sense of time (NIDA, 2019). Other short-term effects of halluci- nogens include increased blood pressure, tachypnea, hyperther- mia, loss of appetite, dry mouth, spiritual experiences, relaxation, uncoordinated movements, excessive sweating, panic, paranoia, psychosis, and bizarre behaviors (NIDA, 2019). Long-term effects include persistent psychosis and hallucinogen persistent percep- tion disorder, which are also evident in individuals with mental illness (NIDA, 2019). Dissociative hallucinogens Common dissociative drugs include the following: ● PCP (phencyclidine) was developed as a general anesthetic but is no longer used because of serious side effects. Now it is found in a variety of forms. ● Ketamine is a dissociative anesthetic for animals and humans. Unfortunately, much of it is obtained illegally from veterinary offices. This is also used as a date rape drug (NIDA, 2019). ● Dextromethorphan (DXM) is an over-the-counter cold and cough medicine. ● Salvia is a plant common to southern Mexico and Central and South America. This drug is ingested by chewing fresh leaves and drinking the extracted juice. Dissociative hallucinogens interfere with glutamate, which regu- lates pain perception, environmental response, emotion, and learning and memory (NIDA, 2019). Dissociative drugs can cause numbness, disorientation, loss of coordination, hallucinations, and increased blood pressure, heart rate, and body temperature; long-term effects cause speech problems, memory loss, weight loss, anxiety, and depression or suicidal thoughts (NIDA, 2019). PCP can be addictive. 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. In- halants 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 chang- es, memory loss, and decreased cognitive functioning may also develop. Inhalants can also cause lung damage with hypoxia, si- nus discharge, coughing, and cyanosis. Arrhythmias, heart block, and heart failure are also possible with inhalant use. Other medi- cal 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. ● There is a persistent desire or unsuccessful efforts to cut down or control hydrocarbon-based inhalant substance use.
Individuals demonstrating a problematic pattern of substance use which leads to significant impairment as manifested by two or more of the following over a 12-month period meet the criteria for a hallucinogen use disorder (PCP): ● PCP is taken in larger amounts than intended. ● There is a persistent desire or unsuccessful efforts to cut down or control PCP. ● A great deal of time is spent in activities to obtain PCP. ● Craving is an urge to use PCP. ● Recurrent PCP use results in a failure to fulfill work or home obligations. ● PCP use is continued despite persistent or recurrent interper- sonal problems. ● Important social, occupational, or recreational activities are given up or reduced due to stimulant use. ● Recurrent PCP use occurs in situations when physically hazard- ous. ● PCP use is continued despite the knowledge of having physi- cal or psychological problems that may have been caused or exacerbated by PCP. ● Tolerance develops: ○ A need for increased amounts of PCP to achieve intoxica- tion. ○ Diminished effect with continued use of the same amount of the stimulant. ● Withdrawal occurs: ○ Characteristic withdrawal syndrome for PCP. ○ PCP taken to relieve or avoid the withdrawal. (APA, 2013)
INHALANT USE DISORDER
● A great deal of time is spent in activities to obtain the hydro- carbon-based inhalant substance. ● Craving is an urge to use hydrocarbon-based inhalant sub- stances. ● 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 sub- stance use. ● Hydrocarbon-based inhalant substance use recurs in situa- tions when physically hazardous. ● Hydrocarbon-based inhalant substance use is continued de- spite the knowledge of having physical or psychological prob- lems that may have been caused or exacerbated by hydrocar- bon-based inhalant substances. ● Tolerance develops: ○ A need for increased amounts of a hydrocarbon-based in- halant 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 in- dividual, called sudden sniffing death . Individuals who try to quit inhalants may experience withdrawal symptoms including nau- sea, loss of appetite, diaphoresis, problems sleeping, and mood changes.
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