Comorbidity of mental disorders and substance use: a brief guide for the primary care clinician
11.8 Major clinical issues with gambling and inhalant/ solvent use
11.8.1 Effects of solvents/ inhalants on problem gambling
- Inhalant use is relatively rare among people with problem gambling(464) and appears to be one of the least misused classes of substances reported by people with problem gambling(432, 485).
11.8.2 Interactions between solvents/ inhalants and therapeutic agents for problem gambling
- Inhalants can exacerbate the sedative effects of tricyclic antidepressants, and mood stabilisers (lithium and sodium valproate). This increases the risk of impaired driving and injury as well as overdosex.
- Most antidepressants reduce seizure threshold. Therefore, risks should be appraised prior to commencementx.
11.8.3 Management approaches to comorbid problem gambling and inhalant/ solvent use
- As with most other substances, inhalant users should be encouraged to try and reduce or cease use.
- In general, with respect to inhalant/solvent use(65):
- Outline the harms associated with inhalant/solvent use.
- Investigate polysubstance use as this is common.
- Standard CBT approaches to both sets of issues should be used, with particular attention to the development of:
- Assertiveness skills (refusal skills).
- Coping skills for controlling and managing emotions such as anger and sadness.
- Offer alternatives to inhalant use, for example, recreational activities.
- Community reinforcement approaches should be developed by mobilising the local health and welfare service system in individual care plans.
- Family interventions need to be considered, for example, increasing communication between the person and the family.
- Assertive outreach and follow-up may be required.