VSU
Dealing with intoxicated people can be challenging. A person is considered intoxicated when their functioning is significantly affected or impaired. This can result in challenging behaviour for themselves and others.
As with alcohol and other drugs, the effects of volatile substance use (VSU) intoxication will differ between individuals, as all drug experiences are impacted by a range of factors related to the drug, the individual and the environment.
Understanding the possible effects of VSU can assist with an effective response. While a person's behaviour under the influence of volatile substances can be somewhat unpredictable, having knowledge of the effects of volatile substance intoxication can be helpful to assess the level of risk and anticipated behaviour.
This knowledge can also reduce fear and anxiety if you know what to expect and can ensure you are in a position to provide appropriate assistance in an emergency situation.
The approach you take will depend on your role (i.e. drug and alcohol worker, ambulance officer, youth worker, police officer or community street patrol) and the purpose of your interaction with the intoxicated person. Whatever your role, ensure you are familiar with your agency’s protocols for managing intoxication.
Signs of VSU intoxication
VSU intoxication usually occurs within minutes of the initial inhalation, with the effects only lasting a few minutes after the person stops inhaling. Prolonged use may cause intoxication for up to one hour after the person stops inhaling the volatile substance.
If other drugs have also been used, it is difficult to predict how long intoxication will last, as it depends on a range of factors including what has been inhaled, how long for, the person’s tolerance and the interactive effect between the drugs used.
While there is no definitive list of signs and symptoms of volatile substance intoxication, there are some indicators that may alert you to whether someone is intoxicated from VSU.
- euphoria/excitement
- reduced inhibitions
- drowsiness/sedation
- slurred speech
- blurred vision
- bloodshot eyes
- coughing
- sneezing/runny nose
- cardiac arrhythmia/arrest
- flushing
- hyper-salivation
- poor coordination
- impaired judgement
- nausea/vomiting
- dizziness
- disorientation/confusion
- impaired attention and memory
- loss of consciousness /coma
- muscle weakness/lethargy
- agitation/aggression
- hallucinations/delusions
- delirium
- central nervous system (CNS) depression – slowed breathing and heart rate
- convulsions
- seizure (fit).
The person may also report:
- headaches
- diarrhoea
- abdominal pain
- tinnitus (ringing in the ears)
- palpitations.
There are a number of other factors that can produce signs and symptoms similar to those of VSU. For example, the indicators above could also be signs of a physical or medical condition such as a head injury, infection, poisoning, epilepsy, stroke, diabetes or other drug use; or a psychological or emotional state such as depression, anxiety, stress or grief.
Being aware of signs and symptoms of intoxication can assist you to respond effectively, however it is also important to draw upon your existing skills in managing difficult situations (i.e. focus on the presenting issues / behaviours and look for solutions to prevent the situation escalating). Your behaviour can play a big part in the outcome of a situation.
Managing an intoxicated person
In the first instance, ensure you are familiar with your agency's policies and procedures regarding managing intoxicated clients.
The following steps can assist in the management of an intoxicated person.
First and foremost, assess the situation and consider your safety, the affected person’s safety, and the safety of others. Enlist others to help you manage the situation if necessary.
- Introduce yourself and your role
- Ask their name
- Ask if they know where they are and what is happening
- When talking:
- use the person’s name (if known)
- speak clearly and ask simple questions
- talk slowly and gently
- be firm but non-threatening
- adjust your pace to theirs
- keep eye contact (where culturally appropriate)
- keep instructions brief and clear
- avoid information overload but repeat when necessary
- avoid ‘hot’ topics and long discussions
- be friendly and polite
- help the person where needed
- Also remember to:
- remain calm
- listen to the person
- do not shout or argue back
- do not make sudden movements.
Reducing the impact of intoxication
There are things that you can do to reduce some of the harms associated with VSU intoxication. For example, do not chase or physically restrain a person who has been using volatile substances as physical exertion can increase their risk of sudden sniffing death.
If the intoxicated person is conscious and not in need of immediate first aid:
- confiscate the substance, if it is safe to do so
- reduce any immediate risks to the person or others by:
- opening doors and windows if in an enclosed area
- removing matches and lighters and not permitting smoking
- reduce stimulation by:
- moving to a safe location with low stimulus, or
- making the immediate environment low stimulus by removing bystanders. Over-stimulating environments for an intoxicated person could result in an acute physiological reaction such as shock or sudden death
- discourage any exertion, encourage the person to relax and remain calm
- keep calm, reassure the person, speak quietly
- stay with the person until effects have worn off
- if necessary, seek medical advice or call for an ambulance.
Acute intoxication
If someone is acutely intoxicated from the effects of VSU, there is the possibility of overdose. This can develop from the toxic effects of the substance/s used, mixing with other drugs (particularly other central nervous system depressants such as alcohol and benzodiazepines), having a low tolerance and not seeking help at the first signs that something is wrong.
A person recovering from acute VSU intoxication should be kept safe and monitored until they have fully recovered. If possible, monitor the person in a clinical setting throughout the period of acute intoxication, even if they regularly use volatile substances. This should be for approximately 2-4 hours if recovery is uncomplicated, or longer if recovery is delayed. If it is not possible to transfer the person to a medical service, monitor them closely and call emergency services if they become unconscious, have a seizure or if their condition becomes worse in any way (National Health and Medical Research Council, 2011).
The person should be provided with immediate medical assistance if they:
- are injured
- are unconscious or seem to be losing consciousness
- have collapsed
- are not breathing normally
- have a seizure (fit).
(National Health and Medical Research Council, 2011)
If the person is unconscious, apply first aid immediately:
Check for danger to yourself, bystanders and the patient. Remove anything dangerous near them (i.e. matches/lighter) and make sure there is plenty of fresh air.
Check for a response. Ask their name and squeeze their shoulders. No response may indicate that they are unconscious so it is important to get help as quickly as possible. If there is a response, seek permission to help them and monitor breathing and response.
Call triple zero (000) for an ambulance (or call for a local health worker if no ambulance). If there is someone else nearby, ask them to make the call. If you are by yourself, place the person in the recovery position before leaving to call for help.
Clear the airway - place one hand on the forehead and two fingers on the chin. Open the mouth and check for foreign material or obstruction. If foreign material or obstruction is present, roll them on to their side into the recovery position and clear their airway of anything that may be blocking it. Then move them onto their back again. If no foreign material found, leave them in the position you found them in, open their airway by lifting their chin and tilting their head back.
Check breathing. Look, listen and feel for 10 seconds. If breathing, place them in the recovery position and monitor their breathing. Stay with them until medical help arrives. If they are not breathing, call an ambulance and commence CPR.
Start CPR - 30 chest compressions then 2 breaths. Continue CPR until help arrives or the person starts to breath normally.
If a defibrillator is available, turn it on and follow the voice prompts. Continue CPR except when the defibrillator delivers a shock and until medical help arrives.
IMPORTANT: Do not use a defibrillator in an explosive environment (e.g. an oxygen enriched, gaseous or fume-filled environment) or if the person has flammable liquid on their chest.
Intoxication legislation
Police can assist under the Protective Custody Act (2000) which allows them to take an intoxicated person, who does not require emergency treatment or hospitalisation, to a safe place or place them into protective custody until a parent, guardian or responsible person has been located. It also allows police to confiscate intoxicating substances from juveniles.
For more information, visit the Law page of this website.
Self-care
Managing an intoxicated person can be a difficult experience.
Ensure you debrief with a colleague or supervisor after an incident.
Self-care is important when dealing with such challenging situations.
Page last updated15 July 2025