Inhalant Use Disorder
Overview
Using inhalants for recreational purposes is most commonly seen in young adolescents, peaking around age 15, with numbers dropping each subsequent year. Experts suggest that using inhalants, or “huffing,” may be popular among younger people because of the fact that it’s easy to hide use and everyday household products are readily available (e.g., nail polish, lighter fluid, volatile solvents, whipped cream [for the nitrous oxide in the dispenser]). Comparatively few adults experience inhalant use disorder (formerly called inhalant abuse), but those who do may also experience depression, other mental health conditions, and suicidal ideation.
Inhalant use and inhalant intoxication1 can also be more dangerous than other drugs because, depending on the compound, death can occur even after one session of inhaling (via sudden sniffing death). Inhalant use disorder does not refer to the unintentional inhalation of these compounds or even to one experimental intentional use by an individual. Inhalant use disorder is the continued use of such inhalants over time. Use of inhalants can lead to long-term consequences, including damage to the brain or central nervous system.
Symptoms
The number of symptoms from the following list of possible inhalant use disorder symptoms helps the diagnosing professional decide the severity of the condition. Two to three symptoms qualify as mild, four to five symptoms moderate, and six or more can be classified as severe inhalant use disorder. The symptoms include:
- The individual desires to cut down or quit using inhalants but finds it difficult
- They inhale more inhalants than intended or use them for longer
- They continue craving inhalants
- Inhalant use interferes with function, with the individual spending less time doing previously enjoyed activities, neglecting tasks, or dropping out of social life
- The individual spends a significant amount of time acquiring, using, and recovering from the effects of inhalants
- Builds a tolerance2 to the inhalant, which means they require more to achieve the same effects
- Engages in high-risk behavior while using inhalants
- Continues using inhalants despite interpersonal, social, or physical problems caused by inhalant use
For family members who suspect someone of inhalant use, there are some common signs to look for:
- Noticing a chemical smell on their breath or clothing, unexplained staining on their hands or clothes
- They have irritation around the mouth or nose, including ulcers
- You find large amounts of empty containers hidden in the trash or in a child’s room (such as paint, glue bottles, aerosols, or lighter fluid)
- You notice behavioral changes, changes in friends, or declining school performance
- Frequent runny nose or nosebleeds
- Slurred speech
- You notice sudden rapid weight loss and significant loss of appetite
Causes
Research agrees that there isn’t a single cause for inhalant use disorder, addiction, or substance use disorders.3 Multiple causes exist that may lead to substance abuse, such as genetic predisposition if their parents have also struggled with addiction or a harmful environment where drug use is seen as acceptable.
Factors that contribute to substance abuse include:
- History of abusing other substances.
- Family history of addiction.
- Personal or family history of mental health conditions.
- Childhood abuse or neglect.
- Personal experience with violence and crime.
- Chronic exposure to the abuse of substances by friends or family members.
- Lacking healthy coping skills.
Inhalant use disorder risk factors
Some people seem to be more susceptible to using inhalants and developing inhalant use disorder, including:
- Teenagers (especially younger teens) are more likely to try inhalants.
- Individuals who may be unemployed or those who live in rural areas are more likely to use inhalants.
- People with other mental health conditions tend to use inhalants at a higher rate than the general population.
- Those who experience trauma like physical, mental, or sexual abuse or live in a high-risk household are at a greater risk for inhalant use.
Treatments
Treatment for inhalant use disorder may be a combination of psychotherapy, medication, and strong community support.
Therapy
Talk therapy, more specifically cognitive behavioral therapy (CBT),4 is the most common treatment for inhalant use disorder. Cognitive behavioral therapy is a form of therapy that identifies and targets negative thought and behavior patterns and offers a variety of tools to replace them with more positive patterns. A CBT therapist may also address any psychiatric disorders that may result from use (such as an inhalant-induced psychotic disorder).
There are no specific medications approved specifically for inhalant addiction. Some people with inhalant use disorder may experience undiagnosed mental disorders, such as anxiety, depression, or bipolar disorder, and medications may be prescribed by a licensed healthcare professional to treat these conditions. A healthcare provider may be able to help with any withdrawal symptoms, which inhalant users can report to their provider, whether they think they’re clinically significant or not.
It is important to consult a doctor or medical professional before beginning or changing any medication plan. It's also important to note that medication alone is not usually sufficient for treating inhalant addiction. Therapy is usually part of treatment.
Other Treatment Options for inhalant use disorder
In addition to CBT, family therapy can be beneficial for building a solid support team to help the individual experiencing addiction. A therapist can educate on ways family members can be there for the person with inhalant use disorder and offer support lovingly and healthily.
Support groups can be a helpful factor in recovery from inhalant use disorder. This can come in the form of a traditional 12-step program or through community outreach programs. The latter allows for a person experiencing addiction to interact and build social connections with other teens who are not users, as well as participate in fun social activities like hikes, movie nights, and dances.
A therapist will likely support their client by sharing and guiding them toward healthy self-care practices. Some of these may include:
- Building a strong social group of people who do not use inhalants and finding new hobbies and interests
- Avoiding people or situations that are connected to using
- Getting regular physical activity (this can help with mood regulation and reduce stress)
- Learning and implementing stress management or relaxation techniques such as meditation, visualization, or breathing exercises
Resources
Therapy is the most common and effective way to treat inhalant use disorder because it addresses the behaviors, thoughts, beliefs, and feelings around using. A licensed therapist can be a powerful partner in learning to manage emotions and change thoughts and behaviors. In addition, they can offer support through education on stress management, healthy lifestyle habits, and improving self-esteem.
It can be difficult in some geographical areas to find a specialization in therapy and someone with whom they connect and trust. Online therapy is a solution that allows a person to connect with a therapist who meets all of their needs, as online platforms pull from a vast pool of therapist candidates.
Online therapy platforms like BetterHelp offer a simple questionnaire that they use to match you with a licensed therapist who works with substance use disorders and allows you to change therapists without financial penalty if you decide you need something different. Therapy sessions are offered over video conferencing, messaging, or phone calls.
Here are some additional resources you can utilize for inhalant use disorder and other substance-related concerns:
- Substance Abuse And Mental Health Services Administration (SAMHSA)
- National Alliance On Mental Health (NAMI) Helpline
- National Institute on Drug Abuse
For those with thoughts of suicide, contact 988 Suicide & Crisis Lifeline at 988. Please also see our Get Help Now page for more immediate resources.
For help with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357).
Research
In a 2011 literature review, researchers concluded that despite the negative impact of inhalant use in adolescents and even adults- adults who experience inhalant use disorder were found to be at far greater risk for depression and suicidal ideation- the research into treatments and prevention for inhalant use disorder are not robust. The authors recommended that more studies investigate the effects of inhalants and treatment modalities to give healthcare professionals a clearer path to evidence-based care.
In a 2023 clinical assessment of inhalant use disorder, the author reiterated that despite the everyday use of inhalants, its use is one of the most overlooked and neglected forms of substance use. Because the use of chemical inhalants can permanently alter the adolescent brain, more research needs to be done in the prevention phase rather than simply the supportive aspect of treatment. The author recommends more education for physicians, children, parents, and teachers.
A 2016 literature synthesis echoed the previous study’s conclusion that more research is necessary but also reported that the preliminary studies on the disorder show that a multimodal approach is most effective in treating inhalant use. This includes CBT, family therapy, and activity and engagement programs as the first line of treatment. More severe presentations may require residential treatment programs.
Statistics
Here are a few key statistics on inhalant use:
- In the 2021 National Survey On Drug Use and Health, 0.8% of those aged 12 or older (2.2 million people) reported using inhalants in the previous 12 months.
- A 2022 report shared that in the past 12 months, an estimated 3.6% of 8th, 2.4% of 10th, and 1.8% of 12th graders reported using inhalants in the previous 12 months.
- Among those who reported in the National Survey On Drug Use and Health, 684,000 of those 12 and over who used inhalants in the past year were diagnosed with an inhalant use disorder.
- The Office of Justice presented the results of a study that showed most substance use treatment programs were effective at helping adolescents recover from substance use disorders by using a combination of CBT, motivational enhancement therapy, and family therapy.