Disorders due to use of volatile inhalants

Disorders Due to Use of Volatile Inhalants are characterized by the pattern and consequences of volatile inhalant use. Volatile inhalants include a range of compounds that are in the gaseous or vapour phase at ambient temperatures and include various organic solvents, glues, gasoline (petrol), nitrites and gases such as nitrous oxide, trichloroethane, butane, toluene, fluorocarbons, ether and halothane. They have a range of pharmacological properties but are predominantly central nervous system depressants, with many also having vasoactive effects. They tend to be used by younger persons and may be used when access to alternative psychoactive substances is difficult or impossible. Volatile Inhalant Intoxication is well recognized. Volatile inhalants have dependence-producing properties and Volatile Inhalant Dependence and Volatile Inhalant Withdrawal are recognized although comparatively uncommon worldwide. Volatile Inhalant-Induced Mental Disorders are described. They may also cause neurocognitive impairment, including Dementia.

Diagnostic Categories that Apply to Volatile Inhalants

Following is a list of specific diagnostic categories of that apply to volatile inhalants:

• 6C4B.0 Episode of Harmful Use of Volatile Inhalants
• 6C4B.1 Harmful Pattern of Use of Volatile Inhalants
• 6C4B.2 Volatile Inhalant Dependence
• 6C4B.3 Volatile Inhalant Intoxication
• 6C4B.4 Volatile Inhalant Withdrawal
• 6C4B.5 Volatile Inhalant-Induced Delirium
• 6C4B.6 Volatile Inhalant-Induced Psychotic Disorder
• 6C4B.70 Volatile Inhalant-Induced Mood Disorder
• 6C4B.71 Volatile Inhalant-Induced Anxiety Disorder
• 6C4B.Y Other Specified Disorder Due to Use of Volatile Inhalants
• 6C4B.Z Disorder Due to Use of Volatile Inhalants, Unspecified

Additional categories of disorders induced by psychoactive substances are included in other parts of the ICD-11 chapter on Mental, Behavioural, and Neurodevelopmental Disorders. They are cross-listed in the section below on Substance-induced Mental Disorders for reference. These categories include:

• 6D72.13 Amnestic Disorder Due to Use of Volatile Inhalants
• 6D84.2 Dementia Due to Use of Volatile Inhalants

The first three diagnoses listed above (Episode of Harmful Use of Volatile Inhalants, Harmful Pattern of Use of Volatile Inhalants, and Volatile Inhalant Dependence) describe the pattern of volatile inhalant use. One of these three diagnoses, or Disorder Due to Use of Volatile Inhalants, Unspecified, for cases in which the use pattern in unknown at the time of evaluation, is considered to be the primary diagnosis. That is, one of these four diagnoses should be assigned when making a diagnosis of a Disorder Due to Volatile Inhalant Use.

The remaining diagnoses reflect the impact of the pattern of volatile inhalant use and are thus considered to be associated with one of the primary use pattern diagnoses. These diagnoses should therefore be assigned together with the relevant primary diagnosis. For example, 6C4B.1/ 6C4B.5 is Harmful Pattern of Use of Volatile Inhalants associated with Volatile Inhalant-Induced Psychotic Disorder, 6C4B.2/6C4B.70 is Volatile Inhalant Dependence associated with Volatile Inhalant-Induced Mood Disorder, 6C4Z/6C4B.3 is Disorders Due to Substance Use, Unspecified associated with Volatile Inhalant Intoxication (i.e., the pattern of use in this last case is unknown).

Volatile Inhalant-induced Mental Disorders are characterized by psychological, cognitive, or behavioural symptoms that develop during or soon after volatile inhalant intoxication or withdrawal or use. The duration or severity of the symptoms is substantially in excess of the characteristic syndrome of Volatile Inhalant Intoxication or Volatile Inhalant Withdrawal.