Comorbidity of mental disorders and substance use: a brief guide for the primary care clinician
3.6 Inhalants/ solvents
Inhalants and solvents are psychoactive drugs that are part of a class of volatile substances that give off gas or vapours at room temperature. They include a wide range of substances including petrol, spray paints and some glues as well as other chemicals such as butane.
The effects of inhalants or solvents vary greatly and depend on which substance is inhaled or sniffed. Most are absorbed rapidly and produce short-term effects similar to those of anaesthetics by depressing the central nervous system. When inhaled in sufficient concentrations, inhalants can cause intoxication and feelings of stimulation that are intense but usually only last a few minutes. This effect of intoxication can be extended for several hours by breathing in inhalants repeatedly. Repeated inhalations make users feel less inhibited and less in control. Users can lose consciousness with continued use.
Young people may use inhalants as they are cheaper and more easily accessible than alcohol. Long-term chronic inhalant users become difficult to treat due to cognitive impairment combined with multiple social and psychological issues.
Effects sought by user: Excitement, dizziness, exhilaration and feelings of self confidence.
Associated harms: Visual and auditory hallucinations, nausea, dullness, disorientation, loss of self control, blurred vision, drowsiness, lack of muscle coordination and slurring, red and watery eyes, cough, runny nose, short-term memory loss, mental confusion, thinking and learning problems, irritability, hostility, extreme tiredness, trembling, loss of control of fine movements, slowed reaction time, dizziness, chronic headaches, sinusitis and nosebleeds, spots/rash around the mouth and nose, indigestion and stomach ulcers, liver and kidney damage and hearing loss.
Permanent brain injury can occur from the use of solvents.
Overdose: More likely to occur with high concentration substances such as butane and occurs after repeated sniffing/inhalations in a single session. Tachyarrhythmias, heart failure and death can be directly induced within minutes of a session of repeated inhalation.
Delirium, fever, hallucinations, restlessness, seizures, confusion and unconsciousness can all occur with repeated sniffing. Death from hypoxia can occur through the displacement of oxygen in the lungs or by effects on haemoglobin oxygen binding.
Withdrawal: Headache, nausea, stomach and other muscle cramps, fatigue, tremors, hallucinations and visual disturbances, anxiety, depression, loss of appetite, irritation, aggressive behaviour and dizziness.
Psychological presentations commonly associated with use (likely to resolve on cessation of substance use): Paranoia and psychosis(60-62) and depression(63, 64).
For further information please consult:
National Directions on Inhalant Abuse Final Report(65).