Environmental. Inhalant gases are widely and legally available, increasing the risk of mis- use. Childhood maltreatment or trauma also is associated with youthful progression from inhalant non-use to inhalant use disorder.
Genetic and physiological. Behavioral disinhibition is a highly heritable general propensity to not constrain behavior in socially acceptable ways, to break social norms and rules, and to take dangerous risks, pursuing rewards excessively despite dangers of adverse consequences.
Youths with strong behavioral disinhibition show risk factors for inhalant use disorder: early- onset substance use disorder, multiple substance involvement, and early conduct problems.
Because behavioral disinhibition is under strong genetic inﬂuence, youths in families with substance and antisocial problems are at elevated risk for inhalant use disorder.
Certain native or aboriginal communities have experienced a high prevalence of inhalant problems. Also, in some countries, groups of homeless children in street gangs have ex- tensive inhalant use problems.
Although the prevalence of inhalant use disorder is almost identical in adolescent males and females, the disorder is very rare among adult females.
Urine, breath, or saliva tests may be valuable for assessing concurrent use of non-inhalant substances by individuals with inhalant use disorder. However, technical problems and the considerable expense of analyses make frequent biological testing for inhalants them- selves impractical.
Functional Consequences of Inhalant Use Disorder
Because of inherent toxicity, use of butane or propane is not infrequently fatal. Moreover, rhythmia. Fatalities may occur even on the first inhalant exposure and are not thought to be dose-related. Volatile hydrocarbon use impairs neurobehavioral function and causes various neurological, gastrointestinal, cardiovascular, and pulmonary problems.
Long-term inhalant users are at increased risk for tuberculosis, HIV/AIDS, sexually transmitted diseases, depression, anxiety, bronchitis, asthma, and sinusitis. Deaths may occur from respiratory depression, arrhythmias, asphyxiation, aspiration of vomitus, or accident and injury.
Inhalant exposure (unintentional) from industrial or other accidents. This designation is used when findings suggest repeated or continuous inhalant exposure but the involved individual and other informants deny any history of purposeful inhalant use.
Inhalant use (intentional), without meeting criteria for inhalant use disorder. Inhalant use is common among adolescents, but for most of those individuals, the inhalant use does not meet the diagnostic standard of two or more Criterion A items for inhalant use disorder in the past year.
Inhalant intoxication, without meeting criteria for inhalant use disorder. Inhalant intox- uals whose use does not meet criteria for inhalant use disorder, which requires at least two of the 10 diagnostic criteria in the past year.
Inhalant-induced disorders (i.e., inhalant-induced psychotic disorder, depressive dis- order, anxiety disorder, neurocognitive disorder, other inhalant-induced disorders) without meeting criteria for inhalant use disorder. Criteria are met for a psychotic, de- pressive, anxiety, or major neurocognitive disorder, and there is evidence from history, physical examination, or laboratory findings that the deficits are etiologically related to the effects of inhalant substances. Yet, criteria for inhalant use disorder may not be met (i.e., fewer than 2 of the 10 criteria were present).
Other substance use disorders, especially those involving sedating substances (e.g., alcohol, benzodiazepines. barbiturates). Inhalant use disorder commonly co-occurs with other substance use disorders, and the symptoms of the disorders may be similar and overlapping. To disentangle symptom patterns, it is helpful to inquire about which symp- toms persisted during periods when some of the substances were not being used.