer stimulants called “bath salts” and cannabinoids called “spice,” along with the abuse of prescription drugs and volatile substances, are now widely recognized problems in many societies. The wide variety and continuingly expanding clinical manifestations of toxicity of recreational drugs of abuse is not widely appreciated by clinicians. This edition attempts to summarize six major classes of drugs of abuse and their clinical effects with special emphasis on their immunological and respiratory effects.

The main objective of this paper is the assessment of the environmental impact due to accidental spills of toxic and flammable liquids on land. Different case studies of possible accidents in the State of Qatar were considered. An EPA-based dispersion model was utilized to estimate the size and location of the dangerous clouds generated by such spills at different elapsed times. Three case studies of possible accidents in the State of Qatar involving gasoline were considered. Due to the transient nature of the dispersion processes in the case studies, the results showed clearly the phenomenon of growth and decay of the generated dangerous clouds. An interface between the dynamic results of the dispersion software and the static data of the Qatar geographical information system (GIS) allowed the immediate identification of the major landmarks affected by the considered accidents. These data would be of great help in developing an emergency evacuation plan for such accidents.

Reviews the response of Government and drug agencies to the problem of volatile substance abuse (VSA). Describes how VSA has, in the past, been treated differently to abuse of other drugs, both legal and illegal, but that most agencies now believe it should be dealt with alongside other drugs. Reviews the main findings of a report on volatile substances from the Advisory Council on the Misuse of Drugs, and the Government's response to it. Describes the measure put in place in the UK to help control the supply of sniffable substances, and the need for education campaigns for parents and young people. Concludes there are no grounds for optimism, as the latest figures on deaths due to VSA show a rise. Gives recommendations for professionals who wish to seek further help for those involved with VSA.

Purpose – The purpose of this paper is to explore whether there are ways in which the preventive strategies used to tackle volatile substance abuse (VSA) can be usefully applied to today’s new psychoactive substances (NPS). Design/methodology/approach – In 2010-2013, with funding from the Big Lottery, Re-Solv, in partnership with St George’s, University of London, and educari, commissioned a re-analysis of both the mortality data relating to VSA and of the legislative and preventative measures taken that may have played a part in the steady downward trend in VSA mortality since. This paper is informed by Re-Solv’s research findings and the papers resulting from it, namely, Ives (2013) and Butland et al. (2013). Findings – Efforts to reduce the harm from NPS could benefit from a re-examination of preventive approaches to VSA, which have resulted in a downward trend in mortality over the past two decades. Social implications – There is evidence from past prevention practice which could be relevant and applied to present day concerns about drugs and substances not previously available or used. Originality/value – This is the first paper to explore how learning from VSA might be applied to NPS and the “legal highs” of today.