Comorbidity of mental disorders and substance use: a brief guide for the primary care clinician
6.8 Major clinical issues with anxiety disorders and inhalent/ solvent use
Table of contents
- Acknowledgments
- Abbreviations
- Preface
- Introduction
1. Levels of evidence- 2. Management of people with comorbidity of mental disorders and substance use
- 3. The common drug groups
- 4. Tobacco
- 5. Depression and substance use
6. Anxiety disorders and substance use- 6.1 Anxiety
- 6.2 Comorbidity with anxiety disorders
- 6.3 Major clinical issues with anxiety disorders and cannabis/ hallucinogen use
- 6.4 Major clinical issues with anxiety disorders and alcohol use
- 6.5 Major clinical issues with anxiety disorders and opioid use
- 6.6 Major clinical issues with anxiety disorders and stimulant (including methamphetamine) use
- 6.7 Major clinical issues with anxiety disorders and benzodiazepine use
- 6.8 Major clinical issues with anxiety disorders and inhalent/ solvent use
- 7. Psychosis (schizophrenia and bipolar disorder) and substance use
- 8. Personality disorders and substance use
- 9. Eating disorders and substance use
- 10. Somatoform disorders and substance use
- 11. Gambling and substance use
- 12. Brain injury, mental disorders and substance use
- 13. Bibliography
- 14. Appendices
- Inhalant users have higher rates of anxiety disorders.
- The sedative effects of antidepressants and benzodiazepines may be exacerbated by inhalants and may possibly result in severe sedation and overdose.
- As with most other substances, inhalant users should be encouraged to reduce or cease use to observe whether anxiety symptoms resolve.
6.8.1 Effects of inhalants/ solvents on anxiety disorders
- Inhalant users have higher rates of anxiety disorders. Causal relationships are unclear(249, 250).
6.8.2 Interactions between inhalants/ solvents and therapeutic agents for anxiety disorders
- The sedative effects of antidepressants and benzodiazepines may be exacerbated by inhalants and may possibly result in severe sedation and overdosex.
- Most antidepressants lower seizure threshold and tricyclic antidepressants can cause cardiac arrhythmias. Therefore, risks should be appraised prior to commencementx.
6.8.3 Management approaches to comorbid anxiety disorders and inhalant/ solvent use
- There is no literature that sheds light on managing people with both anxiety and inhalant/solvent use related problems.
- As with most other substances, inhalant users should be encouraged to reduce or cease use to observe whether anxiety symptoms resolve.
- 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.
- 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.
