Inhalants and related disorde... Health Article

Definition

The inhalants are a class of drugs that include a broad range of chemicals found in hundreds of different products, many of which are readily available to the general population. These chemicals include volatile solvents (liquids that vaporize at room temperature) and aerosols (sprays that contain solvents and propellants). Examples include glue, gasoline, paint thinner, hair spray, lighter fluid, spray paint, nail polish remover, correction fluid, rubber cement, felt-tip marker fluids, vegetable sprays, and certain cleaners. The inhalants share a common route of administration— that is, they are all drawn into the body by breathing. They are usually taken either by breathing in the vapors directly from a container (known as "sniffing"); by inhaling fumes from substances placed in a bag (known as "bagging"); or by inhaling the substance from a cloth soaked in it (known as "huffing"). Inhalants take effect very quickly because they get into the bloodstream rapidly via the lungs. The "high" from inhalants is usually brief, so that users often take inhalants repeatedly over several hours. This pattern of use can be dangerous, leading to unconsciousness or even death.

The latest revision of the manual that is used by mental health professionals to diagnose mental disorders is the Diagnostic and Statistical Manual of Mental Disorderspublished in 2000 (also known as DSM-IVTR). It lists inhalant dependence and inhalant abuse as substance use disorders. In addition, the inhalantinduced disorder of inhalant intoxication is listed in the substance-related disorders section as well. Inhalant withdrawal is not listed in the DSM-IV-TRbecause it is not clear that there is a "clinically significant" withdrawal syndrome. In addition, withdrawal is not included as a symptom of inhalant dependence, whereas withdrawal is a symptom of dependence for all other substances. Withdrawal symptoms are symptoms that occur when a person who is dependent on a substance stops using the substance.

Anesthetic gases (such as nitrous oxide, chloroform, or ether) and nitrites (including amyl or butyl nitrite) are not included under inhalant-related disorders in the DSM-IV-TRbecause they have slightly different intoxication syndromes. Problems with the use of these substances are to be diagnosed under "Other Substance-Related Disorders." There is, however, a significant degree of overlap between the symptoms of disorders related to inhalants and these "other" substances.

Inhalant dependence

Other substance use disorders are commonly seen among people diagnosed with inhalant dependence. The use of inhalants is usually secondary to the use of other substances, however; only occasionally are inhalants a person's primary drug of choice.

Inhalant abuse

The use of other substances is not uncommon among people who abuse inhalants.

Inhalant intoxication

Inhalant intoxication is often treated in a hospital emergency room when the affected person begins to suffer serious psychological (such as hallucinations or delusions) or medical consequences (difficulty breathing, headache, nausea, vomiting) from inhalant use. The most serious medical risk from inhalant use is "sudden sniffing death." A person using inhalants, especially if they are using the substance repeatedly in a single, prolonged session, may start to have a rapid and irregular heartbeat or severe difficulty breathing, followed by heart failure and death. Sudden sniffing death can occur within minutes. In addition, inhalant use can cause permanent damage to the brain, lung, kidney, muscle, and heart. The vapors themselves cause damage, but there are also dangerously high levels of copper, zinc, and heavy metals in many inhalants.

People who use inhalants may also be treated for injuries sustained while under the influence of inhalants or while using inhalants. For example, individuals intoxicated by inhalants may fall and injure themselves, or they may drive while intoxicated and have an accident. People who use inhalants may also die from or require treatment for burns because many inhalants are highly flammable. They may also need emergency treatment for suffocation from inhaling with a plastic bag over the head, or for choking on inhaled vomit.

Causes

Because inhalants are readily available and inexpensive, they are often used by children (ages six to 16) and the poor. Factors that are associated with inhalant use include poverty; a history of childhood abuse; poor grades; and dropping out of school. The latter two factors may simply be a result of inhalant use, however, rather than its cause.

The use of inhalants is highly likely to be influenced by peers. Inhalants are often used in group settings. The solitary consumption of inhalants is associated with heavy, prolonged use; it may indicate that the person has a more serious problem with these substances.