Phenomenology of Inhalant-Induced Disorders

DSM-IV-TR (American Psychiatric Association 2000) tecognizes six inhalant-induced disotdets inhalant intoxication, inhalant intoxication delirium. 

Studies of the intoxicating effects of toluene showed that the inhalation of its vapor at a concentration of 200 ppm was associated with the development of mild-to-moderate intoxication, characterized by sedation, paresthesias, and hyporeflexia. Toluene vapor concentrations of 600-800 ppm induced a confusional state, whereas greater concentrations produced an intense euphoria (Benignus 1981 Press and Done 1967). In humans, plasma concentrations of toluene of 10-100 pM have been reported to be intoxicating these concentrations are close to the intoxicating concentrations of alcohol and in-halational anesthetics (Miller 1985). 

Intoxication with amyl nitrite or butyl nitrite (i.e., poppers) is characterized by euphoria, warm feelings, change in perception of time, a sense of fullness in the head, relaxation of smooth muscle, vasodilatation, increased heart rate, and decreased systolic blood pressure. An increase in sexual drive and intensification of orgasm, poor judgment, and a reduction in inhibitions are 

Intoxication delirium may occur with solvents, nitrous oxide (Sterman and Coyle 1983), ether, or other general anesthetics (Delteil et al. 1974). However, to our knowledge, there are no reports describing delirium associated with nitrite intoxication. The description of delirium presented here derives mainly from what has been observed during solvent intoxication. 

The main disturbance in inhalant intoxication delirium is a reversible decrease in the level of consciousness and awareness of the environment, which includes an inability to focus, sustain, or shift attention. The intoxicated person is confused and easily distracted by irrelevant stimuli and difficult to engage in a meaningful conversation. He or she may also exhibit prominent disorientation, short- and long-term memory deficits, language disturbances, and perceptual disturbances that may include illusions and hallucinations. Other prominent features associated with inhalant intoxication delirium are 

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