OTHER SUBSTANCE ADDICTION TREATMENT

Inhalants include a wide range of household and industrial products — aerosol sprays, cleaning fluids, paint thinners, glue, and nitrous oxide — that produce psychoactive effects when their vapours are inhaled. They are particularly dangerous because they are legal, easily accessible, and often used by younger adolescents. The risk of “sudden sniffing death” from cardiac arrhythmia exists even with first-time use. Chronic use causes cognitive impairment, peripheral neuropathy, liver and kidney damage, and bone marrow toxicity. Dependence develops through repeated use despite awareness of these risks.

Anabolic-androgenic steroids (AAS) are synthetic derivatives of testosterone used to build muscle mass and enhance athletic performance. Unlike other substances of abuse, steroids do not produce a typical “high” — the addiction is driven by body image concerns and the desire to maintain physical gains. Health consequences include cardiovascular disease (heart attacks, strokes), liver damage, hormonal disruption, severe acne, hair loss, testicular atrophy in men, and menstrual irregularities in women. Psychiatric effects include aggression (“roid rage”), depression, irritability, and in some cases psychosis.

Nicotine is one of the most addictive substances known, with a dependence potential comparable to heroin. Found in tobacco products and increasingly in vaping devices (e-cigarettes), nicotine produces rapid effects on the brain’s reward system within seconds of inhalation. Withdrawal symptoms include intense cravings, irritability, anxiety, difficulty concentrating, and increased appetite — symptoms that drive continued use despite awareness of health risks including lung cancer, COPD, cardiovascular disease, and stroke. The rise of vaping has introduced nicotine addiction to a new generation, with high-nicotine salt formulations delivering particularly rapid dependence.

Caffeine is the world’s most widely consumed psychoactive substance, found in coffee, tea, energy drinks, and soft drinks. While generally safe in moderation, high consumption can lead to caffeine use disorder, characterised by continued use despite negative effects, inability to cut down, and withdrawal symptoms. Caffeine withdrawal — headache, fatigue, irritability, difficulty concentrating — can be severe enough to interfere with daily functioning. Extreme consumption (over 1000mg/day, equivalent to 10+ cups of coffee) can cause anxiety, insomnia, cardiac palpitations, and gastrointestinal distress.

Synthetic cannabinoids are manufactured chemicals sprayed onto plant material and sold as “herbal incense” or “potpourri.” They bind to cannabinoid receptors with much greater potency than natural THC, producing effects that are both more intense and more unpredictable. Medical complications are frequent and severe: acute kidney injury, seizures, myocardial infarction, stroke, severe agitation, and psychosis. The chemical formulations change constantly as manufacturers attempt to evade legal restrictions, making each batch potentially more dangerous than the last. Withdrawal can include severe anxiety, depression, headaches, and intense cravings.