Potentially serious consequences for the use of Bitrex as a deterrent for the intentional inhalation of computer duster
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LETTER TO THE EDITOR
Potentially serious consequences for the use of Bitrex as a deterrent for the intentional inhalation of computer duster sprays Brian E. Perron1 · Joseph M. Haroney2 · David E. Hayes2 · Rebeccah L. Sokol3 · Seth A. Kolton4 Received: 22 September 2020 / Accepted: 31 October 2020 © Japanese Association of Forensic Toxicology 2020
Dear Editor, Inhalant abuse refers to the intentional inhalation of a volatile substance for purposes of recreation potentially associated with danger. Frequently referred to as the “hidden epidemic,” inhalants have received relatively little attention in terms of research and intervention despite high rates of misuse in relation to other substances. Commonly used inhalants include amyl nitrite, correction fluid, gasoline, glue, shoe polish, toluene, halothane, ether, paint solvents, butane, propane, nitrous oxide and aerosol sprays, among others. Effects of inhalant intoxication are dependent on the properties of the substance and may include euphoria, amnesia, slurred speech, rapid heartbeat, sexual arousal, depressed mood, suicidal ideation, and death. The high risk for morbidity and mortality makes inhalants one of the most dangerous forms of substance misuse [1]. In this article, we are centrally concerned about the intentional inhalation of computer duster sprays, which are cheap and widely accessible in common retail stores throughout the United States and around the world. While individuals who abuse computer duster sprays experience immediate and short-lived euphoric effects, various sources of evidence show profound consequences for this risky behavior, including (but not limited to) frostbite of the face, mouth, throat and fingers [1–3]; rapid airway compromise [4]; cardiovascular and multi-organ toxicity [5]; cardiac arrhythmia [6]; * Brian E. Perron [email protected] 1
University of Michigan School of Social Work, 1080 University Avenue, Ann Arbor, MI 48109, USA
2
College of Pharmacy, University of Michigan, 428 Church Street, Ann Arbor, MI 48109, USA
3
Wayne State University School of Social Work, 5447 Woodward Ave, Detroit, MI 48202, USA
4
Shendell & Pollock, P.L., 2700 Military Trail, Suite 150, Boca Raton, FL 33431, USA
and sudden death due to physiological complications [6–8]; and accidents due to impaired functioning [9]. Almost no restrictions or regulations exist on products containing 1,1-difluoroethane (DFE), which makes computer duster sprays one of the most commonly abused inhalants, especially among the adolescent population [1]. Manufacturers are aware of this problem and have responded by adding an aversive agent to the computer sprays to deter inhalation. The aversive, bittering agent is denatonium benzoate (DB) and registered under the trademark Bitrex. DB is intended to mix with the DFE to make the taste of the product unbearable. To date, however, no evidence exists that demonstrates DB being effective in deterring intentional inhalation. In fact, ongoing news reports and reports to poison control centers provide compell
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