Inhalant Use Disorder in the DSM-5

Inhalants are a range of substances, including volatile hydrocarbons, toxic gasses typically found in household products such as glue, paint thinners, white-out, and various cleaning products. The repeated use of inhalants can sometimes lead to an addiction known as inhalant use disorder.

Inhalant use disorder is a psychiatric condition that applies to the deliberate use of inhalants. This diagnosis does not apply to the accidental inhalation of toxic or psychoactive substances, even if they are the same substances that people inhale when they have inhalant use disorder and even if they produce identical effects.

Symptoms of Inhalant Use Disorder

Inhalant use disorder refers to a problematic pattern of inhalant use over time, not the acute effects of inhalants, even if they are life-threatening. The Diagnostic and Statistical Manual of Mental Disorder (DSM-5-TR), identifies the following symptoms of the condition:

• The person uses the inhalants in larger amounts or for longer than they had planned to.
• The person wants to cut down on using inhalants but has a hard time doing so.
• The person spends a lot of time getting the inhalant, using it or recovering from its effects.
• Cravings for more inhalants keep happening.
• The person fails to carry out important tasks related to home, school, or work, because of their inhalant use and may reduce or give up activities that were important to them.
• Despite having social, interpersonal, physical or psychological problems caused by inhalant use, the person continues to use inhalants.
• Risk-taking in inhalant use — which is always risky by nature.
• Tolerance to inhalants, meaning more is needed to get the same effect.

The number of symptoms present is used to gauge the severity of the disorder. The condition can be specified as mild (two to three symptoms), moderate (four to five symptoms), or severe (six or more symptoms).

Recognizing Inhalant Use Disorder

Many of the signs that someone has the inhalant use disorder are similar to the typical problems of adolescence so this can add to the confusion of worried parents of teenagers.

Signs of inhalant use disorder that may be typical teenage behavior include social and interpersonal problems, changing friendship groups, getting into arguments or fights with family or others, withdrawing from family, excessive sleepiness, neglect of chores and other expectations, moodiness, and socially unacceptable behavior, such as rude and disrespectful behavior, particularly towards authority figures.

Signs of inhalant use disorder that are less likely to be typical teenage behavior include:

• Intoxication that does not appear to be caused by alcohol or other drugs — especially if drug testing does not reveal these substances have been used
• Chemical smells on the body or clothing, scabs or sores around the nose or mouth
• Unusually excessive deposits in the trash or stockpiled in the bedroom, of containers for substances such as glue bottles, aerosols, paint bottles, lighter fluid, etc.

Health Risks of Inhalant Use Disorder

Inhalants have serious health risks. In the short-term, people may experience hallucinations and delusions. Inhalants can also be deadly, leading to seizures, coma, cardiac arrest, and death.

Long-term risks of inhalant use include bone marrow damage, brain damage, hearing loss, and liver and kidney damage.

Treatment for Inhalant Use Disorder

There are no FDA-approved medications to treat inhalant use disorder. Behavioral interventions can often be helpful, however. Some treatments that may be used include:

• Cognitive behavioral therapy (CBT): This therapy helps people learn to recognize the thoughts and situations contributing to inhalant use. It can also help people learn to manage stress more effectively and develop coping skills that can help.
• Contingency management (CM): This behavioral treatment involves using reinforcers such as vouchers or monetary awards to reward people for not using substances.
• Motivational enhancement therapy (MET): This type of therapy focuses on helping people improve their motivation to stay drug-free.

Support groups and lifestyle modifications can also help support long-term recovery from inhalant use disorder. If you think you might have an inhalant addiction, talk to your doctor about your treatment options.