# Treatments for Inhalant and Volatile Substance Misuse: A Scoping Review

## TL;DR

This paper reviews treatment options for inhalant and volatile substance misuse, highlighting gaps in FDA-approved drugs and the need for more comprehensive research.

## Contribution

The paper provides a scoping review of treatment approaches for inhalant misuse, emphasizing the lack of standardized and pharmacological interventions.

## Key findings

- Pharmacological treatments like aripiprazole showed some success in reducing inhalant use.
- Holistic programs like YSAP and Mt Theo had the highest success rates but are culturally specific.
- Psychosocial interventions like CBT and family therapy showed promise but need more research.

## Abstract

Inhalant and volatile substance misuse present significant challenges to society, yet the treatment options have largely been overlooked. Currently, there are no FDA-approved pharmacotherapies for inhalant use disorders. Additionally, there are limited nonpharmacological studies focused on the treatment and management of the disorders. These limitations have made it difficult to establish a standardized approach when treating the disorder and have limited the treatment options available to individuals facing the addiction.

This scoping review examines the proposed treatment options for inhalant and volatile substance misuse. It categorizes the proposed treatments and specifically outlines their effectiveness and limiting factors. The review utilized multiple databases such as PubMed, ScienceDirect, and PsycINFO to explore various case reports, public health reports, clinical trials, and community-based programs. There was a focus on studies and reports that specifically explored the pharmacological, psychosocial, supportive, and holistic approaches in treating and managing the disorder.

The supportive approaches primarily focused on medical stabilization during the initial hospitalization. They emphasized the management of the airway, breathing, circulation, disability, and exposure (ABCDE) approach, along with patient decontamination. However, these methods offered limited insight into their long-term effectiveness in addressing inhalant and volatile substance misuse. In contrast, pharmacological approaches did explore long-term outcomes in managing inhalant use disorders. Clinical studies involving medications such as aripiprazole showed significant reductions in sustained inhalant use. Similarly, case reports examining the use of baclofen, naltrexone, and lamotrigine reported varying degrees of success in promoting abstinence from inhalants and volatile substances. Nevertheless, these findings were primarily based on small clinical trials and case reports, thus limiting conclusions about their broader effectiveness. Holistic and multifaceted programs, such as the Youth Solvent Addiction Program (YSAP) and the Mt Theo Program, demonstrated the highest success rates among the interventions reviewed. Many of these residential programs incorporated various culturally specific strategies. While effective in their respective contexts, they may pose challenges for broader replication. Psychosocial interventions, including cognitive behavior therapy (CBT)-based brief interventions and family therapy, also demonstrated a reduction of volatile substance use. Yet, they require larger, more comprehensive studies to better evaluate their efficacy.

The treatment of inhalant and volatile substance misuse has been approached through various mechanisms. Multiple studies and reports involving the supportive, holistic, pharmacological, and psychosocial approaches have successfully demonstrated varying levels of success when managing inhalant and volatile substance misuse. Yet, no FDA-approved pharmacological treatment or standardized approaches have been developed for managing the disorder. The literature review found that many of the approaches have only demonstrated efficacy on smaller scales and were limited by a culturally specific context. Therefore, further research employing large-scale and multifaceted methodologies is necessary to establish the efficacy and replicability of these interventions.