In late March Eastport resident Tessa Chaffey Ftorek noticed a number of whipped cream canisters on the side of High Street near the cemetery and along outer Clark Street. When she went back to clean up the garbage, she was astonished at the number she collected -- over 55. She says, "When I posted this on Facebook I received numerous personal messages from folks saying they have found these canisters around Eastport as well as other communities."
     Canisters of this type contain the propellant nitrous oxide, more commonly known as "laughing gas." Besides being a propellant for whipped cream, the gas is also used as a sedative by healthcare practitioners for minor medical procedures. However, since its creation in the 18th century, it has been used to become intoxicated or high. Ftorek says that when she posted her concerns to social media, "The comments ranged from folks saying this has been around for decades, to some parents saying they had never heard of this. Parents need to be informed and know what to look for."

Health consequences significant
     Tara Young, a substance prevention specialist with Healthy Acadia, explains, "Huffing is very dangerous." Huffing is a term used to describe the use of inhalants to become intoxicated, and sources can include nitrous oxide, paint thinner, any type of aerosol can product, lighter fluid, dry erase and permanent markers, correction fluid, glue and more. The dangers are significant, and none more so than to the state's youth. "It is detrimental to the brain" and causes long term and permanent damage to those whose brains are still developing, which encompasses those up to age 25, says Young. Such use also has serious effects on the adult brain.
     The Alcohol and Drug Foundation lists symptoms such as loss of blood pressure, heart attack, incontinence, numbness in hands and feet, birth defects in children born to those who use during pregnancy, depression, psychosis and more. Death can occur through heart attack, but also through asphyxiation. In addition, the National Institute of Health reports that use can result in serious neurological damage with degeneration of the spinal cord, in part because nitrous oxide inactivates vitamin B12, a nutrient that helps keep the body's nerve and blood cells healthy and helps make DNA, the genetic material in all cells.
     Community Health Director Maria Donahue of Healthy Acadia says that there could be an uptick in use because of the pandemic, with whipped cream canisters being a legal food item that can be accessed easily. Maine Integrated Youth Survey data indicate in 2017 that 2.9% of fifth and sixth graders in Hancock and Washington counties had tried inhalants, with that number increasing to 3.4% in 2019. In 2019, 4.8% of seventh and eighth graders in the two counties had tried inhalants. Donahue says, "The use tends to be higher in middle school." Data for 2020 are not yet available.
     Eastport schools Principal Paul Theriault says, "I am also hearing about this from around the community. We have been watching for students migrating to the cemetery area, as we have heard that that was a problem in the past, and are not finding many students going that way. And we are not seeing any obvious issues with impaired students." He adds, "The uptick is certainly a concern. It has been harder to follow this year because of the high numbers of remote students, but we certainly are actively monitoring. We are also concerned that this is a bigger issue than just students."
     "It's something that I'm concerned about," says Eastport school system Athletic Administrator Erin Mahar. She teaches health and physical education to K-12 students. "I want kids to know the dangers to their bodies." She had just been wrapping up a unit on the dangers of vaping and tobacco as inhalants when another staff member came to her with concerns about the number of whipped cream canisters they were finding on the side of the road. The staff member's children were walking home from school, saw the canisters and told her about it, but not before picking one up to bring home. It promptly went into the garbage can, but not before a quick discussion about leaving the garbage on the side of the road for adults to deal with. Mahar has high praise for Healthy Acadia's assistance and resources for when she needs to discuss these kinds of difficult subjects with students and plans to discuss this newest danger with them next. "It seems to be an issue right now, and I would like to discuss it with the kids," she adds.
     Whipped cream canisters and small canisters of nitrous oxide, known as whippets, are perfectly legal to purchase in stores and online, as are many other forms of inhalants. Nitrous oxide is used for whipped cream because as of yet no other gas has been found that keeps cream from going rancid and maintains a safe pressure in a lightweight can. However, Maine law states, "The inhalation of vapors, fumes and gases from common, legal products, such as household, school and office products to get 'high' is illegal in Maine. It is also illegal to possess inhalants with the intent to inhale their vapors, fumes or gases."
     Bob Bore, manager at the Farmers' Union in Perry, has seen comments on social media about canisters on the side of the road. "I'm certainly aware of it, but I haven't seen any uptick in sales," he says. He adds, "If I did, I would probably alert officials like police departments and let them know that Joe Blow has bought a whipped cream canister every day for the past week." He notes that he has good rapport with area law enforcement for just these sorts of discussions.
     In Eastport, R&M IGA's Merilyn Mills relays that about six to eight weeks ago a cashier noticed an adult male at least in his 40s who bought about seven canisters. Other than that time, there have been no unusual purchases or sudden uptick in the need to order the item, she adds. About three years ago the police came to talk to her about the same issue and had a specific individual in mind, but her store had not seen any changes to sales at that time either.

Resources for schools, stores and parents
     Healthy Acadia has a number of resources available to help with substance use disorder. One, the Responsible Server and Seller program, helps store owners, managers and staff understand what to look for. "We always talk about whipped cream," says Young. For example, she explains, if a check out staff member sees someone purchasing a number of whipped cream canisters, they are within their right to refuse to sell. A store could decide to have a policy that they only sell to those 18 and older. The training is from two to four hours, depending on the size of the establishment, and at the moment takes place by Zoom.
     School systems and educators can participate in two different Healthy Acadia programs. The Drug Impairment training program, which takes less than an hour, is very straightforward, says Healthy Acadia's Katie Sell, a substance prevention specialist who works with Washington County entities. The program explains data, the risk, the impact on the developing brain and "can be a great asset to any school." She also provides a Prime for Life curriculum program for students of about eight to 10 hours that can be stretched out over a semester or a shorter period of time depending on the needs of the school. The program engages students in identifying risks, helping them identify their personal values and how they go about protecting their values by setting boundaries and more.
     Parents, guardians and partners of adults who are using substances to get high should be aware of the signs to look for when it comes to inhalant use. Sell says poor coordination, dizziness, brain fog, the inability to concentrate, sleepiness and other symptoms of the brain shutting down are all signs that engaged adults will notice. When oxygen levels become compromised, the area around the mouth can turn mildly blue, as can fingertips. "It's important for parents to notice changes, to pay attention." She adds that if their normally engaged student is missing school, sports or other extracurricular activities and becoming depressed or irritable, they should engage using approaches of empathy and understanding. "As a parent I would talk more generally about what to do if they're offered a substance."
     Parents and guardians will find a wealth of information about how to talk to youth and young adults about the harms of substance use at the Department of Health and Human Services Substance Abuse and Mental Health Administration's website at www.samhsa.gov. For more information about Healthy Acadia's programs, visit www.healthyacadia.org.