Comorbidity of mental disorders and substance use: a brief guide for the primary care clinician
8.8 Major clinical issues with personality disorders and inhalant/ solvent use
- Inhalant users have high rates of personality disorders with early-onset inhalant use in particular being strongly associated with personality disorders.
- Inhalants will exacerbate the sedative effects of carbamazepine, lithium, sodium valproate and antidepressants such as tricyclics.
- Inhalant users should be encouraged to try and reduce or cease use.
8.8.1 Effects of inhalants/ solvents on personality disorders
- Inhalant users have high rates of personality disorders with early onset inhalant use, in particular, being strongly associated with personality disorders(250).
8.8.2 Interactions between inhalants/ solvents and therapeutic agents for personality disorders
- Inhalants will exacerbate the sedative effects of carbamazepine, lithium, sodium valproate and antidepressants such as tricyclicsx.
8.8.3 Management approaches to comorbid personality disorders 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.