Inhalant use is a serious problem worldwide, particularly among disadvantaged populations and adolescents. In the United States, inhalant use is the second most widely used illicit drug, trailing only marijuana. Despite the extensive use of inhalants and their known deleterious health outcomes, inhalants are one of the least studied drugs. The current study explored inhalant patterns and characteristics associated with progression to abuse and dependence among a national sample of youths aged 12 to 17 years. Data were drawn from the 2000 and 2001 National Household Surveys on Drug Abuse; a sample of 36,859 respondents answered questions regarding past year inhalant use, utilization of mental health services, history of foster care placement, delinquency, incarceration, past year other drug or alcohol use, abuse, and dependence. Results of multinominal logistic regression analyses indicated that inhalant use was common among the respondents, but only 0.4 percent met the DSM-IV inhalant abuse or dependence criteria during the past year. Early first use, weekly use, and use of multiple types of inhalants were associated with the progression from inhalant use to abuse and dependence. The adolescents with inhalant dependence also reported suffering coexisting multiple drug abuse and dependence, seeking mental health treatment, and engaging in delinquent behaviors. Adolescent inhalant abusers thus represent a highly troubled population plagued by multiple problems. Prevention programs should target elementary school students and future research should focus on best-practices in treatment. Tables, references