https://www.psychiatrictimes.com/view/the-dangers-of-inhalant-use-disorder?ekey=RUtJRDpFOTIxNUQyMy03MkY0LTREOEUtQjRBRi1GNEI1RjcyQ0M4ODM%3D&utm_campaign=emailname&utm_medium=email&_hsenc=p2ANqtz--Q3toXx5OdHeTiuCEFIrhcQq2sdxT-VwYo6avepF6-jd5_gxupH8oArc-ndrK1ttNeodja5HwcHms_AZLGEiNBsfKqUg&_hsmi=330101293&utm_source=hsThe Dangers of Inhalant Use Disorder
Author(s): Syed Murtaza, MD, Lama Mahmoud Abdurrahman, BS, Michelle Raji, MD
Key Takeaways
Inhalant use disorder involves the misuse of volatile substances, leading to severe health risks, including neurological damage and sudden death.
Adolescents, particularly from marginalized backgrounds, are at higher risk for inhalant use disorder, often underreported due to societal stigma.
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Inhalant use disorder is a form of substance use disorder characterized by the intentional inhalation of volatile substances for their psychoactive effects.
TALES FROM THE CLINIC
Case Vignette
In the bustling landscape of the outpatient clinic, we encountered “Michelle,” a woman aged 27 years who has a medical history of inhalant use disorder, hypertension, and major depressive disorder (MDD). Initially, she came to us in a state of profound sadness, struggling with medication adherence. We proposed a fresh start with her medications and recommended additional therapy. However, she missed her subsequent appointment and disappeared from our radar for 6 months.
When she resurfaced, it was under dramatic circumstances—post hospital discharge. Michelle reported that she missed her follow-up appointment and was nonadherent with her medications, which deepened her feelings of sadness, hopelessness, and self-loathing. In her search for relief, she turned to a dangerous and readily available escape: inhaling an office cleaning duster. A friend had suggested it for a quick high, and, trapped in her despair, Michelle found the idea appealing. Her use of inhalants spiraled quickly. Over a mere 2 weeks, she had consumed 30 to 40 cans weekly. This hazardous practice led to several bouts of unconsciousness, persistent nausea, and frequent vomiting. During one such episode, she experienced a fall that resulted in a head injury. Fortunately, her brother visited unexpectedly, found her unconscious, and summoned emergency services.
In the emergency department, the situation grew more dire. The rapid response team found Michelle severely dehydrated, with critically low potassium levels, which had plummeted from 3.1 mEq/L to a dangerous 1.6 mEq/L. An electrocardiogram revealed a perilously prolonged QTc interval over 600, indicating serious heart rhythm issues, whereas her eosinophil count was abnormally high at 9%. This constellation of symptoms necessitated immediate admission to telemetry, where her usual medications were temporarily discontinued.
Following a critical period of cardiac monitoring and electrolyte replacement, she was stabilized enough to be transferred back to psychiatry. There, a dual-focused treatment approach awaited her, aiming to address both her MDD and her perilous journey through substance use disorder (SUD). This case poignantly underscores the complexities at the intersection of mental health and SUDs, highlighting the importance of comprehensive, integrated care approaches that address the full spectrum of a patient’s needs.
Inhalant Use Disorder
Inhalant use disorder, also known as volatile substance misuse, is a form of SUD characterized by the intentional inhalation of volatile substances for their psychoactive effects. These substances are often found in common household, industrial, or medical products, making them easily accessible and contributing to the prevalence of the disorder. The substances commonly misused include solvents and volatile compressed gases, such as hydrocarbons, fluorocarbons, nitrites, and nitrous oxide (see Table). The misuse of these substances can lead to significant health risks, including neurological damage, organ dysfunction, and even sudden death.1
One of the new additions to these inhalants is office dusters. The easy access to office dusters in retail and online markets has contributed significantly to their misuse as inhalants. These products, typically used for cleaning electronic equipment and hard-to-reach areas, contain compressed gases that can be misused for their psychoactive effects. The widespread availability of these dusters, often with minimal age restrictions or purchasing limits, facilitates their acquisition by individuals, including teenagers who seek a quick and inexpensive high. This accessibility raises concerns about the potential health risks associated with inhalant use disorder, as the chemicals in these products can cause severe neurological damage and other health issues when inhaled. As a result, there is a growing need for regulatory measures to control the sale and distribution of such potentially harmful substances. The disorder is often associated with significant social and health-related problems, including academic failure, family conflict, and physical and mental health issues.
Epidemiology
Research from the World Health Organization (WHO) shows that inhalant abuse is prevalent worldwide but often overlooked due to underreporting and societal stigma. In many regions, it predominantly affects adolescents, often from marginalized backgrounds. Data indicate that youth in lower socioeconomic settings tend to be at higher risk due to easier access to products like paint, glue, and solvents.
The onset of inhalant use typically occurs in adolescence, with the peak prevalence in the midteen years. However, the disorder can persist into adulthood and occurs in both men and women.2 The prevalence of inhalant use disorder varies widely across different regions and populations. Globally, it is estimated that tens of millions of individuals have used inhalants at least once.3 According to the Substance Abuse and Mental Health Services Administration, approximately 0.8% of the population 12 years or older reported using inhalants in the past year in 2019.4 The prevalence is highest among adolescents and young adults, with 1.4% of individuals aged 12 to 17 years reporting past-year inhalant use.4
One of the new additions to these inhalants is office dusters. The easy access to office dusters in retail and online markets has contributed significantly to their misuse as inhalants. These products, typically used for cleaning electronic equipment and hard-to-reach areas, contain compressed gases that can be misused for their psychoactive effects. The widespread availability of these dusters, often with minimal age restrictions or purchasing limits, facilitates their acquisition by individuals, including teenagers who seek a quick and inexpensive high. This accessibility raises concerns about the potential health risks associated with inhalant use disorder, as the chemicals in these products can cause severe neurological damage and other health issues when inhaled. As a result, there is a growing need for regulatory measures to control the sale and distribution of such potentially harmful substances. The disorder is often associated with significant social and health-related problems, including academic failure, family conflict, and physical and mental health issues.
Epidemiology
Research from the World Health Organization (WHO) shows that inhalant abuse is prevalent worldwide but often overlooked due to underreporting and societal stigma. In many regions, it predominantly affects adolescents, often from marginalized backgrounds. Data indicate that youth in lower socioeconomic settings tend to be at higher risk due to easier access to products like paint, glue, and solvents.
The onset of inhalant use typically occurs in adolescence, with the peak prevalence in the midteen years. However, the disorder can persist into adulthood and occurs in both men and women.2 The prevalence of inhalant use disorder varies widely across different regions and populations. Globally, it is estimated that tens of millions of individuals have used inhalants at least once.3 According to the Substance Abuse and Mental Health Services Administration, approximately 0.8% of the population 12 years or older reported using inhalants in the past year in 2019.4 The prevalence is highest among adolescents and young adults, with 1.4% of individuals aged 12 to 17 years reporting past-year inhalant use.4
