Toluene is a commonly used volatile organic chemical in industry and is the most often chosen illicit substance among volatile substance abusers. Studies involving healthy volunteers suggest that ethanol consumption inhibits toluene metabolism, thus increasing its blood levels. In this study, a lethal case of combined ethanol consumption and toluene inhalation has been reported. Our case was a 30-year-old male who had used volatile substance for 15 years. The autopsy revealed no abnormal findings. Toxicological analysis revealed alcohol and toluene in the blood and the cause of death was considered as toxicity due to acute combined intake of alcohol and toluene. Lethal combined ethanol and toluene intake is rarely reported in the literature. Experimental studies indicate that toluene increases the risk of ethanol dependence and each substance increases the toxic effects of the other.
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