INHALANT USE DISORDER
● There is a persistent desire or unsuccessful efforts to cut down or control hydrocarbon-based inhalant substance use. ● A great deal of time is spent in activities to obtain the hydrocarbon-based inhalant substance. ● Craving is an urge to use hydrocarbon-based inhalant substances. ● Recurrent hydrocarbon-based inhalant substance use results in a failure to fulfill work and home obligations. ● Hydrocarbon-based inhalant substance use continues despite persistent or recurrent interpersonal problems. ● Important social, occupational, or recreational activities are given up or reduced due to hydrocarbon-based inhalant substance use. ● Hydrocarbon-based inhalant substance use recurs in situations when physically hazardous. ● Hydrocarbon-based inhalant substance use is continued despite the knowledge of having physical or psychological problems that may have been caused or exacerbated by hydrocarbon-based inhalant substances. ● Tolerance develops: ○ A need for increased amounts of a hydrocarbon-based inhalant substance to achieve intoxication. ○ Diminished effect with continued use of the same amount of the hydrocarbon-based inhalant substance. ● Withdrawal: ○ Characteristic withdrawal syndrome for hydrocarbon- based inhalant substance. ○ Hydrocarbon-based inhalant substance taken to relieve or avoid the withdrawal. (APA, 2013) The individual can overdose on inhalants when the ingested drug causes a toxic reaction, resulting in harmful symptoms or death (NIDA, 2020). The concentration of chemicals can cause cardiac arrest within minutes, which can occur in an otherwise healthy individual, called sudden sniffing death . Individuals who try to quit inhalants may experience withdrawal symptoms including nausea, loss of appetite, diaphoresis, problems sleeping, and mood changes.
Inhalants produce chemical vapors that can be inhaled to induce psychoactive or mind-altering effects. The range of chemicals have a variety of pharmacologic effects found in hundreds of products (NIDA, 2022). Precise categorization of these products is difficult, but they generally are identified as volatile solvents, aerosols, gases, and nitrates: ● Solvents include paint thinner, gasoline, lighter fluid, and glue. ● Aerosols include spray paint, hair spray, and vegetable oil sprays. ● Gases include propane tanks, whipped cream aerosols; and butane lighters and nitrous oxide. ● Nitrates include room deodorizers and leather cleaner. (NIDA, 2022) People who use inhalants will abuse any available substance. Inhalants are CNS depressants and influence gamma- aminobutyric acid (GABA). Physiological effects of inhalant use include a variety of body functions. Most of the damage initially affects the brain, observed through tremors and uncontrolled shaking (Brannon, 2019). Headaches and seizures are common. Personality changes, memory loss, and decreased cognitive functioning may also develop. Inhalants can also cause lung damage with hypoxia, sinus discharge, coughing, and cyanosis. Arrhythmias, heart block, and heart failure are also possible with inhalant use. Other medical effects associated with inhalant use include gastrointestinal, liver, and kidney failure; bone marrow damage; and peripheral nervous system damage (Brannon, 2019). Psychological effects of inhalant use include impaired judgment, hyperactivity, aggressive behavior, speech problems, and increased accidents, especially unplanned suicides in children who use inhalants (Brannon, 2019). Individuals demonstrating a problematic pattern of substance use that leads to significant impairment as manifested by two or more of the following over a 12-month period meet the criteria for a hydrocarbon-based disorder: ● A hydrocarbon-based inhalant substance is taken in larger amounts than intended.
TOBACCO USE DISORDERS/VAPING
● An individual has a craving or strong desire or urge to use tobacco. ● Recurrent tobacco use involves failing to fulfill major work tobacco. ● Tobacco use continues despite having persistent, recurrent social and interpersonal problems caused by tobacco. ● Important social, occupational, or recreational activities are given up or reduced because of tobacco use. ● Recurrent tobacco use occurs in situations that are physically hazardous. ● Continued tobacco use occurs despite knowledge of persistent or recurrent psychological or physical problems. ● Tolerance means a need for a markedly increased amount to achieve intoxication and markedly diminished effect with continued use of the same amount of tobacco. ● Withdrawal occurs. (APA, 2013) Tobacco withdrawal Withdrawal symptoms are often a barrier to stopping tobacco use, often due to nicotine deprivation (APA, 2013). Withdrawal symptoms begin within 24 hours of abruptly quitting tobacco and include: ● Irritability, frustration, or anger. ● Anxiety. ● Difficulty concentrating.
Tobacco use is widespread in the United States, and its deleterious effects are well documented (NIDA, 2021; CDC, 2022). Smoking cigarettes leads to disease and disability in almost every organ in the body (CDC, 2022) including cancer, heart disease, stroke, lung disease, diabetes, and chronic obstructive pulmonary disease. Additionally, there is an increased risk for tuberculosis, eye diseases, and immune diseases (CDC,2022). Secondhand smoke also harms nonsmoking adults and children including stroke, lung cancer, sudden infant death syndrome, middle ear disease, worsening asthma, acute respiratory infections, and slowed lung growth (CDC, 2022). The strongest predictors of nicotine addiction are the time to first cigarette and total cigarettes per day (Lande, 2018). Cigarettes are a highly efficient drug delivery system. On average, the individual takes in 1-2 milligrams of nicotine per lit cigarette and takes 10 puffs over a 5-minute period. This equates to 200 hits of nicotine to the brain daily (CDC, 2022). The adrenaline rush increases blood pressure, respiration, and heart rate while stimulating reward pathways in the brain. While nicotine is addictive, multiple dosing is needed to prevent withdrawal symptoms. Tobacco use disorders are documented in the DSM-5 : ● An individual takes tobacco in larger amounts over a longer period than intended. ● The individual experiences a persistent desire or unsuccessful efforts to cut down on tobacco use. ● A great deal of time is spent in activities necessary to obtain tobacco.
● Increased appetite. ● Depressed mood. ● Insomnia. (APA, 2013)
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