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Inhalant-Related Psychiatric Disorders Treatment & Management

  • Author: Guy E Brannon, MD; Chief Editor: Iqbal Ahmed, MBBS, FRCPsych(UK)  more...
Updated: May 21, 2014

Medical Care

See the list below:

  • The medical care of patients with inhalant-related psychiatric disorders encompasses many areas.
    • A team of medical professionals must work in unison to ensure that every aspect of the treatment plan is fulfilled.
    • Patients likely require hospitalization. Especially if the patient is delirious, suicidal, homicidal, or gravely disabled. As inpatients, they may require the administration of medications (eg, haloperidol, risperidone, carbamazepine) to relieve any psychosis related to the chemicals inhaled.
    • Counseling (supportive therapy) should be initiated, along with patient education to explain the dangers of huffing. Evaluate patients for psychiatric comorbidity.
  • No controlled studies have been performed to guide the treatment of patients who abuse inhalants and who have inhalant dependence. Additionally, no specific medications indicated by the pharmaceutical industry are available for detoxification from inhalants.
  • Programs are available that specifically treat inhalant abuse; however, they are rare and difficult to find. Therefore, treatment planning most often is tailored much like that of the treatment of patients with chemical dependence, in which the first step is to detoxify the patient.
    • Patients who are addicted to inhalants experience withdrawal symptoms similar to those of any other patient addicted to drugs, including tremors, chills, sweats, cramps, nausea, and hallucinations.
    • Next, a peer system is established.
    • Once these 2 tasks are accomplished, assess the patient for physical, cognitive, and neurologic problems. If any problems are noted in these areas, they must be treated immediately. Identify any strengths the patient has and build on these strengths to increase them and to create new additional strengths for the patient. Address any other problems they may have. The goals are to return the patient to the community with a drug-free peer network and to continue or enhance self-support.
    • Treat any conduct problems noted.
    • Once the patient is detoxified, evaluate for other psychiatric illnesses using the DSM-IV-TR.
  • The patient should participate in group therapy sessions, 12-step programs/chemical dependency groups, rational-emotive therapy, cognitive behavior therapy, and family therapy.
  • Discuss safe sex with the patient, including partner precautions and birth control. In addition, the family should receive education about the disorder, secure substances that could be huffed, and become familiar with local mental health laws regarding commitment policies.
  • No medications should be used unless a treatable DSM-IV-TR diagnosis has been identified.
    • If the patient has depression independent of the inhalant abuse, treat with the antidepressant of choice.
    • If the patient abuses alcohol in addition to inhalants, disulfiram (Antabuse) or naltrexone can be used in appropriate settings.
    • If the patient meets DSM-IV-TR criteria for attention-deficit/hyperactivity disorder, a psychostimulant such as pemoline (Cylert) can be used for treatment. The United States Food and Drug Administration (FDA) concluded that the overall risk of liver toxicity from pemoline outweighs the benefits. In May 2005, Abbott chose to stop sales and marketing of their brand of pemoline (Cylert) in the United States. In October 2005, all companies that produced generic versions of pemoline also agreed to stop sales and marketing of pemoline.
    • If the patient is psychotic as a result of the inhalant abuse (inhalant-induced psychosis), the physician may use an appropriate antipsychotic such as haloperidol (Haldol) or risperidone (Risperdal), with or without a benzodiazepine. This is the physician's choice.
    • If the patient has an inhalant-induced mood disorder, detoxification is recommended, without the use of any medications unless the depression persists for longer than 2-4 weeks after withdrawal.
    • Detoxification is also recommended for patients who are experiencing inhalant-induced anxiety; however, the use of sedatives or antianxiety medications is contraindicated because inhalant intoxication can worsen if the patient uses again.
  • If the patient cannot maintain sobriety, the physician should consider residential treatment options, which can last anywhere from 3-12 months.
  • Most persons who abuse inhalants receive most of their medical care in local emergency departments after they have either passed out or become psychotic from chemical inhalation. In the emergency department, they receive supportive care, social interventions, and appropriate medical care.

Surgical Care

See the list below:

  • Patients may need liver or kidney transplantation.


See the list below:

  • Chemical dependence counselor
  • Attorney, if legal problems develop
  • Social worker
  • Family therapist
  • Peer-group therapist
  • Dietitian (possibly)


See the list below:

  • Consultation with a dietitian may be helpful if patients have poor nutrition (eg, liver problems, low protein).
  • If no additional medical problems are present, patients can eat a regular diet.


See the list below:

  • Maintain sobriety.
  • Patients who are not a danger to themselves or others, are not gravely disabled, and are medically stable can maintain routine activities.
Contributor Information and Disclosures

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

Disclosure: Received income in an amount equal to or greater than $250 from: Sunovion; Forest.


Jennifer M Thomas, MS, MA Clinical Research Coordinator, Louisiana Clinical Research, LLC

Jennifer M Thomas, MS, MA is a member of the following medical societies: Psi Chi

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Iqbal Ahmed, MBBS, FRCPsych(UK) Faculty, Department of Psychiatry, Tripler Army Medical Center; Clinical Professor of Psychiatry, Uniformed Services University of the Health Sciences; Clinical Professor of Psychiatry, Clinical Professor of Geriatric Medicine, University of Hawaii, John A Burns School of Medicine

Iqbal Ahmed, MBBS, FRCPsych(UK) is a member of the following medical societies: Academy of Psychosomatic Medicine, American Neuropsychiatric Association, American Society of Clinical Psychopharmacology, Royal College of Psychiatrists, American Association for Geriatric Psychiatry, American Psychiatric Association

Disclosure: Nothing to disclose.

Additional Contributors

Barry I Liskow, MD Professor of Psychiatry, Vice Chairman, Psychiatry Department, Director, Psychiatric Outpatient Clinic, The University of Kansas Medical Center

Disclosure: Nothing to disclose.

  1. Howard MO, Bowen SE, Garland EL, Perron BE, Vaughn MG. Inhalant use and inhalant use disorders in the United States. Addict Sci Clin Pract. 2011 Jul. 6(1):18-31. [Medline]. [Full Text].

  2. Baydala L. Inhalant abuse. Paediatr Child Health. 2010 Sep. 15(7):443-54. [Medline]. [Full Text].

  3. Ahern NR, Falsafi N. Inhalant abuse: youth at risk. J Psychosoc Nurs Ment Health Serv. 2013 Aug. 51(8):19-24. [Medline].

  4. Phatak DR, Walterscheid J. Huffing air conditioner fluid: a cool way to die?. Am J Forensic Med Pathol. 2012 Mar. 33(1):64-7. [Medline].

  5. Praharaj SK, Kongasseri S. Naphthalene addiction. Subst Abus. 2012. 33(2):189-90. [Medline].

  6. Takagi MJ, Yücel M, Lubman DI. The dark side of sniffing: paint colour affects intoxication experiences among adolescent inhalant users. Drug Alcohol Rev. 2010 Jul. 29(4):452-5. [Medline].

  7. Youth Use of Inhalants and Aerosols - State Laws 2010. National Conference of State Legislatures. Available at

  8. Howard MO, Bowen SE, Garland EL, Perron BE, Vaughn MG. Inhalant use and inhalant use disorders in the United States. Addict Sci Clin Pract. 2011 Jul. 6(1):18-31. [Medline]. [Full Text].

  9. Howard MO, Perron BE, Sacco P, Ilgen M, Vaughn MG, Garland E. Suicide ideation and attempts among inhalant users: results from the national epidemiologic survey on alcohol and related conditions. Suicide Life Threat Behav. 2010 Jun. 40(3):276-86. [Medline].

  10. Sakai JT, Hall SK, Mikulich-Gilbertson SK, Crowley TJ. Inhalant use, abuse, and dependence among adolescent patients: commonly comorbid problems. J Am Acad Child Adolesc Psychiatry. 2004 Sep. 43(9):1080-8. [Medline].

  11. Garland EL, Howard MO. Volatile substance misuse : clinical considerations, neuropsychopharmacology and potential role of pharmacotherapy in management. CNS Drugs. 2012 Nov. 26(11):927-35. [Medline].

  12. Whitt A, Garland EL, Howard MO. Helium inhalation in adolescents: characteristics of users and prevalence of use. J Psychoactive Drugs. 2012 Nov-Dec. 44(5):365-71. [Medline].

  13. 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.

  14. Duncan JR, Lawrence AJ. Conventional concepts and new perspectives for understanding the addictive properties of inhalants. J Pharmacol Sci. 2013. 122(4):237-43. [Medline].

  15. Baird CA, Furek MW. Adolescents and inhalant abuse: how huffing affects the myelin sheath. J Addict Nurs. 2012 May. 23(2):129-31. [Medline].

  16. Takagi M, Lubman DI, Walterfang M, Barton S, Reutens D, Wood A, et al. Corpus callosum size and shape alterations in adolescent inhalant users. Addict Biol. 2013 Sep. 18(5):851-4. [Medline].

  17. Tsao JH, Hu YH, How CK, Chern CH, Hung-Tsang Yen D, Huang CI. Atrioventricular conduction abnormality and hyperchloremic metabolic acidosis in toluene sniffing. J Formos Med Assoc. 2011 Oct. 110(10):652-4. [Medline].

  18. Bowen SE. Two serious and challenging medical complications associated with volatile substance misuse: sudden sniffing death and fetal solvent syndrome. Subst Use Misuse. 2011. 46 Suppl 1:68-72. [Medline].

  19. Hsu CK, Chen YQ, Lung VZ, His SC, Lo HC, Shyu HY. Myelopathy and polyneuropathy caused by nitrous oxide toxicity: a case report. Am J Emerg Med. 2012 Jul. 30(6):1016.e3-6. [Medline].

  20. McCabe A, McCann B, Kelly P. Pop goes the O2: a case of popper-induced methaemoglobinamia. BMJ Case Rep. 2012 Nov 21. 2012:[Medline].

  21. Vilar-López R, Takagi M, Lubman DI, et al. The effects of inhalant misuse on attentional networks. Dev Neuropsychol. 2013. 38(2):126-36. [Medline].

  22. National Inhalant Prevention Coalition. National Inhalant Prevention Coalition Web Site. Available at Accessed: Feb 4, 2008.

  23. Substance Abuse and Mental Health Services Administration, Office of Applied Studies. The NSDUH Report: Trends in Adolescent Inhalant Use: 2002 to 2007. March 16, 2009. Available at

  24. Kay J, Lieberman JA, Tasman A. Inhalant Use Disorders. Psychiatry: behavioral science and clinical essentials. 1st. Philadelphia, Penn: WB Saunders Company; 2000. 263-269.

  25. Substance Abuse and Mental Health Services Administration, Office of Applied Studies. 2006. Youth Violence and Illicit Drug Use. U.S. Department of Health and Human Services. Available at

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

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

  28. 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. 2007 Aug. 31(4):343-63. [Medline].

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

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

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

  32. 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].

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

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

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

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

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

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

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

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

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

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

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

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

  45. McDermott MJ, Drescher CF, Smitherman TA, et al. Prevalence and sociodemographic correlates of lifetime substance use among a rural and diverse sample of adolescents. Subst Abus. 2013. 34(4):371-80. [Medline].

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

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

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

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

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

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

  52. 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.

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

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

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

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

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

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

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

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

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

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