Prevalence, timing, and predictors of transitions from inhalant use to Inhalant Use Disorders

Background: Few studies of the natural history of DSM-IV inhalant substance use disorders (I-SUDs) have been conducted. This investigation examined the prevalence, timing, and predictors of transitions from inhalant use to formal I-SUDs among inhalant users within a nationally representative sample. Methods: Participants were 664 U.S. residents participating in the 2000-2001 National Epidemiologic Survey on Alcohol and Related Conditions who reported lifetime inhalant use. Respondents completed structured interviews assessing DSM-IV psychiatric/substance use disorders. Bivariate and Cox regression analyses were conducted to identify risk factors for transitions from inhalant use to I-SUDs. Results: Nearly one in five (19.4%) persons initiating inhalant use developed an I-SUD. Most I-SUD transitions were to inhalant abuse rather than inhalant dependence. Risk for development of I-SUDs was greatest in the first year following initiation of inhalant use and low thereafter. Multivariate proportional hazards models indicated that presence of a mood/anxiety disorder (HR = 7.7, CI = 3.1-18.9) or alcohol use disorder (HR = 11.9, CI = 5.46-26.00) antedating initiation of inhalant use predicted significantly elevated risk for I-SUDs, whereas being married conferred a lower risk for onset of I-SUDs. Conclusions: I-SUDs were relatively common among inhalant users, generally occurred in the year following initiation of inhalant use, and were associated with early-onset mood/anxiety and alcohol use disorders. Given the young average age at onset of inhalant use and the rapidity with which most I-SUDs developed, interventions directed to adolescents who have initiated inhalant use might be effective in reducing the proportion of inhalant users who develop I-SUDs.