Abuse of volatile substances ("sniffing substances") Medical and toxicological aspects in the assessment of a sudden sniffing death syndrome

The increasing abuse of volatile substances (sniffing substances) can be attributed to easy handling and administration as well as the ubiquitous availability and low costs. The most common volatile substances of abuse are used as propellants, e.g. for lighters and gas bottles (butane, propane) and the risk of a potentially life-threatening impairment of the central nervous system is often underestimated. The diagnosis of sudden sniffing death syndrome (SSDS) during the external examination of the corpse is often challenging due to inconspicuous results of the medicolegal autopsy. Thus, the examination has to focus on additional toxicological and histopathological analyses. This article provides a current review of the literature on forensic considerations regarding volatile substance abuse and practical recommendations.