Inhalants are breathable chemical vapors or gases that produce psychoactive (mind-altering) effects when abused or misused. These include volatile organic solvents, fuel gases, nitrites, and anesthetic gases. People who abuse inhalants are found throughout the population, and no one group can be categorized as "inhalant abusers." Chronic inhalant abuse significantly damages the heart, lungs, kidney, liver, and peripheral nerves; it can cause heart failure and complete hepatic and renal failure. People who abuse inhalants chronically have manifested a range of mental dysfunction, from mild cognitive impairment to severe dementia. Studies have reported that people who abuse inhalants can build up tolerance that requires them to increase their dosages to achieve the intoxication effect. As a group, people who abuse inhalants often have multiple problems, such as polydrug abuse, a chaotic family life, low self-esteem, poor academic records, personality disorders, and poor cognitive function, and they may present with neurological deficiencies. Thus, treatment is more complicated and requires more resources than for people who abuse other drugs. A detailed history and thorough physical examination are especially important in order to identify specific substances abused and their physical effects, followed by medical treatment of physical conditions. Because inhalants can stay in the body for weeks, detoxification periods could extend for a month. Abusers often are not ready to begin therapy until detoxification is complete, and they often require therapy for as long as 2 years. Family involvement in treatment is especially important for youth, and intervention to improve parenting or bonding skills or treatment of parental substance abuse may be needed. Initial therapy sessions should be short, and involvement in group therapy with other types of drug abusers should be gradual. Aftercare and follow-up are particularly important for inhalant abusers and may involve multiple community resources. Education about the effects and dangers of inhalants may help abusers abstain from future inhalant use. 29 references