eMedicine Specialties > Psychiatry > Addiction

Inhalant-Related Psychiatric Disorders: Follow-up

Author: Guy E Brannon, MD, Associate Clinical Professor of Psychiatry, Louisiana State University Health Sciences Center; Director, Adult Psychiatry Unit, Chemical Dependency Unit, Clinical Research, Brentwood Behavior Health Company
Coauthor(s): Jeanie McGee Gary, BS, Editorial Manager, Department of Neurosurgery, Louisiana State University Health Sciences Center in Shreveport
Contributor Information and Disclosures

Updated: Feb 5, 2008

Follow-up

Further Inpatient Care

  • Patients who represent a danger to themselves or to others, are gravely disabled, or are medically unstable require inpatient care, even if involuntary measures are needed.

Further Outpatient Care

  • Therapy should include interventions such as a 12-step program or chemical dependency counseling, cognitive behavior therapy, or rational-emotive therapy.
  • Continued pharmacotherapy may be indicated.
  • Patients may need to join Alcoholics Anonymous.

Inpatient & Outpatient Medications

  • Continued pharmacotherapy depends on the diagnosis and what medications were started in the hospital.

Transfer

  • Transfer to a medical/surgical hospital may be necessary.
  • If legal problems develop, transfer to prison, jail, or a juvenile detention center may be necessary.

Deterrence/Prevention

  • Educating students, educators, parents, those who abuse inhalants, and the community in general may help prevent further abuse and decrease experimentation with inhalants.
  • Early identification of the problem may help prevent continued abuse.

Complications

  • Social problems
  • Difficulty at work
  • Psychosis
  • Dementia
  • Anxiety
  • Mood disorders
  • Delirium
  • Legal problems
  • Death
  • Visual problems
  • Decreased coordination
  • Nausea or vomiting
  • Arrhythmias
  • Violence or aggression
  • Confusion or impaired judgment

Prognosis

  • The prognosis is fair if inhalants are used short-term.
  • The prognosis is poor if inhalants are used long-term.

Patient Education

Family education
  • If you suspect someone is huffing, call 911 immediately. Attempt to keep the patient calm.
  • Contact the poison control center for information if no emergency exists.
  • Inform the physician of the source of the inhalant (eg, gasoline, glue)
  • Children and adolescents need to be taught the purpose of household products, the proper use of the products, and precautions in the use of the products. Review the risk and consequences of abusing the household products.

Miscellaneous

Medicolegal Pitfalls

  • Failure to know local and state laws is a potential pitfall; persons who abuse inhalants may be placed in jail.

Special Concerns

  • HIV infection: Any person who engages in risky behavior that results in impaired judgment (eg, use of drugs, alcohol, inhalants) should be made aware of the risks associated with the acts, especially drug abuse that is known to occur in a subgroup of adolescents aged 12-17 years. Whether the impaired judgment leads to promiscuity, impaired cognitive functioning that can affect driving, or other activities in which accidents can be expected to occur, an awareness of the additional risk of HIV infection must be conveyed. Even tissue damage in the nose associated with huffing, which can cause nosebleeds, can put someone at risk.
  • Pregnancy: The use of inhalants can cause preterm labor, fetal growth retardation, low birth weight, and abnormalities similar to those associated with fetal alcohol syndrome. Other issues involve decreased cognition, speech, and motor ability for the child exposed to inhalants in utero.
  • Conduct disorder: Abuse may be more frequent and extensive, thus worsening treatment outcome.
  • Antisocial personality disorder: Abuse may be more frequent and extensive, thus worsening treatment outcome.
  • Chronicity and relapse: Inhalant-related psychiatric disorders may have a chronic and relapsing course, which can be difficult to treat and can be frustrating for both families and physicians. A nonjudgmental approach may decrease some of this frustration.
 


More on Inhalant-Related Psychiatric Disorders

Overview: Inhalant-Related Psychiatric Disorders
Differential Diagnoses & Workup: Inhalant-Related Psychiatric Disorders
Treatment & Medication: Inhalant-Related Psychiatric Disorders
Follow-up: Inhalant-Related Psychiatric Disorders
References
[ CLOSE WINDOW ]

References

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). 4th ed. Washington, DC: APA Press; 2000:257-64.

  2. National Inhalant Prevention Coalition. National Inhalant Prevention Coalition Web Site. Available at www.inhalants.org. Accessed Feb 4, 2008.

  3. Balster RL. Neural basis of inhalant abuse. Drug Alcohol Depend. Jun-Jul 1998;51(1-2):207-14. [Medline].

  4. Cheong R, Wilson RK, Cortese IC, Newman-Toker DE. Mothball withdrawal encephalopathy: case report and review of paradichlorobenzene neurotoxicity. Subst Abus. Dec 2006;27(4):63-7. [Medline].

  5. Courser MW, Holder HD, Collins D, Johnson K, Ogilvie K. An evaluation of retail outlets as part of a community prevention trial to reduce sales of harmful legal products to youth. Eval Rev. Aug 2007;31(4):343-63. [Medline].

  6. Deas D, Brown ES. Adolescent substance abuse and psychiatric comorbidities. J Clin Psychiatry. Jul 2006;67(7):e02. [Medline].

  7. Dinwiddie SH. Abuse of inhalants: a review. Addiction. Aug 1994;89(8):925-39. [Medline].

  8. Doogue M, Barclay M. Death due to butane abuse--the clinical pharmacology of inhalants. N Z Med J. Nov 11 2005;118(1225):U1732. [Medline].

  9. Edwards RW, Stanley L, Plested BA, Marquart BS, Chen J, Thurman PJ. Disparities in young adolescent inhalant use by rurality, gender, and ethnicity. Subst Use Misuse. 2007;42(4):643-70. [Medline].

  10. Espeland K. Identifying the manifestations of inhalant abuse. Nurse Pract. May 1995;20(5):49-50, 53. [Medline].

  11. Flanagan RJ, Ives RJ. Volatile substance abuse. Bull Narc. 1994;46(2):49-78. [Medline].

  12. Giovacchini RP. Abusing the volatile organic chemicals. Regul Toxicol Pharmacol. Mar 1985;5(1):18-37. [Medline].

  13. Hernandez-Avila CA, Ortega-Soto HA, Jasso A, et al. Treatment of inhalant-induced psychotic disorder with carbamazepine versus haloperidol. Psychiatr Serv. Jun 1998;49(6):812-5. [Medline].

  14. Jones HE, Balster RL. Inhalant abuse in pregnancy. Obstet Gynecol Clin North Am. Mar 1998;25(1):153-67. [Medline].

  15. Kaplan HI, Sadhock BJ. Kaplan and Sadhock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. 8th ed. Baltimore, Md: Williams & Wilkins; 1998:430-32.

  16. Korman M, Matthews RW, Lovitt R. Neuropsychological effects of abuse of inhalants. Percept Mot Skills. Oct 1981;53(2):547-53. [Medline].

  17. Kucuk NO, Kilic EO, Ibis E, et al. Brain SPECT findings in long-term inhalant abuse. Nucl Med Commun. Aug 2000;21(8):769-73. [Medline].

  18. Kurbat RS, Pollack CV Jr. Facial injury and airway threat from inhalant abuse: a case report. J Emerg Med. Mar-Apr 1998;16(2):167-9. [Medline].

  19. Kurtzman TL, Otsuka KN, Wahl RA. Inhalant abuse by adolescents(1). J Adolesc Health. Mar 2001;28(3):170-80. [Medline].

  20. Lacy BW, Ditzler TF. Inhalant abuse in the military: an unrecognized threat. Mil Med. Apr 2007;172(4):388-92. [Medline].

  21. Maxwell JC. Deaths related to the inhalation of volatile substances in Texas: 1988-1998. Am J Drug Alcohol Abuse. Nov 2001;27(4):689-97. [Medline].

  22. McGarvey EL, Clavet GJ, Mason W, Waite D. Adolescent inhalant abuse: environments of use. Am J Drug Alcohol Abuse. Nov 1999;25(4):731-41. [Medline].

  23. Meadows R, Verghese A. Medical complications of glue sniffing. South Med J. May 1996;89(5):455-62. [Medline].

  24. Misra LK, Kofoed L, Fuller W. Treatment of inhalant abuse with risperidone. J Clin Psychiatry. Sep 1999;60(9):620. [Medline].

  25. Muilenburg JL, Johnson WD. Inhalant use and risky behavior correlates in a sample of rural middle school students. Subst Abus. Dec 2006;27(4):21-5. [Medline].

  26. National Conference of State Legislatures. Unpublished Information on Inhalation Legislation through June 2000.

  27. National Institute on Drug Abuse. Inhalant Abuse Research Report. 2005.

  28. National Institute on Drug Abuse and University of Michigan. Monitoring the Future 2005 Data From In-School Surveys of 8th-, 10th-, and 12th-Grade Students. Dec 2005.

  29. Office of National Drug Control Policy. Drug Policy Information Clearinghouse, Street Terms: Drugs and the Drug Trade Inhalations Section.

  30. Oh SJ, Kim JM. Giant axonal swelling in "huffer's" neuropathy. Arch Neurol. Aug 1976;33(8):583-6. [Medline].

  31. Russe BR, McCoy CB, Barton JE. Recent findings concerning inhalant use. Chem Depend. 1980;4(1-2):113-26. [Medline].

  32. Santos de Barona M, Simpson DD. Inhalant users in drug abuse prevention programs. Am J Drug Alcohol Abuse. 1984;10(4):503-18. [Medline].

  33. Shen YC. Treatment of inhalant dependence with lamotrigine. Prog Neuropsychopharmacol Biol Psychiatry. Apr 13 2007;31(3):769-71. [Medline].

  34. Soderberg LS. Immunomodulation by nitrite inhalants may predispose abusers to AIDS and Kaposi's sarcoma. J Neuroimmunol. Mar 15 1998;83(1-2):157-61. [Medline].

  35. Weintraub E, Gandhi D, Robinson C. Medical complications due to mothball abuse. South Med J. Apr 2000;93(4):427-9. [Medline].

  36. Wu LT, Ringwalt CL. Inhalant use and disorders among adults in the United States. Drug Alcohol Depend. Oct 15 2006;85(1):1-11. [Medline].

  37. Young SJ, Longstaffe S, Tenenbein M. Inhalant abuse and the abuse of other drugs. Am J Drug Alcohol Abuse. May 1999;25(2):371-5. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

huffing, sniffing, bagging, volatile substance abuse, substance abuse, drug abuse, drug-induced psychosis, inhalant abuse, inhalant dependence, inhalant intoxication, substance intoxication delirium, substance-induced anxiety disorder, inhalant-related disorder NOS, inhalant-related disorder not otherwise specified, substance-induced psychotic disorder, depression, general anxiety disorder, sudden sniffing death syndrome

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Guy E Brannon, MD, Associate Clinical Professor of Psychiatry, Louisiana State University Health Sciences Center; Director, Adult Psychiatry Unit, Chemical Dependency Unit, Clinical Research, Brentwood Behavior Health Company
Guy E Brannon, MD is a member of the following medical societies: American Medical Association, American Medical Writers Association, American Psychiatric Association, American Society of Addiction Medicine, Association of Clinical Research Professionals, Louisiana State Medical Society, and Southern Medical Association
Disclosure: AstraZeneca Honoraria Speaking and teaching; Takeda Honoraria Speaking and teaching; Wyeth Honoraria Speaking and teaching; Janssen Honoraria Speaking and teaching

Coauthor(s)

Jeanie McGee Gary, BS, Editorial Manager, Department of Neurosurgery, Louisiana State University Health Sciences Center in Shreveport
Jeanie McGee Gary, BS is a member of the following medical societies: American Medical Writers Association
Disclosure: Nothing to disclose.

Medical Editor

Barry I Liskow, MD, Vice Chairman, Director Psychiatry Residency Program, Professor, Department of Psychiatry, University of Kansas Medical School
Barry I Liskow, MD is a member of the following medical societies: American Academy of Addiction Psychiatry
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Iqbal Ahmed, MBBS, Professor, Department of Psychiatry, John A Burns School of Medicine, University of Hawaii
Iqbal Ahmed, MBBS is a member of the following medical societies: Academy of Psychosomatic Medicine, American Association for Geriatric Psychiatry, American Neuropsychiatric Association, and American Psychiatric Association
Disclosure: Nothing to disclose.

CME Editor

Harold H Harsch, MD, Program Director of Geropsychiatry, Department of Geriatrics/Gerontology, Associate Professor, Department of Psychiatry and Department of Medicine, Froedtert Hospital, Medical College of Wisconsin
Harold H Harsch, MD is a member of the following medical societies: American Psychiatric Association
Disclosure: lilly Honoraria Speaking and teaching; BMS Honoraria Speaking and teaching; Forest Labs Honoraria Speaking and teaching; AstraZeneca Honoraria Speaking and teaching; Pfizer Grant/research funds Other; Northstar Grant/research funds Other; Novartis  Other

Chief Editor

Stephen Soreff, MD, President of Education Initiatives, Nottingham, NH; Faculty, Metropolitan College of Boston University, Boston, MA
Stephen Soreff, MD is a member of the following medical societies: American College of Mental Health Administration and American Psychosomatic Society
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.