Inhalant Use Disorders Research Articles

Case Report: Dust Remover Inhalant Use Disorder in an Individual in Early Remission from Alcohol Use Disorder Treated with Naltrexone.

Inhalants are a very diverse class of substances with a highly prevalent recreational use. Difluroethane (DFE) is a psychoactive ingredient present in several propellants and dust remover products. Past reports have described the toxicological effects of this compound, but its addictive potential is poorly described in the literature. We present a case report (N = 1) of an adult man who very rapidly developed a severe inhalant use disorder (IUD), in the context of an early remission of an alcohol use disorder (AUD). He received treatment with naltrexone in a residential treatment program. He provided verbal and written consent for the publication of this case report. This is the first follow-up case of dust remover-IUD treated with naltrexone described in the literature. This case is clinically important for several reasons, including its atypical age of presentation, rapid progression, medical consequences, and positive response to multimodal treatment. The easy availability and lack of regulation of many inhalants, such as DFE, combined with the inability to be detected in regular screening tests, make this phenomenon a potential public health threat. We hypothesize that, consistent with previous reports, there might be a common neurobiological signature between AUD and IUD.

Profile of Inhalant Users Seeking Treatment at a De-addiction Center in Kashmir

Background: As substances of abuse, inhalants are chemicals whose vapors can be intentionally inhaled to produce psychoactive effects. Serious mental health and substance use problems commonly co-occur with inhalant-use disorders (IUDs). Methods: It was a cross-sectional study. All patients attending the outpatient service and inpatient department of the de-addiction center of the institute-seeking treatment for inhalant use were approached for the study. Diagnosis of IUD was made as per the Diagnostic and Statistical Manual-5 criteria by the consultant psychiatrist. A semi-structured questionnaire was used to record the sociodemographic status. A phenomenology checklist was used to assess the phenomenology. Results: A total of 92 patients were included in our study. Nearly 98.9% of participants were males and 70.5% were of urban background. About 59.8% of participants were educated up to middle classes. The mean age of the study group was 18.38 years. Two-third of our study group were in the age group of 10–19 years. Adhesives were the most predominant inhalant used by 100% of cases. Bagging was the predominant mode of intake of inhalants (83.7%), followed by sniffing (16.3%). Feeling of relaxation (100%) followed by euphoria (73.9%) was the common hedonic experiences, whereas nausea was the most common aversive experience reported by 73.9% of cases. All patients reported high levels of craving. Conclusion: Our results showed that inhalant users were mostly urban male students who were using adhesives as the predominant inhalant. Bagging was the most common mode of intake of inhalants. Policymakers need to develop strategies regarding inhalant-use problem, especially in schools.

Adolescent inhalant use prevention, assessment, and treatment: A literature synthesis

Inhalant use refers to the use of substances such as gases, glues, and aerosols in order to achieve intoxication, while inhalant use disorder (IUD) encompasses both DSM-IV-TR criteria for inhalant abuse and dependence. Inhalant use among adolescents is an international public health concern considering the severe medical and cognitive consequences and biopsychosocial correlates. In this paper, we summarize the current state of the literature on inhalant use among adolescents focusing on social context, prevention, assessment, and treatment strategies. Psychoeducation, skills training, and environmental supply reduction are helpful strategies for preventing adolescent inhalant use, while parent and adolescent self-report as well as physician report of medical signs and symptoms can aid in assessment and diagnosis. Although research has only begun to explore the treatment of inhalant use, preliminary findings suggest that a multimodal approach involving individual counselling (i.e., CBT brief intervention), family therapy, and activity and engagement programs is the first-line treatment, with residential treatment programs indicated for more severe presentations. The limited nature of treatments developed specifically for inhalant use combined with high prevalence rates and potential for significant impairment within the adolescent population indicate the need for further research. Research should focus on understanding the social context of use, establishing the efficacy of current adolescent substance use treatments adapted for inhalant use, and exploring long-term outcomes.

Suicide Ideation and Attempts among Inhalant Users: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

Few studies have examined associations of inhalant use and inhalant use disorders (IUDs) to suicide ideation and attempts. We investigated these relationships in the largest comorbidity survey conducted in the United States. Suicidal ideation was significantly more prevalent among inhalant users than nonusers and severity of inhalant use problems was positively related to suicidal ideation. Among persons with IUDs, 67.4% had thought about committing suicide and 20.2% had attempted suicide. Multivariate logistic regression analyses indicated that respondents with IUDs reported significantly higher levels of suicide ideation than inhalant nonusers. Inhalant use is associated with significantly increased risk for suicide ideation, especially among women and persons with DSM-IV IUDs.

Inhalant Use, Inhalant-Use Disorders, and Antisocial Behavior: Findings From the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

Few studies have explored the topography of antisocial behavior in a nationally representative sample of inhalant users. We examined (a) the lifetime prevalence of 20 childhood and adult antisocial behaviors in inhalant users with inhalant-use disorders (IUD+) and without IUDs (IUD-); (b) the nature and strength of associations between inhalant use, IUDs, and specific antisocial behaviors in multivariate analyses; and (c) the relationships between inhalant use, IUDs, and antisocial behaviors in a national sample of adults with antisocial personality disorder. The National Epidemiologic Survey on Alcohol and Related Conditions was a multistage national survey of 43,093 U.S. residents. Respondents completed a structured psychiatric interview. IUD+ and IUD- respondents were significantly younger and more likely to be unemployed, to be male, to have never married, and to report family and personal histories of alcohol and drug problems than inhalant nonusers. Family histories of alcohol problems and personal histories of drug problems were significantly more prevalent among IUD+ respondents, compared with IUD- respondents. In bivariate analyses, IUD+ and IUD- respondents evidenced significantly higher lifetime levels of all childhood and adult antisocial behaviors than inhalant nonusers. IUD+ respondents were significantly more likely than their IUD- counterparts to report bullying behavior, starting physical fights, using dangerous weapons, physical cruelty to people, staying out all night without permission, running away, and frequent truancy in childhood, as well as greater deceitfulness, impulsivity, irritability/aggressiveness, recklessness, and irresponsibility in adulthood. Multivariate analyses indicated that IUD+ respondents had a significantly elevated risk for childhood and adult antisocial behaviors, compared with inhalant nonusers, with the strongest effects for using dangerous weapons, physical cruelty to animals, and physical cruelty to people. Similarly, IUD+ respondents differed significantly from their IUD- counterparts primarily across measures of interpersonal violence. Among persons with antisocial personality disorder, inhalant use and IUDs were associated with greater antisocial behavior, albeit with fewer and weaker effects. Respondents with IUDs had pervasively elevated levels of antisocial conduct, including diverse forms of early-onset and interpersonally violent behavior.

Adolescent inhalant use, abuse and dependence

To compare adolescent inhalant users without DSM-IV inhalant use disorders (IUDs) to youth with IUDs (i.e. abuse or dependence) across demographic, psychosocial and clinical measures. Cross-sectional survey with structured psychiatric interviews. Facilities (n = 32) comprising the Missouri Division of Youth Services (MDYS) residential treatment system for juvenile offenders. Participants Current MDYS residents (n = 723); 97.7% of residents participated. Most youth were male (87%) and in mid-adolescence (mean = 15.5 years, standard deviation = 1.2, range = 11-20); more than one-third (38.6%, n = 279) reported life-time inhalant use. Antisocial behavior, temperament, trauma-exposure, suicidality, psychiatric symptoms and substance-related problems. Among life-time inhalant users, 46.9% met criteria for a life-time DSM-IV IUD (inhalant abuse = 18.6%, inhalant dependence = 28.3%). Bivariate analyses showed that, in comparison to non-users, inhalant users with and without an IUD were more likely to be Caucasian, live in rural or small towns, have higher levels of anxiety and depressive symptoms, evidence more impulsive and fearless temperaments and report more past-year antisocial behavior and life-time suicidality, traumatic experiences and global substance use problems. A monotonic relationship between inhalant use, abuse and dependence and adverse outcomes was observed, with comparatively high rates of dysfunction observed among inhalant-dependent youth. Multivariate regression analyses showed that inhalant users with and without an IUD had greater levels of suicidal ideation and substance use problems than non-users. Youth with IUDs have personal histories characterized by high levels of trauma, suicidality, psychiatric distress, antisocial behavior and substance-related problems. A monotonic relationship between inhalant use, abuse and dependence and serious adverse outcomes was observed.

A Survey of Inhalant Use Disorders among Delinquent Youth: Prevalence, Clinical Features, and Latent Structure of DSM-IV Diagnostic Criteria

BackgroundInhalant use is among the most pernicious and poorly understood forms of adolescent substance use. Many youth in the juvenile justice system have used inhalants, but little is known about inhalant use disorders (IUDs) in antisocial youth populations. The purpose of this study was to examine the prevalence, clinical features, and latent structure of DSM-IV IUDs in a state population of antisocial youth.MethodsCross-sectional survey conducted in 2003. Of 740 youth residing in Missouri State Division of Youth Services' (MDYS) residential treatment facilities at the time the study was conducted, 723 (97.7%) completed interviews. Eighty-seven percent were male, with a mean age of 15.5 (SD = 1.2). Nearly 4 in 10 youth (38.5%; n = 279) reported lifetime inhalant use. Youth ranged from very mildly to severely antisocial.ResultsOf 279 inhalant users, 52 (18.6%) met DSM-IV inhalant abuse criteria and 79 (28.3%) met inhalant dependence criteria. Five of 10 IUD criteria were met by > 10% of the total sample. Latent class analyses demonstrated a substantial concordance between DSM-IV-defined IUDs and an empirically-derived classification based on responses to DSM-IV IUD diagnostic criteria.ConclusionIUDs and constituent criteria were prevalent among youth in the juvenile justice system. Two groups of problem inhalant users were identified, symptomatic users-DSM-IV inhalant abuse and highly symptomatic users-DSM-IV inhalant dependence, which differed primarily in severity of inhalant-related problems. Inhalant screening, prevention and treatment efforts in juvenile justice settings are rarely delivered, but critically needed.