Inhalant Use Disorder: What It Is, Symptoms & Treatment
The immediate effects of inhalants can be dangerous due to the mind-altering effects; however, recurring, regular use is also dangerous as this may cause long-term permanent damage to major organs. Some reports of long-term inhalant use have shown severe brain damage from lack of oxygen flow and overexposure to chemicals. Death from inhalants can occur as early as one’s first use, and does not appear to be related to the dosage.
What is the most important information I should know about inhalant use disorder?
It’s caused by direct contact with toxic chemicals, which can burn delicate skin tissue. In severe cases, blisters may form on the lips or inside of the nostrils due to exposure. Ulceration of the nasal septum is also possible from the chronic use of specific inhalants such as gasoline. Inhalant abuse has many physical and mental health symptoms that can occur shortly after inhalation.
What is inhalant use disorder?
Brain damage is the primary effect because inhalants quickly penetrate the blood-brain barrier (a protective ‘shield’ around the brain). However, there are criteria established that are used to diagnose this addiction. Two or more of the 11 symptoms of a substance use disorder as outlined by the DSM must be present in order to diagnose the condition.
The Clinical Assessment and Treatment of Inhalant Abuse
If you’re noticing signs that a loved one may have inhalant use disorder, try to gently suggest that they get some help. Inhalant use disorders are among the least prevalent substance use disorders. The past-year prevalence of inhalant use disorder among adult participants in the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions was 0.02 percent (Grant et al., 2004). Analysis for urinary metabolites of certain solvents (benzene, toluene, xylene and chlorinated solvents) may be conducted to ensure treatment compliance, but generally routine urine screening and other laboratory tests do not detect inhalant abuse (10,29). Although it may be the most valuable tool in inhalant abuse detection, screening is seldom performed by health care providers (30). Additionally, family, peers, teachers, counsellors and others should be made aware of the signs of inhalant abuse and how to refer children and youth who may be at risk.
- Neuropsychological assessments can be helpful in evaluating cognitive deficits, measuring the severity of neurologic vs psychiatric impairments, and making decisions regarding appropriate potential rehabilitation treatments.
- Psychoeducation and skills training should focus on the dangers of inhalant use including sudden death, burns, flash fires and brain damage.
- In the Wu, Pilowsky, and Schlenger NHSDA-based study (2004), adolescents who had initiated inhalant use before age 15 were five to six times as likely as those who had started later to be diagnosed with inhalant dependence in the year prior to the survey.
- It involves helping the patient identify and modify the negative thoughts and behaviors contributing to their substance use disorder.
- Long-term use of inhalants, even in small amounts, can lead to permanent organ damage and other serious health problems.
- Psychological withdrawal is marked by irritability and the inability to feel normal without the substance, while physical withdrawal effects generally consist of headaches and fatigue.
Inhalants are volatile substances that produce chemical vapors that can be inhaled to induce a psychoactive, or mind-altering, effect. Although other abused substances can be inhaled, the term “inhalants” is used to describe a variety of substances whose main common characteristic is that they are rarely, if ever, taken by any route other than inhalation. This definition encompasses a broad range of chemicals that may have different pharmacological effects and are found in hundreds of different products.
Respiratory arrest due to central nervous system depression has been reported in at least one case, and sudden cooling of the larynx (by direct spraying of aerosols) has been suggested to cause fatal vagal depression (19). Likely due primarily to cardiac arrhythmia, ‘sudden sniffing death syndrome’ is the leading cause of death among https://sober-home.org/cbd-addiction-is-cannabidiol-cbd-addictive/ inhalant abusers. Inhalants disrupt myocardial electrical propagation – an effect heightened by hypoxia – increasing the risk of arrhythmia. Inhalants also sensitize the heart to adrenaline; sudden sniffing death can occur when a user is startled during inhalation (such as being caught inhaling) or in vivid hallucinations (19).
Chronic abuse of inhalants can be incredibly destructive; abusing the paint-dissolving chemical toluene, for instance, may produce neurological symptoms strikingly similar to multiple sclerosis. The short-term and long-term health effects can be devastating or even deadly. People who have a more severe inhalant use disorder may receive the best treatment at a residential treatment program.
An innovative, integrated approach to inhalant use prevention involving community mobilization efforts, environmental strategies, and school-based activities was described by Johnson and colleagues at the Pacific Institute for Research and Evaluation. These reports and others that present positive findings regarding inhalant prevention (e.g., Spoth et al., 2007) suggest that comprehensive, theory-informed, and gender-specific prevention approaches may be effective methods for inhalant use prevention. The Canadian Paediatric Society is extremely concerned with the practice of inhalant abuse among children and adolescents, and believes that more needs to be done to understand and combat this dangerous practice. Often, several deep inhalations are needed to achieve full euphoric effects. Rapid pulmonary absorption and lipid solubility mean that the brain is rapidly affected (13).
This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. An electrocardiogram should be obtained to detect dysrhythmias, and brain imaging should be performed if neurologic findings are present. A 13-year-old girl with a primary complaint of headaches is brought to the physician’s office by her mother.
Carboxyhemoglobin levels should be obtained, especially if the patient remains hypoxemic despite oxygen administration or is suspected to have had exposure to methylene chloride. Conventional two-wavelength pulse oximetry does not reliably indicate levels of methemoglobin concentration, so diagnosis should be confirmed by ABG testing to document the methemoglobin percentage. Cyanosis related to methemoglobinemia due to nitrite ingestion also necessitates confirmation by ABG testing.
Although the volatile solvents are central nervous system (CNS) depressants, they may have initial excitatory effects through the release of epinephrine and activation of dopamine system. The most studied agent in this group is toluene, which belongs to the aromatic hydrocarbon family. Table 2 lists the receptor sites and pharmacologic actions of toluene as a representative of https://sober-home.org/ the volatile solvents. A strong need to continue using inhalants has been reported by many individuals, particularly those who have abused inhalants for prolonged periods over many days. Compulsive use and a mild withdrawal syndrome can occur with long-term inhalant abuse. Inhalant abusers are younger and suffer greater social dysfunction than abusers of other substances.
For patients with suspected myelopathy secondary to chronic nitrous oxide use, early diagnosis is important, as irreversible neurological damage can result without treatment. Urinary metabolites of some solvents can be analyzed for monitoring and determining treatment compliance in patients already in treatment for inhalant use disorders. For chronic users of volatile inhalants, magnetic resonance imaging of the brain can be useful in detecting signs of cerebral or cerebellar atrophy. Inhalants in this group have high volatility and lipophilicity and are rapidly absorbed through the pulmonary system, bloodstream, and blood–brain barrier with immediate and brief effects.
Treatment of inhalant abuse and dependence involves counseling, strict abstinence by the abuser, and other drug dependency protocols (e.g., 12-step programs, support groups, inpatient and outpatient dependency treatment). However, a survey22 of drug treatment providers concluded that most treatment programs are not yet adequately equipped to handle inhalant abuse or dependence. While addiction to inhalants has been reported in various case studies, no studies have estimated its prevalence. Few studies have examined pharmacological or psychosocial interventions for those who use inhalants or who have inhalant-induced disorders. Drug abuse researchers may have been slow to recognize the importance of inhalant use disorders, perhaps because of the stigmatized nature of the behavior.
In addition, people who have inhalant use disorders may be difficult to recruit, assess, and follow because they are typically dependent on multiple drugs and afflicted with comorbid mood, anxiety, and personality disorders. Inhalant abuse and dependence criteria parallel the generic substance abuse and dependence diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV; APA, 2000). The criteria do not include withdrawal symptoms, although some evidence suggests a characteristic withdrawal syndrome (Perron et al., 2009a).
In the general population, males are slightly more likely to use inhalants, but in the age group most likely to use—those between the ages of 12 and 17—it is slightly more common among females than males. According to the DSM-5, inhalant-use disorder is diagnosed when repeated use of inhalants leads to clinically significant impairment or distress, or when a problematic pattern of intoxication develops. According to a 2020 survey, 2.4 million people in the U.S. ages 12 and older had used an inhalant in the past year. Additionally, the expression of these symptoms must cause clinically significant distress, such as difficulty in social situations, daily functioning, or work settings.
If you’re experiencing PTSD symptoms, the best self-care approach you can implement is to seek help. As noted above, avoiding the trauma and your feelings you more likely to develop PTSD. In addition, getting support from friends, family, and a mental health provider dramatically increases your chances of feeling better sooner. The first steps in diagnosing post-traumatic stress disorder include a physical examination and a psychological evaluation. A physical exam is necessary to determine if symptoms result from a bodily injury, such as head trauma. A psychological evaluation helps develop a clearer picture of the presenting condition and how the symptoms might be classified.
No Comment