Inhalant-related disorders
Inhalant-Related Disorders
This section includes disorders induced by inhaling the aliphatic and aromatic hydrocarbons found in substances such as gasoline, glue, paint thinners, and spray paints. Less commonly used are halogenated hydrocarbons (found in cleaners, typewriter correction fluid, spray-can propellants) and other volatile compounds containing esters, ketones, and glycols. The active ingredients include toluene, benzene, acetone, tetrachloroethylene, methanol, and other substances. Reflecting different modes of action and profiles of associated problems, disorders arising from the use of anesthetic gases (e.g., nitrous oxide, ether) as well as short-acting vasodilators (e.g., amyl and butyl nitrate ["poppers"]) are described instead under Other (or Unknown) Substance-Related Disorders on p. 294. Most compounds that are inhaled are a mixture of several substances that can produce psychoactive effects, and it is often difficult to ascertain the exact substance responsible for the disorder. Unless there is clear evidence that a single, unmixed substance has been used, the general term inhalant should be used in recording the diagnosis. These volatile substances are available in a wide variety of commercial products and may be used interchangeably, depending on availability and personal preference. Although there may be subtle differences in the psychoactive and physical effects of the different compounds, not enough is known about their differential effects to distinguish among them. All are capable of producing Dependence, Abuse, and Intoxication.
Several methods are used to inhale intoxicating vapors. Most commonly, a rag soaked with the substance is applied to the mouth and nose, and the vapors are breathed in-a process called "huffing." The substance may also be placed in a paper or plastic bag and the gases in the bag inhaled-a procedure called "bagging." Substances may also be inhaled directly from containers or from aerosols sprayed in the mouth or nose. There are reports of individuals heating these compounds to accelerate vaporization. The inhalants reach the lungs, bloodstream, and target sites very rapidly.
This section contains discussions specific to the Inhalant-Related Disorders. Texts and criteria sets have already been provided for generic aspects of Substance Dependence (p. 192) and Substance Abuse (p. 198) that apply across all substances. The application of these general criteria to Inhalant Dependence and Abuse is provided below. However, there are no unique criteria sets for Inhalant Dependence or Inhalant Abuse. A specific text and criteria set for Inhalant Intoxication is also provided below. Tolerance has been reported among individuals with heavy use. Although withdrawal-like symptoms have been seen in animals after repeated exposure to trichloroethane, it has not been established that a clinically meaningful withdrawal syndrome occurs in humans. For this reason, the diagnosis of inhalant withdrawal is not included in this manual. The Inhalant-Induced Disorders (other than Inhalant Intoxication) are described in the sections of the manual with disorders with which they share phenomenology (e.g., Inhalant-Induced Mood Disorder is included in the "Mood Disorders" section). Listed below are the Inhalant Use Disorders and the Inhalant-Induced Disorders.
Inhalant Use Disorders
- 304.60 Inhalant Dependence (see p. 258)
- 305.90 Inhalant Abuse (see p. 259)
Inhalant-Induced Disorders
- 292.89 Inhalant Intoxication (see p. 259)
- 292.81 Inhalant Intoxication Delirium (see p. 143)
- 292.82 Inhalant-Induced Persisting Dementia (see p. 168)
- 292.11 Inhalant-Induced Psychotic Disorder, With Delusions (see p. 338)
Specify if: With Onset During Intoxication - 292.12 Inhalant-Induced Psychotic Disorder, With Hallucinations (see p. 338) Specify if: With Onset During Intoxication
- 292.84 Inhalant-Induced Mood Disorder (see p. 405) Specify if: With Onset During Intoxication
- 292.89 Inhalant-Induced Anxiety Disorder (see p. 479) Specify if: With Onset During Intoxication
- 292.9 Inhalant-Related Disorder Not Otherwise Specified (see p. 263)