Mental and Behavioural Health Clinical Reference Group

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Question 1: Are the following assumptions about the DSM-5 term 'inhalant' correct?:

  • does not describe a specific class of drugs defined in terms of molecular structure and/or mechanism of action
  • does not include drugs that are heated to inhale,  burned to smoke, or crushed to snort
  • includes only substances that are gases (volatile) at room temperature
  • includes only psycho-active substances - i.e., excludes drugs that exert their effects primarily via toxicity/cell damage v altering neural activity
  • includes pharmaceutical agents (e.g., nitrous oxide)
  • has the same meaning as the term 'volatile inhalant' used in ICD-11

Question 2:  Does a clinician diagnose a substance-induced mental disorder if the exposure to the substance is unintentional  - e.g., environmental or work-related exposure to fumes; atypical reaction to pharmaceutical agent used in the context of health care?

Thanks,

Piper


Contributors (2)

2 Comments

  1. Matt Cordell

    This looks like an old question, but I've only just come across it, and since there's no answer.
    My input as a non-clinician terminologist, who's handled some content requests in this space.

    I would expect the answer to Q1 is yes. With a couple of notes:

    • "substances that are gases (volatile) at room temperature" - Looking at the concepts we've added to the Australian extension, we haven't specified the physical state of the substance (gas), but it's implied to be the fumes. ie. Our concept is "Petrol inhalation abuse" rather than "Petrol fumes inhalation abuse". The fumes rather than the liquid aren't being inhaled. However, the liquid is what's typically handled. Make a liquid/gas distinction for such concepts, introduces unnecessary complexity.
    • "ihalants" are intentionally inhaled for their psychoactive response; I'm not aware of an inhalant with some other desirable (systemic?) effect (exclusively, doesn't affect neural activity).

    Q2, I would also expect yes (again with a non-clinician caveat). The disorder is caused by the substance. The mode of exposure might be useful, and could be subtypes. But the problem is the same. Knowing intentional exposure could be useful for additional (e.g. addiction) treatments.

    FYI, these are the concepts we've added (as required in Australia)

    1382521000168108 | Aerosol inhalation abuse (disorder) |
    1382531000168106 | Petrol inhalation abuse (disorder) |
    1382541000168102 | Paint inhalation abuse (disorder) |
    1382551000168100 | Butane inhalation abuse (disorder) |
    1382561000168103 | Nitrite inhalation abuse (disorder) |
    1382571000168109 | Nitrous oxide inhalation abuse (disorder) |
    1382581000168107 | Glue inhalation abuse (disorder) |

  2. Piper Allyn Ranallo

    Matt Cordell,

    Thanks for the thoughtful response.  

    Agree regarding the unnecessary complexity of introducing meaning around state of substance (gas/liquid).  I like your approach of using the term "inhalation" in the FSN (unambiguously describing how the substance gets into the body) rather than the term "inhalant" (which implies a class of substances that can be unambiguously defined).

    Best,

    Piper