Inhalants withdrawal symptoms

Chronic use of inhalants can lead to the body s physical need for a drug, which is called dependence. Addiction is a psychological and physical disease, and dependence is a physical manifestation of the disease. The body adapts to the presence of the drug, and heavy users experience withdrawal if they stop using inhalants abruptly. Withdrawal symptoms indicate an abuser is physically dependent on inhalants. These symptoms have been reported to occur in approximately 50% to 60% of inhalant users. When they quit inhaling, withdrawal symptoms appear. The body has... 

Molander L, LuneU E, Andersson SB, Kuylenstiema F (1996) Dose released and absolute bioavaU-abUity of nicotine from a nicotine vapor inhaler. CUn Pharmacol Ther 59 394 00 Murphy JK, Edwards NB, Downs AD, Ackerman BJ, Rosenthal TL (1990) Effects of doxepin on withdrawal symptoms in smoking cessation. Am J Psychiatry 147 1353-1357 Nabi Biopharmaceuticals (2007). Nabi biopharmaceuticals announces positive results of phase Ilb trial of NicVAX. Medical News Today, 3 May 2007. See http //www.medicalnewstoday.com/ articles/69666.php, accessed October 11, 2007... 

Tolerance to inhalants can develop with frequent use, and withdrawal symptoms include sleep disturbance, irritability, jitteriness, sweating, nausea and vomiting, fast heart rate, and hallucinations or delusions. Withdrawal can last one month or longer, and the relapse rate is high. 

When a patient switches from oral or parenteral therapy to inhalation therapy, the systemic effect is reduced, just as if the dose of systemic glucocorticoid is reduced, and precautions should be taken to avoid withdrawal symptoms. 

The toxic chemicals in inhalants are stored in fatty tissue in the body for weeks. Thus, when long-term abusers attempt to quit, they may develop withdrawal symptoms several hours to a few days afterward. The Office of National Drug Control Policy and the American Academy of Pediatrics list these common withdrawal symptoms hand tremors, excessive sweating, constant... 

Much remains unknown about the physiology of withdrawal from various subcategories of inhalants and the best ways to address withdrawal symptoms. In early 2002, the National Institute on Drug Abuse, which had not funded a study specifically looking at treatment for inhalant abusers, was actively encouraging researchers to submit proposals in this area. 

And somewhat ironically, nitrous oxide appears to have some use as an treatment for withdrawal symptoms. Several South African studies have demonstrated the usefulness of nitrous oxide in treating withdrawal symptoms and reducing cravings during alcohol, marijuana, and nicotine detoxification. And in early 2002, a small study published in Clinical Psychiatry found that the gas may also be helpful in helping smokers kick the habit. Researchers found that 92% of patients who inhaled a 50%/50% mixture of nitrous oxide and oxygen... 

However, if the patient has also been abusing other inhalants, the detoxification period could conceivably take up to 40 days, depending on the chemicals involved. Withdrawal symptoms in inhalant abusers may include nausea, vomiting, muscle pain and cramping, chills and sweats, irritability, tremors, headaches, and hallucinations. Depending on the severity of the symptoms and the patient s physical condition, the controlled environment of a residential setting may be preferred for the detox period. 

Most inhalant abusers have tried to but are unable to quit, and have reported this to treatment facilities. In spite of knowing the adverse consequences of their continued use, addicted individuals continue using inhalants. Relapse into use of the drug because of withdrawal symptoms and desire for the drug can prevent addicted users from quitting. 

Lunell E, Molander L, Leischow SJ, Fagerstrom KO. Effect of nicotine vapour inhalation on the relief of tobacco withdrawal symptoms. Eur J Clin Pharmacol 1995 48(3-4) 235 0. 

Yes. This approach may be helpful with smokers who report persistent withdrawal symptoms during the course of pharmacotherapy or who desire long-term therapy. A minority of individuals who successfully quit smoking use ad libitum nicotine replacement medications (gum, nasal spray, inhaler) long term. The use of these medications long term does not present a known health risk. Additionally, the FDA has approved the use of bupropion SR for long-term maintenance. 

Despite the paucity of systematic studies in humans, the available evidence suggests that, like drugs such as alcohol, sedatives, and stimulants, inhalant drugs (i.e., solvents, general anesthetics, and nitrites) exert reinforcing effects and increase motor activity. Furthermore, with continuous use, these drugs appear to induce both tolerance and symptoms of withdrawal. 

During withdrawal, some patients may experience symptoms of steroid withdrawal (eg, joint or muscular pain, lassitude, depression) despite maintenance or even improvement of respiratory function. Encourage continuance with the inhaler, but observe for objective signs of adrenal insufficiency (eg, fatigue, lassitude, weakness, nausea and vomiting, hypotension). If adrenal insufficiency occurs, increase the systemic steroid dose temporarily and continue further withdrawal more slowly. During periods of stress or severe asthma attack, transfer patients will require supplementary systemic steroids. 

Treatment consists primarily of abstinence and symptomatic management of withdrawal or related disorders. Carbamazepine and haloperidol have equal efficacy for treating inhalant-induced psychotic disorder (Hernandez-Avila et al. 1998). Risperidone may effectively treat the psychotic symptoms and craving for inhalants (Misra et al. 1999). 

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