Inhalants and related disorde... Health Article

Demographics

Inhalants are one of the few substances more commonly used by younger children rather than older ones. It has been estimated that 10%–20% of youths aged 12–17 have tried inhalants. About 6% of the United States population admits to having tried inhalants prior to fourth grade. The peak time for inhalant use appears to be between the seventh and ninth grades. Inhalants are sometimes referred to as "gateway" drugs, which means that they are one of the first drugs that people try before moving on to such other substances as alcohol, marijuana, and cocaine. Only a small proportion of those who have used inhalants would meet diagnostic criteria for dependence or abuse.

Males generally use inhalants more frequently than females. However, a National Household Survey on Drug Abuse has shown no gender differences in rates of inhalant use in youths between the ages of 12 and 17. Children younger than 12 and adults who use inhalants, however, are more likely to be male.

Diagnosis

People rarely seek treatment on their own for inhalant dependence or abuse. In some cases, the child or adolescent is brought to a doctor by a parent or other relative who is concerned about personality changes, a chemical odor on the child's breath, or other signs of inhalant abuse. The parent may also have discovered empty containers of the inhaled substance in the child's room or elsewhere in the house. In other cases, the child or adolescent's use of inhalants is diagnosed during a medical interview, when he or she is brought to a hospital emergency room after overdosing on the inhalant or being injured in an accident related to inhalant use. Although inhalants can be detected in blood or urine samples, laboratory tests may not always confirm the diagnosisbecause the inhalants do not remain in the system very long.

Inhalant dependence and abuse

The course of inhalant abuse and dependence differs somewhat depending on the affected person's age. Younger children who are dependent on or abuse inhalants use them regularly, especially on weekends and after school. As children get older, they often stop using inhalants. They may stop substance use altogether or they may move on to other substances. Adults who abuse or are dependent on inhalants may use inhalants regularly for years. They may also frequently "binge" on inhalants (i.e., using them much more frequently for shorter periods of time). This pattern of use can go on for years.

The use of inhalants and subsequent dependence on the substance occurs among people who do not have access to other drugs or are otherwise isolated (such as prison inmates). Also, as with other substance use disorders, people who have greater access to inhalants are more likely to develop dependence on them. This group of people may include workers in industrial settings with ready access to inhalants.

Prevention

Comprehensive prevention programs that involve families, schools, communities, and the media (such as television) can be effective in reducing substance abuse. The recurring theme in these programs is to stay away from drugs in the first place, which is the primary method of ensuring that one does not develop a substance use disorder.

Parents can help prevent the misuse of inhalants by educating their children about the negative effects of inhalant use. Both teachers and parents can help prevent inhalant abuse and dependence by recognizing the signs of inhalant use, which include chemical odors on the child's breath or clothes; slurred speech; a drunken or disoriented appearance; nausea or lack of appetite; and inattentiveness and lack of coordination.

See also Polysubstance abuse

BOOKS

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders.4th edition, text revised. Washington, DC: American Psychiatric Association, 2000.

Kaplan, Harold I., M.D., and Benjamin J. Sadock, M.D. Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences, Clinical Psychiatry.8th edition. Baltimore: Williams and Wilkins.

ORGANIZATIONS

American Psychiatric Association. 1400 K Street, Washington, DC 20005. (202) 682-6000. <http://www.psych.org>.

American Psychological Association. 750 First Street, NE, Washington, DC 20002-4242. (800) 374-2721. <http://www.apa.org>.

National Clearinghouse for Alcohol and Drug Information. (800) 729-6686. <http://www.health.org>.

National Institute of Mental Health. 6001 Executive Boulevard, Room 8184, MSC 9663, Bethesda, MD 20892-9663. (301) 443-4513. <http://www.nimh.nih.gov>.

National Institute on Drug Abuse (NIDA). 5600 Fishers Lane, Room 10-05, Rockville, MD 20857. Nationwide Helpline: (800) 662-HELP. <http://www.nida.nih.gov>.

National Library of Medicine. 8600 Rockville Pike, Bethesda, MD 20894. <http://www.nlm.nih.gov/medlineplus/drugabuse.html>.

Jennifer Hahn, Ph.D.