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New guidelines to shape Tx for inhalant abuse. (Treatment Often Complicated).

WASHINGTON -- Treating patients who abuse inhalants is more complicated than treating those who abuse other drugs, a new advisory says.

That's because inhalant abuse patients often abuse other drugs and "have a chaotic family life, low self-esteem, poor academic records, personality disorders, and poor cognitive function," according to the advisory.

The advisory and a draft of what will be the first guidelines for the care of people who abuse inhalants were released at a press briefing sponsored by the National Inhalant Prevention Coalition in Washington.

The purpose of the advisory, issued by the Substance Abuse and Mental Health Services Administration (SAMSHA) and a coalition of private organizations, is to help treatment professionals and other health care providers "broaden the field's understanding about inhalant use issues," said Dr. H. Westley Clark, director of SAMSHA's Center for Substance Abuse Treatment (Substance Abuse Treatment Advisory 3[1]:2003).

Officials at the briefing noted that about 141,000 people now use or are dependent on inhalants; half are 12-17 years old.

Stephen Pasierb, president and chief executive officer of Partnership for a Drug Free America, said nearly one in five kids in America at some point in adolescence has tried inhalants. A total of 4.5 million teenagers have tried them, he said.

Inhalants are either sniffed through the nose or inhaled as fumes through the mouth (known as "huffing"). Commonly abused substances include glue, nail polish, markers, correction fluid, paint thinner, and gasoline. Laughing gas and amyl nitrite ("poppers") can also be abused, as can hairspray and other aerosols.

Not only do many of the youth involved in huffing also abuse other substances, they have the freedom to continue to huff without the threat of being detected, Dr. Clark said at the briefing. As such, treatment is more complicated and requires "a unique set of treatment protocols to address the unique needs of inhalant users."

Although inhalant use among students in grades 8, 10, and 12 is at its lowest level in 20 years, concern among officials is growing, because surveys show that the perceived risk of inhalants is decreasing among younger children.

Inhalants can cause an immediate "rush," followed by a loss of self-control, nausea and vomiting, giddiness, loss of appetite, or in some cases, sudden death. Chronic use can cause heart, lung, kidney, liver, and peripheral nerve damage and mental impairment, and can lead to death.

At the press briefing, Dr. Clark advised physicians to be alert to the signs of inhalant abuse, which can include runny nose and eyes; spots or sores on the mouth; chemical breath odor; a drunk, dazed, or dizzy appearance; and anxiety and irritability.

According to the draft guidelines, young users "are typically more depressed, more anxious, feel that they are blamed, and experience greater anger than other youth. It is likely that the emotional and social problems predated inhalant use and it is an attempt to cope with these problems."

The guidelines are still in draft form, but they are not expected to change much before they are completed later this spring, according to Harvey Weiss, founder and executive director of the National Inhalant Prevention Coalition. Draft guidelines can be Viewed online at

Typical programs for alcohol and drug abuse are ineffective for inhalant abusers, according to the guidelines. Because users may be abusing more than one substance, a rigorous assessment and a thorough patient history are essential, and medical care for physical conditions may be necessary.
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Author:Defino, Theresa
Publication:Clinical Psychiatry News
Geographic Code:1USA
Date:Apr 1, 2003
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