DSM-IV

For more information, see Substance Intoxication

The essential feature of Inhalant Intoxication is the presence of clinically significant maladaptive behavioral or psychological changes (e.g., belligerence, assaultiveness, apathy, impaired judgement, impaired social or occupational functioning) that develop during, or shortly after, the intentional use of, or short-term, high-dose exposure to, volatile inhalants (Criteria A and B). The maladaptive changes are accompanied by signs that include dizziness or visual disturbances (blurred vision or diplopia), nystagmus, incoordination, slurred speech, an unsteady gait, tremor, and euphoria, Higher doses of inhalants may lead to the development of lethargy and psychomotor retardation, generalized muscle weakness, depressed reflexes, stupor, or coma (Criterion C). The disturbance must not to due to a general medical condition and is not better accounted for by another mental disorder (Criterion D).

Diagnostic Criteria

A. Recent intentional use or short-term, high-dose exposure to volatile inhalants (excluding anesthetic gases and short-acting vasodilators).

B. Clinically significant maladaptive behavioral or psychological changes (e.g., belligerence, assaultiveness, apathy, impaired judgement, impaired social or occupational functioning) that developed during, or shortly after, use of or exposure to volatile inhalants.

C. Two (or more) of the following signs, developing during, or shortly after, inhalant use or exposure:

  1. dizziness
  2. nystagmus
  3. incoordination
  4. slurred speech
  5. unsteady gait
  6. lethargy
  7. depressed reflexes
  8. psychomotor retardation
  9. tremor
  10. generalized muscle weakness
  11. blurred vision or diplopoa
  12. stupor or coma
  13. euphoria

D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder.

DSM-5

Diagnostic Criteria

A. Recent intended or unintened short-term, high-dose exposure to inhalant substances, including volatile hydrocarbons such as toluene or gasoline.

B. Clinically significant problematic behavioral or psychological changes (e.g., belligerance, assaultiveness, apathy, impaired judgement) that developed during, or shortly after, exposure to inhalants.

C. Two (or more) of the following signs or symptoms developing during, or shortly after, inhalant use or exposure:

  1. Dizziness.
  2. Nystagmus.
  3. Incoordination.
  4. Slurred speech.
  5. Unsteady guilt.
  6. Lethargy.
  7. Depressed reflexes.
  8. Psychomotor retardation.
  9. Tremor.
  10. Generalized muscle weakness.
  11. Blurred vision or diplopia.
  12. Stupor or coma.
  13. Euphoria.

D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication with another substance.

Differential Diagnosis

Inhalant exposure, without meeting the criteria for inhalant intoxication disorder

The individual intentionally or unintentionally inhaled substances, but the dose was insufficient for the diagnostic criteria for inhalant use disorder to be met.

Intoxication and other substance/medication-induced disorders from other substances, especially from sedating substances (e.g., alcohol, benzodiazepines, barbiturates)

These disorders may have similar signs and symptoms, but the intoxication is attributable to other intoxicants that may be identified via a toxicology screen. Differentiating the source of the intoxication may involve discerning evidence of inhalant exposure as described for inhalant use disorder. A diagnosis of inhalant intoxication may be suggested by possession, or lingering odors, of inhalant substances (e.g., glue, paint thinner, gasoline, butane lighters); paraphernalia possession (e.g., rags or bags for concentrating glue fumes); perioral or perinasal "glue-sniffer's rash"; reports from family or friends that the intoxicated individual possesses or uses inhalants; apparent intoxication despite negative results in standard drug screens (which usually fail to identify inhalants); apparent intoxication occurring in that age range with the highest prevalence of inhalant use (12-17 years); association with others known to use inhalants; membership in certain small communities with prevalent inhalant use (e.g., some native or aboriginal communities, homeless street children and adolescents); or unusual access to certain inhalant substances.

Other inhalant-related disorders

Episodes of inhalant intoxication do occur during, but are not identical with, other inhalant-related disorders. Those inhalant-related disorders are recognized by their respective diagnostic criteria; inhalant use disorder, inhalant-induced neurocognitive disorder, inhalant-induced psychotic disorder, inhalant-induced depressive disorder, inhalant-induced anxiety disorder, and other inhalant-induced disorders.

Other toxic, metabolic, traumatic, neoplastic, or infectious disorders that impair brain function and cognition

Numerous neurological and other medical conditions may produce the clinically significant behavioral or psychological changes (e.g., belligerence, assaultiveness, apathy, impaired judgement) that also characterize inhalant intoxication.

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