VSU
Volatile substance use (VSU) can be a passing phase for many young people who use. Most young people experiment with volatile substances a few times and then stop, often due to the unpleasant side effects. Only a small number go on to use in a regular or chronic way. Therefore, not everyone who uses volatile substances requires treatment. In many cases diversionary activities, such as recreational opportunities or skills development, may be an appropriate response to meet the needs of these young people (National Inhalant Abuse Taskforce, 2006).
There are a range of factors to consider when choosing the most appropriate treatment response for someone who uses volatile substances. As with any alcohol and other drug (AOD) treatment, there is no single treatment approach that will suit all individuals so treatment should be tailored to suit the individual’s specific needs. A further consideration is the availability of suitable services based on location, age appropriateness, cultural and other needs.
In Australia, as elsewhere in the world, there are few dedicated treatment programs for people who use volatile substances (National Inhalant Abuse Taskforce, 2006). However, general AOD treatment programs and responses such as counselling, brief interventions and residential rehabilitation, can also be applicable and suitable for people who use volatile substances.
While best practice principles of effective AOD interventions apply equally to people who use volatile substances, the following considerations should be given specifically when dealing with VSU:
- the predominantly young age of those who use
- the low developmental age of many of those who use
- the cultural background of the person
- many are highly marginalised and may lack social skills
- many are from families who may not engage or participate in the treatment process
- they may be using inhalants in addition to or in combination with other drugs, for example, cannabis and alcohol
- young people are often reluctant to access AOD treatment services
- the need to avoid labelling young people as ‘drug users’
- many access treatment through the mental health or juvenile justice systems
- many also have other health problems, such as mental health issues, requiring assessment and treatment.
(National Inhalant Abuse Taskforce, 2006)
Treatment guidelines
The following are guidelines for the provision of treatment for people who use volatile substances.
All treatment approaches need to be culturally safe and culturally appropriate, creating an environment where Aboriginal people feel respected, valued and free from racism and discrimination. For more information, see the Working with Aboriginal communities section of the Responding to VSU in the community page of this website.
Treatment should be family-inclusive where possible. Research has shown that the involvement and/or participation of family in a person's treatment can improve outcomes. For more information, see the Supporting parents and families page of this website.
As with other substances, relapse is common, so a non-judgemental approach towards the possibility of repeated treatment episodes is crucial.
The pattern and extent of VSU (e.g. experimental, regular, and chronic) should be considered when deciding on treatment or management strategies (Department of Human Services, 2003).
Within treatment settings, it is important to consider the vulnerability of younger people using in a low level/experimental way and their exposure to those who are older and/or more experienced in their use of volatile substances or other substances.
Consider developmental age. Some younger people may not have the capacity, based on their cognitive and emotional development, to engage in certain types of insight-based therapies.
An assessment of mental health and neurological functioning is important to identify any disorder or impairment that may affect treatment, particularly for those who have long-term and/or chronic patterns of use.
Gain medical assistance for episodes of acute intoxication. For more information, see the Intoxication page of this website.
A range of psychological therapies may be appropriate, including general (person-centred) counselling, cognitive-behavioural therapy (CBT), motivational interviewing, narrative therapy, storytelling/yarning, group therapy, peer mentoring or a therapeutic community. For more information about general alcohol and other drug counselling (AOD) techniques and approaches, see Counselling guidelines: Alcohol and other drug issues (4th Edition).
Some therapeutic approaches, for example CBT, may need to be tailored or adapted for people with intellectual impairment (National Health and Medical Research Council, 2011).
Regardless of the treatment approach and mode of delivery, the therapeutic relationship itself is likely to be the most important factor for effective treatment (National Health and Medical Research Council, 2011). The importance of the therapeutic relationship cannot be overstated. Consistent engagement is fundamental to build rapport and trust.
VSU is rarely an isolated issue and should be dealt with in the context of other psychosocial factors. A range of needs should be responded to including medical, psychological, social, vocational and legal issues (Department of Human Services, 2003). Consideration of poly-drug use may also be required.
Treatment should be delivered in conjunction with engagement in alternative activities such as social, recreational, educational or cultural activities and access to employment and training opportunities.
Where possible, proactive outreach approaches should be considered as most people who use volatile substances do not present to AOD services.
Treatment plans should include comprehensive after-care and follow-up, including support for the client to reintegrate back into their community and ensuring the individual develops appropriate social networks.
Where more than one service is involved with the care of an individual, a coordinated case management plan should be implemented. Communication between agencies is imperative.
Treatment approaches
Different treatment approaches are required according to each person's pattern of use. Treatment suited to those who use occasionally, or in an experimental way, may not be appropriate for those who have a more chronic pattern of use.
Treatment should be targeted, focused and relatively short-term, including information/education about the effects and harms of VSU, including harm reduction information. Opportunities for brief interventions should be taken and diversionary activities should be offered in conjunction. Treatment should address short-term problems of intoxication, overdose, binge use, and impulsive or antisocial behaviours.
Treatment may include brief interventions, counselling, motivational work, harm reduction information, use of positive peer influence and provision of alternative activities.
Treatment should generally be longer-term and may include interagency case management; outpatient or residential treatment; medical investigation and management; rehabilitation including skill development and building emotional and social development; and relapse management.
Page last updated13 July 2025