On Oct. 17, 2015, Michele Breault wrote an email to her mom with the subject line “Update On How I’m Doing???”

Breault, 37, had spent much of the previous month in a residential treatment program for substance abuse. While she had not taken a sip of alcohol in 52 days or smoked a cigarette in 11 days, Breault confessed in the email that she spent the previous day high and sick from inhaling canned air.

“I really am trying and it’s not that uncommon for people to Relapse Once or Twice, sometimes even up to 10 times,” Breault wrote to Karyn Pinette. “I’m not making excuses, i’m just telling you the truth.”

Within two months, Breault was dead.

Her autopsy report listed the official cause as “acute 1,1 difluoroethane intoxication,” or a fatal level of the primary chemical in many aerosol products. The police found six cans of industrial-strength Ultra Duster in Breault’s house, and the state medical examiner’s office attributed her death to huffing.

Breault’s death one year ago in South Portland sheds light on a little known drug abuse problem among Maine adults. It can lead to an addiction that is difficult to treat, and one that can be devastating in the most serious cases.

While teenagers are widely considered to be the primary users of inhalants to get high, the federal Substance Abuse and Mental Health Services Administration has reported a decline in adolescent users since the mid-2000s. By 2014, fewer than 1 percent of people between 12 and 17 years old were using inhalants to get high.

At the same time, however, the percentage of adults who are huffing has remained steady over the past decade. About 316,000 American adults aged 26 or older were current users of inhalants in 2014.

And a national report from SAMHSA shows the number of people admitted to treatment programs because of an addiction to inhalants declined from nearly 1,200 in 2004 to less than 800 in 2014. However, the portion of those people who are 18 years or older increased from 56 percent in 2004 to 88 percent in 2014.

Harvey Weiss, executive director of the National Inhalant Prevention Coalition in Tennessee, said anecdotally he has seen an uptick in the number of calls he receives about adults who are huffing.

“There is a lack of awareness of the problem among adults,” Weiss said. “When the population thinks about inhalant use, they think that’s something that kids do in middle school and high school and that’s it. But it’s all ages.”

Inhalants still account for just a fraction of substance abuse nationwide, but as even overdose deaths from other drugs like heroin and fentanyl increase, limited resources are available for adults who are addicted to huffing.

Breault’s mother and former boyfriend said she had used other drugs, like alcohol, her prescription medications and, at least once, crack cocaine. Her former boyfriend even worried she was trying to get access to heroin when she died.

But it was an aerosol can that killed her.

ANGER AND DEPRESSION

Breault’s favorite color was purple.

She never graduated from Fort Fairfield High School, but she had a job as a waitress until back pain prevented her from working. She loved to cook and text photos of her creations to her mother – an unsuccessful experiment with tomato soup and tuna fish, the turkey dinner at her last Thanksgiving. Even when Breault moved to southern Maine in the last year of her life, she drove up to Caribou to surprise Pinette with a birthday dinner.

“All my kids are special in their own way, but Michele was always the thoughtful one,” Pinette said.

Breault also struggled with anger and depression.

As a little girl, Breault was sexually abused by two separate family members. In the second case, the abuse stretched over almost three years, and she was just 11 years old when the man went to jail. The family went to counseling, but Pinette said her daughter was an adult before she was ready to truly talk about the abuse to a therapist.

While the mother and daughter were very close, Pinette still doesn’t know much about Breault’s drug use.

Inhalants include a wide range of substances – among them keyboard cleaner, nail polish remover, gasoline and bath salts. Because inhalants are often easily found around the house or sold in stores, their ease of access and low cost is often attractive to their users.

“You don’t need a prescription,” said Dr. Karen Simone, director of the Northern New England Poison Center. “You don’t need a drug dealer. You just need to walk into the store.”

An annual study conducted by the National Institute of Drug Abuse reported between 5 and 10 percent of high schoolers have tried inhalants at least once. In 2014, SAMHSA estimated 546,000 people 12 years or older – just 0.2 percent of the population – were current users of inhalants.

“I don’t think it’s so uncommon that we should not pay attention to it,” Simone said. “It’s common enough to worry about it, and it’s persistent through decades.”

Simone said young teenagers will often experiment with inhalants and move on to other drugs, but some continue huffing as adults.

“We do find some people whose lives have been completely ruined by these substances,” she said. “They live to abuse these substances.”

When Breault told her toward the end of her life about her addiction to huffing, Pinette had to look it up on the internet to learn what it was.

“When I looked it up, it said you could die the first time you do it,” Pinette said. “I told her, I think it was even less than a week before she died, I said, ‘You realize this could kill you, don’t you?’ ”

By then, her daughter knew.

“She said, ‘I didn’t realize how much it had a hold on my life,’ ” Pinette said. “Initially it was probably an every-once-in-a-while thing, and then it escalated.”

MOVE TO SOUTHERN MAINE

Breault spent most of her life in northern Maine, but in late 2014, she moved in with Tony Verdelli in South Portland.

She met Verdelli two years previously when she was visiting a family friend undergoing cancer treatment at Maine Medical Center, where Verdelli is a nurse. When she told him about her substance abuse, she said she wanted to make a change in her life. He agreed to let her live with him, and they began a romantic relationship.

“I thought, here’s a person who really is sincere about wanting to change,” Verdelli said.

Verdelli knew about the sexual abuse in Breault’s past, as well as her drug use. In addition to the substances she had experimented with as an adult, she told him she had been huffing canned air since she was a teenager. He helped her find individual counseling and recovery groups. She encouraged Verdelli to go to church with her. She began to wean herself off the substances that had been part of her daily life – alcohol and marijuana, cigarettes and prescription painkillers.

But Simone said addiction to huffing cannot be treated with methadone or buprenorphine, which can ease addiction to opiates. A successful approach would likely include cognitive behavior therapy, she said, because the psychological and social factors that contributed to the inhalant abuse should also be addressed.

“Programs are out there for people to try and stop using alcohol, marijuana, cocaine, methamphetamine,” Simone said. “I’m not aware of any single program that’s been extremely successful in helping people who are seriously addicted (to inhalants). This is a hard habit to quit.”

In August 2015, Verdelli said Breault spent five days in a residential program at Crossroads for Women in Portland. She left briefly, and then returned for 25 more days of treatment.

Dr. Mark Publicker, a Portland-based physician who specializes in addiction treatment, said inhalant addiction among adults is rare but desperate.

“My sense of it is that adults who are addicted to it have co-occurring psychiatric disorders that are probably predisposing them to it,” Publicker said. “If you have a choice of better drugs, there are better drugs than inhalants.”

A person who has developed a dependence on inhalants is likely abusing other substances like alcohol, he said, and a residential treatment program would be the best person to help that person with his or her addiction.

But despite treatment and counseling, Breault still struggled.

In particular, she was still huffing. Toward the end of her life, she got into a car accident and admitted to Verdelli she was high from canned air at the time. He later discovered drug paraphernalia that could be used for heroin among her belongings; while Verdelli doesn’t believe she had access to it during her life, he worried she was seeking the drug before she died.

“There were victories, but it was like sand,” Verdelli said. “The more you tried to hold, the more it kind of slipped out.”

THEFT IN CARIBOU

On Nov. 8, 2015, a security camera captured an image of Breault walking into a Caribou Rite Aid at 8:02 p.m.

Her long blond hair was pulled back, and she wore a purple jacket. According to a police report, Breault stole a can of electronics cleaner valued at $6.99.

Using inhalants to get high is against state law but hard to prove. Unlike other substances, the high from inhalants often lasts just a few minutes. While some states require an ID in order to buy inhalants, Maine does not.

Law enforcement often becomes involved when a person high on inhalants causes an accident or commits a related crime.

For example, Biddeford police say a man huffed stolen computer duster in a Wal-Mart parking lot before he drove his car into the building earlier this year. When Officer Chad Cochran of the Caribou Police Department later spoke to Breault, she confessed she had also been high at the time of the theft.

“She told me she was intoxicated by the aerosol, and she did not know what she was doing,” Cochran said. “She hoped she didn’t get in trouble.”

Cochran said police only have a short window of time to identify someone impaired by inhalants. Signs of recent use include slurred speech, chemical stains or odors, disorientation and nausea.

“You’ll pull over a car and see a bunch of cans of Endust in the back,” Cochran said. “It’s not illegal to have a bunch of empty cans.”

Breault was scheduled for a hearing. Before she could appear in court, the Caribou Police Department received notice of her death.

‘PEOPLE NEED TO KNOW’

Verdelli found Breault passed away in her bed on the morning of Dec. 4, 2015.

“I saw her as this person who had the ability to not only help herself, but eventually help others,” Verdelli said. “And eventually be somebody I could be with. But it never worked out that way, I guess.”

Pinette again turned to Google after her daughter’s death. The state medical examiner’s office had told her the cause was huffing, but she searched for information on that chemical – 1,1 difluoroethane – to be sure.

“People need to know,” she said “People know about heroin and cocaine and all this other stuff. But what about huffing? I didn’t know anything about it. Do people know how dangerous it is?”

Data on inhalant-related deaths is limited, but the National Institute on Drug Abuse estimates 100 to 200 people die in the United States each year due to huffing.

In 2015 and 2016, Maine officials have recorded a combined eight fatalities related to huffing. Those numbers are small when compared to overdoses from heroin and fentanyl, which have accounted for more than 550 deaths in the state since the start of 2015.

But Pinette still knows the grief of losing a child to addiction. The urn that holds her daughter’s ashes is shiny and purple.

“Sometimes I think of her and smile,” Pinette said. “Sometimes I think of her and cry for a good life lost too soon.”

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