Inhalant-related disorders are a category of disorders—including inhalant intoxication and inhalant-use disorder—that involve the abuse of glue, paint, lighter fluid, or other substances or volatile hydrocarbons to generate a high through inhaling.
Inhalants are breathed in through the mouth (commonly known as huffing) or sniffed or snorted through the nose; the high that users experience typically lasts only for a few minutes. Although addiction to inhalants is not common, exposure to inhalants can have long-term effects as chemicals remain in the body, potentially causing damage to the kidneys and liver, as well as nerve fibers and brain cells.
Inhalant-related disorders share some of the defining features of addiction. They directly and intensely stimulate the reward and reinforcement systems of the brain, spurring compulsive use that can lead to the neglect of normal activities and negative consequences. Unlike some other substances and classes of drugs, though, individuals generally do not experience withdrawal symptoms when they give up inhalants.
According to the DSM-5, inhalant intoxication occurs when exposure to a high dose of inhalant substances, whether intended or unintended, causes clinically significant behavioral or psychological changes such as belligerence, aggressiveness, apathy, euphoria, and impaired judgment, as well as two or more physical symptoms including:
- poor coordination
- slurred speech
- unsteady walk
- slow movement or reflexes (psychomotor retardation)
- muscles weakness
- blurred vision
- stupor or coma
Inhalant Use Disorder
According to the DSM-5, inhalant-use disorder is diagnosed when repeated use of inhalants leads to clinically significant impairment or distress, or when a problematic pattern of intoxication develops.
The disorder may be diagnosed when at least two of the following symptoms are present over a 12-month period:
- a strong craving or urge to use inhalants
- a strong desire to cut down on inhalant use, or unsuccessful efforts to do so
- spending a lot of time obtaining, using, or recovering from the effects of an inhalant
- continuing to use inhalants despite problems they cause in major areas of life, such as work, school, family life, or personal relationships
- giving up important social, career, or recreational activities because of inhalant use
- using inhalants repeatedly despite awareness of the physical hazards
- needing an increasing amount of the inhalant to become intoxicated or reach the desired high
How common is inhalant use?
The use of inhalants for intoxication is not common in the general population, occurring in about 0.8 percent of all Americans over the age of 12. But its prevalence is higher among younger adults, and especially in people between 12 and 17. According to 2020 research from the National Institute on Drug Abuse, in the prior 12 months, about 6 percent of American eighth-graders had used inhalants, along with 3 percent of tenth-graders and 1 percent of twelfth-graders. The institute estimates that 12.6 percent of current American eighth-graders will use inhalants at least once in their lifetime. However, only about 0.4 percent of adolescents progress to inhalant use disorder. Inhalant use is much rarer in older adults.
Is inhalant use more common among men or women?
In the general population, males are slightly more likely to use inhalants, but in the age group most likely to use—those between the ages of 12 and 17—it is slightly more common among females than males.
Can inhalant use lead to other disorders?
Yes. Long-term inhalant users are at increased risk for tuberculosis, HIV/AIDS, sexually transmitted diseases, depression, anxiety, bronchitis, asthma, and sinusitis. The use of inhalants can in some cases lead to a range of other psychological conditions as well. According to the DSM-5, inhalant use can cause inhalant-induced psychotic disorder; inhalant-induced depressive disorder; inhalant-induced anxiety disorder; in­halant-induced major or mild neurocognitive disorder; and inhalant intoxication delirium. These disorders are diagnosed when symptoms in inhalant users are especially severe and fit the diagnostic descriptions of the related disorders.
Can inhalant abuse cause death?
Yes. Death from inhalants can occur as early as one’s first use, and does not appear to be related to the dosage. The use of inhaled substances in a closed container, such as a plastic bag over the head, may lead to unconsciousness, anoxia, and death. Separately, “sudden sniffing death,” likely from cardiac arrhythmia or arrest, may occur after the use of some volatile inhalants. Deaths may also occur from asphyxiation, choking on vomit, or accident and injury. The enhanced toxicity of certain volatile inhalants, such as butane or propane, can increase the risk of fatality.
The majority of inhalant users are under the age of 18, and in this cohort, family dysfunction and easy access are common predictors of inhalant use. Many abused inhalants are common household goods, readily accessible and relatively inexpensive, including spray paint, nail polish remover, white-out, marker, gasoline, glue, keyboard cleaner, shoe polish, and aerosol sprays.
Inhalant abuse is often associated with poverty, family dysfunction, and child abuse. Since inhalants provide a very short “high,” users often inhale a product repeatedly, increasing the physical risk and the likelihood of developing inhalant-use disorder.
Inhalant use disorder is more common in young people with adolescent conduct disorder and in adults with antisocial personality disorder. Adult inhalant use and inhalant use disorder are strongly associated with suicidal ideation and suicide attempts.
Is one’s likelihood of inhalant use genetically determined?
It is not possible to know the degree to which genetics contribute to this behavior. However, the propensity to resist social norms and to take dangerous risks is considered heritable. Young people with strong behavioral disinhibition, or who are in families with substance and antisocial problems, therefore also have risk factors for inhalant use disorder, as well as early-onset substance use disorder. They may also be more likely to abuse multiple substances.
The best ways to prevent, intervene with, and treat inhalant abuse are not clear; more research is needed on this category of substance abuse. Educational campaigns about the safe storage of household products and the physical and psychological risks of inhalant use, as well as laws barring the sale of certain inhalants to children under the age of 18, may eventually help to lower use, but today use remains common among adolescents.
Inhalant abuse may not receive clinical attention until an individual needs to be treated in an emergency room, where doctors must first treat the seizures and heart stoppage caused by inhalant overdose.
Extended therapeutic treatment, once the disorder is identified, includes cognitive behavioral therapy and family therapy involving both the individual and their loved ones.
Do people outgrow inhalant use?
Often, they do. Use tends to decline, often dramatically, in people as they emerge from adolescence and progress through their 20s. But those who develop inhalant use disorder that extends into adulthood often face severe problems, including sometimes multiple substance use disorders, antisocial personality disorder, and suicidal ideation with attempts.