Opinion Review
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. May 9, 2021; 10(3): 43-46
Published online May 9, 2021. doi: 10.5492/wjccm.v10.i3.43
Inhaling muscle spray: A rising trend of abuse
Sohil Pothiawala, Chong King Yong, Rabind Charles
Sohil Pothiawala, Rabind Charles, Department of Emergency Medicine, Woodlands Health Campus, Singapore 768024, Singapore
Chong King Yong, Department of Emergency Medicine, Sengkang General Hospital, Singapore 544886, Singapore
Author contributions: Pothiawala S conceptualized the study; Pothiawala S and Yong CK contributed to data curation and writing the original draft; Pothiawala S and Charles R reviewed and edited the manuscript; all authors have read and approve the final manuscript.
Conflict-of-interest statement: The authors do not have any conflict-of-interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sohil Pothiawala, MBBS, MD, Doctor, Department of Emergency Medicine, Woodlands Health Campus, 2 Yishun Central 2, Singapore 768024, Singapore. drsohilpothiawala@yahoo.com
Received: December 18, 2020
Peer-review started: December 18, 2020
First decision: January 7, 2021
Revised: January 10, 2021
Accepted: March 7, 2021
Article in press: March 7, 2021
Published online: May 9, 2021
Processing time: 141 Days and 2.9 Hours
Abstract

Ethyl chloride was popular as an inhalant recreational drug in the 1980s. It is easily available in pharmacies as well as sold online as a topical anesthetic spray for pain relief. In recent times, its use is gaining popularity again among the youth as an inhalant drug due to its neuro-stimulatory effects. To avoid the risks associated with use of illegal drugs, and ease of availability of ethyl chloride without restrictions, there is a rising trend to use it as a “substitute” drug of abuse. In this paper, we try to highlight to the critical care and emergency physicians that majority of these cases present with predominant neurological symptoms, with occasional involvement of the cardiovascular system. The diagnosis of ethyl chloride poisoning is primarily clinical and supportive care is the mainstay of treatment, along with subsequent counseling. Ethyl chloride abuse should be considered as a differential diagnosis in young patients presenting with predominant neurological symptoms. Alongside raising public awareness, the manufacturers and retail distributors of these products have an important role to play in reducing the risk of abuse.

Keywords: Ethyl chloride; Abuse; Inhalant; Neurological; Recreational; Counselling

Core Tip: The purpose of this manuscript is to highlight to the critical care and emergency physicians regarding the rising trend of ethyl chloride spray as an inhalational drug of abuse, due to ease of availability as over-the-counter drug and its psychoactive effects. This manuscript emphasizes the need to consider ethyl chloride abuse in young patients presenting with predominant neurological symptoms. Also, raising public awareness and improving vigilance on the sale of these products will help in reducing the burden of abuse.