Comorbidity of mental disorders and substance use: a brief guide for the primary care clinician
9.8 Major clinical issues with eating disorders and inhalant/ solvent use
- People with eating disorders do not commonly use inhalants or solvents.
- There is no literature that sheds light on managing people with comorbid eating disorders and problems relating to inhalant/solvent use.
9.8.1 Effects of inhalants/ solvents on eating disorders
- People with eating disorders do not commonly use inhalants or solvents(347).
9.8.2 Interactions between inhalants/ solvents and therapeutic agents for eating disorders
- Inhalants can exacerbate the sedative effects of some antidepressants including tricyclic antidepressants and mirtazepinex.
- Most antidepressants reduce seizure threshold and tricyclic antidepressants can cause cardiac arrhythmias. Therefore, risks should be appraised prior to commencementx.
9.8.3 Management approaches to comorbid eating disorders and inhalant/ solvent use
- There appears to be no literature that sheds light on managing people with comorbid eating disorders and problems relating to 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.