Disorders due to Substance Use: Inhalants

INHALANT ABUSE describes a variety of drug-using behaviors grouped based on their primary mode of administration (i.e., volatilization). Volatile inhalants products are a very diverse group of substances with patterns of use that vary by region, country, and over time. Volatile inhalants can be grouped as follows: (1) industrial or household cleaning and paint-type solvents including paint thinners or solvents, degreasers or dry-cleaning solvents, solvents in glues, and art or office supply solvents; (2) fluorocarbon propellant gases used in household or commercial products, in electronic cleaners, or as refrigerant gases; (3) butane/propane hydrocarbons present in household aerosol sprays such as paint, hair, and fabric protector sprays, or in cigar lighters; (4) medical anesthetic gases such as ether, chloroform, halothane, and nitrous oxide; and (5) aliphatic nitrites. Inhalants abuse can affect multiorgan systems, causes severe morbidity, and results in death. In this chapter, commonly abused volatile inhalants and the products containing them are identified and classified. Primary disorders, including diagnostic and clinical features and criteria according to ICD-11 and DSM-5 classification systems, are characterized. The toxicity caused by inhalants, along etiological and pathological effects on the brain and other organ systems, are also reviewed. Finally, treatment issues are reviewed and two clinical vignettes are presented.