A 16-year-old adolescent male with a normal birth history and developmental milestones and belonging to low socioeconomic status; was brought to the outpatient department by his mother who permitted and consented along with the child in writing the report, complained that the child was smelling a rubber based adhesive using a handkerchief since the last 3 years. There was significant family history of alcohol dependence in father. There was no history of fever, head injury, seizure or attention deficit hyperactive disorder. There was no history of stress, tension or depressive thoughts. The toluene based substance abuse began gradually from 5ml/day and picked up to 20 ml each per day gradually over a span of 1 year which remained relatively stable during the presentation to the outpatient. After acute ingestion of Polychloroprene based solvent; the adolescent complained of tinnitus, slurring of speech, restlessness tremors, dizziness and ataxia. During the phase of withdrawal, there was coprolalia with assaultive and abusive behaviour, increasing fights, maladaptive behaviour and headache. These symptoms increased in severity; which compelled the parent to seek help. In addition, excessive tearing in the morning, headaches, decreased cognitive ability were the prominent symptoms in the morning; due to withdrawal. After obtaining detailed history, it was found that there was no confusion, visual hallucinations and/or seizure. Alcohol abuse began approximately 6 months after the volatile substance abuse, on detailed questioning child was asked whether he needed to cut down on the drinking behaviour, his annoyance, guilty and use of alcohol eye opener in the morning the response was positive for ¾ of the questions. He further added that the alcohol abuse began when the patient's friends circle changed to include more people of higher age group. The patient used to steal money from his house in order to fetch the abused substance. The child was a school drop out as he faced inability to concentrate and low scores at school. Moreover, he often was involved in assaultive behaviour at school. The alcohol consumption increased from initially 20-40 ml of local alcohol (42.6% w/v) average per day to approx 60-120 ml per day (42.6%w/v); later during the span of last 2 months before presentation to the outpatient department. The child abused glue more than the alcohol due to its easy availability. During times of the day when no glue was consumed; alcohol abuse was noted along with the peers of elder age. During the phase of acute alcohol intoxication alone; the adolescent complained of nausea, headache, dizziness and excessive somnolence however when combined with glue sniffing; disorientation and ataxia, restless, diaphoresis and nystagmus were complained of, in addition. The child also developed blurring of vision and inability to perceive numbers and letters in the central visual field and fixed hearing deficits to increased frequency sound was noted; more prominent during the last 2 months, during which period combined...