TOXICOLOGY QUESTION OF THE WEEK

September 29, 2023

Viral (And Deadly) Social Media Challenge Explained: What is Chroming?

In 2019, a 16-year-old New South Wales boy died after inhaling an aerosol. In 2021, a 16-year-old Queensland girl suffered brain damage after inhaling an aerosolized deodorant. In 2022, another 16-year-old boy from the same state passed away after sniffing deodorant. Most recently, in March of 2023, a 13-year-old girl in Melbourne, Australia, went into cardiac arrest and sustained irreparable brain damage due to chemical exposure that occurred at a sleepover after participating in a new TikTok challenge called “chroming.”

What is “chroming”?
Also known as “huffing”, the word “chroming” is an informal word that originates from Australia and refers to the act of inhaling dangerous chemical fumes or vapors to create a temporary high. The term chroming itself came from the act of inhaling the toxic fumes associated with chrome-based spray paint. These chemical fumes emerge from a toxic source of inhalant, from paints to solvents to household chemicals, such as nail polish remover, glue, cleaning supplies, and aerosolized deodorants and hairsprays.

Why has chroming become a popular trend among Gen Z and Gen Alpha?

Despite the decades-old trend of huffing different materials, chroming has gained popularity on the social media platform TikTok in the past few months as experimentation rates among this age group have soared significantly post-pandemic. Users have been posting videos under the term “WhipTok” – a play on the word “whippit” or the recreational use of nitrous oxide. “WhipTok” has nearly 550 million views on the platform and consists of users uploading video clips engaging in the dangerous trend of chroming.

What are the risks associated with chroming?

The initial effects of chroming are typically short-lived, occurring less than six hours after exposure, and are similar to the effects of alcohol ingestion. Long-term abuse can result in cognitive impairment, including the inability to concentrate, memory loss, impaired judgment, and increased impulsivity. While immediate and direct deaths from inhalation of nitrous oxide are rare, this activity can result in deadly side effects, including cardiac arrest, heart attack, seizures, suffocation, permanent organ damage, and more.

What is being done to combat the trend?

Authorities are attempting to raise awareness of the dangerous trend; additionally, several Australian retailers are locking aerosolized products behind a glass case to restrict access to chroming supplies. Currently, the U.S. Centers for Disease Control and Prevention does not specifically address chroming but has addressed substance abuse among teenagers in years past. In the U.S., inhalants and their respective chemicals are sold legally and primarily used in household products; however, it is illegal to inhale nitrous oxide recreationally. TikTok has taken action to prevent dangerous trends like these from spreading, including removing hashtags associated with the trend, strengthening safety policies, collaborating with physicians and educators to develop new resources dedicated to challenges and hoaxes, and creating warning labels that appear when users search the platform for content related to trends. Experts do not suspect that the chemicals will ever be completely prohibited but report that awareness and education regarding the dangers of this trend are most important.

REFERENCES

1. Shultz C. 13-Year-Old Australian Girl Dies From Dangerous ‘Chroming’ Trend. People: Lifestyle and Health. Updated May 23, 2023. https://people.com/australian-teen-dies-chroming-trend-inhaling-aerosol…
2. Steinburg B. What is chroming? Inside lethal trend as teen dies from huffing toxic chemicals. New York Post. Published May 23, 2023. https://nypost.com/article/what-is-chroming/
3. Radparvar S. The clinical assessment and treatment of inhalant abuse. Perm J. 2023 Jun 15;27(2):99-109. doi: 10.7812/TPP/22.164.
4. Young R, Carter C, Cardinali S, et al. Recognizing ethyl chloride neurotoxicity: inhalant abuse hidden in plain sight. Cureus. 2023 Apr 18;15(4):e37795. doi: 10.7759/cureus.37795.
5. Finch CK, Lobo BL. Acute inhalant-induced neurotoxicity with delayed recovery. Ann Pharmacother. 2005 Jan;39(1):169-72. doi: 10.1345/aph.1E159.
6. Shultz C. 13-Year-Old Australian Girl Dies From Dangerous ‘Chroming’ Trend. People: Lifestyle and Health. Updated May 23, 2023. https://people.com/australian-teen-dies-chroming-trend-inhaling-aerosol…
7. Cruz SL, Rivera-García MT, Woodward JJ. Review of toluene action: clinical evidence, animal studies and molecular targets. J Drug Alcohol Res. 2014;3:235840. doi: 10.4303/jdar/235840.

Question submitted by Kennedy Manning Pharm D. PGY2 Cardiology Pharmacy Resident. VUMC

Comment: Inhalants are always of concern.  Both short-term and permanent cognitive damage can occur with even limited use of inhalants. Toluene is especially deadly for causing long-term cognitive impairment as well as white matter lesions in the brain. Just this year, the Tennessee Poison Center has received about 25 calls regarding halogenated hydrocarbons, toluene, and nitrous oxide, respectively.  Although those numbers don’t seem exceedingly high, the potential for permanent cognitive damage in each of these patients is frequently unrecognized. ds

I am interested in any questions you would like addressed in the Question of the Week. Please email me with any suggestions at donna.seger@vumc.org.

DONNA SEGER, MD
Professor Emeritus
Department of Medicine
VUMC