Inhalant Use Disorder 535
Specifiers
This manual recognizes volatile hydrocarbon use meeting the above diagnostic criteria as
inhalant use disorder. Volatile hydrocarbons are toxic gases from glues, fuels, paints, and
other volatile compounds. When possible, th e particular substance involved should be
named (e.g., “toluene use disorder”). However, most compounds that are inhaled are a
mixture of several substances that can produce psychoactive effects, and it is often difficult
to ascertain the exact substance responsible fo r the disorder. Unless there is clear evidence
that a single, unmixed substance has been used , the general term inhalant should be used
in recording the diagnosis. Disorders arising from inhalation of nitrous oxide or of amyl-,
butyl-, or isobutylnitrite are considered as other (or unkn own) substance use disorder. 
“In a controlled environment” applies as a fu rther specifier of remission if the individ-
ual is both in remission and in a controlled en vironment (i.e., in early remission in a con-
trolled environment or in su stained remission in a contro lled environment). Examples of
these environments are closely supervised and substance-free jails, therapeutic communi-
ties, and locked hospital units. 
The severity of individuals’ inhalant use di sorder is assessed by the number of diag-
nostic criteria endorsed. Changing severity of individuals’ inhalant use disorder across
time is reflected by reductions in the frequency (e.g., days used per month) and/or dose
(e.g., tubes of glue per day) used, as assessed by the individual’s self-report, report of oth-
ers, clinician’s observations, and bi ological testing (when practical).
Diagnostic Features
Features of inhalant use disorder include repe ated use of an inhalant substance despite the