In early remission: After full criteria for inhalant use disorder were previously met, none of the criteria for inhalant use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, “Craving, or a strong de- sire or urge to use the inhalant substance,” may be met).
In sustained remission: After full criteria for inhalant use disorder were previously met, none of the criteria for inhalant use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the inhalant substance,” may be met).
Specify if:
In a controlled environment: This additional specifier is used if the individual is in an environment where access to inhalant substances is restricted.
Coding based on current severity: Note for |CD-10-CM codes: If an inhalant intoxication or another inhalant-induced mental disorder is also present, do not use the codes below for inhalant use disorder. Instead, the comorbid inhaIant use disorder is indicated in the 4th character of the inhalant—induced disorder code (see the coding note for inhalant intox- ication or a specific inhalant-induced mental disorder). For example, if there is comorbid inhalant—induced depressive disorder and inhalant use disorder, only the inhalant-induced depressive disorder code is given, with the 4th character indicating whether the comorbid inhalant use disorder is mild, moderate, or severe: F18.14 for mild inhalant use disorder disorder with inhalant-induced depressive disorder.
Specify current severity: 305.90 (F18.10) Mild: Presence of 2—3 symptoms.
304.60 (F18.20) Moderate: Presence of 4—5 symptoms.
304.60 (F1820) Severe: Presence of 6 or more symptoms.
This manual reeognizes volatile hydrocarbon use meeting the above diagnostic criteria as inhalant use disorder. Volatile hydrocarbons are toxic gases from glues, fuels, paints/ and other volatile compounds. When possible, the particular substance involved should be named (e.g., ”toluene use disorder”). However, most compounds that are inhaled are a mixture of several substances that can produce psychoactive effects, and it is often difficult to ascertain the exact substance responsible for the disorder. Unless there is clear evidence that a single, unmixed substance has been used, the general term inhalant should be used in recording the diagnosis. Disorders arising from inhalation of nitrous oxide or of amyl-, buty1-, or isobutylnitrite are considered as other (or unknown) substance use disorder.
"In a controlled environment” applies as a further specifier of remission if the individ- ual is both in remission and in a controlled environment (i.e., in early remission in a con- trolled environment or in sustained remission in a controlled environment). Examples of these environments are closely supervised and substance—free jails, therapeutic communi- ties, and locked hospital units.
The severity of individuals’ inhalant use disorder is assessed by the number of diag- nostic criteria endorsed. Changing severity of individuals’ inhalant use disorder across time is reﬂected by reductions in the frequency (e.g., days used per month) and / or dose (e.g., tubes of glue per day) used, as assessed by the individual’s self—report, report of oth- ers, clinician’s observations, and biological testing (when practical).
Features of inhalant use disorder include repeated use of an inhalant substance despite the individual’s knowing that the substance is causing serious problems for the individual (Criterion A9). Those problems are reﬂected in the diagnostic criteria.