solvent-abuse-pakistan

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Section three substances. Thus while glue is the main drug used (95.2%) children have also been using Thinners (27.6%), Petrol (13.3%) and a minor proportion (5.7%) has reported use of Tincture as well. Table 3.3.1a Solvents abused Adhesive Glues Petrol & related products Thinners Miscellaneous Average Daily cost (mean ± sd) Types of Solvents abused and its daily cost in Pak Rs. Karachi Lahore Quetta Peshawar OVERALL n (%) N (%) n (%) n (%) n (%) 100 (95.2) 14 (13.3) 29 (27.6) 07 (6.7) 47.5 ± 36.5 107 (98.2) 07 (6.4) 02 (1.8) 01 (0.9) 41.6 ± 26.3 94 (92.2) 44 (43.1) 10 (9.8) 05 (4.9) 38.7 ± 26.2 73 (73) 41 (41) 03 (3) 01 (1) 30 ± 28 374 (89.9) 106 (25.5) 44 (10.6) 14 (3.3) 39.7 ± 30.1 Results have shown that an average amount of Rs. 39.7 ± 30.1 is being spent on these solvents, which forms almost 50% of their average earning. (see section 3.1.6). Slight geographical differentiations were noticed; children in Peshawar reported to have spent an average daily amount of Rs.30 on buying these substances in contrast to Rs.47 spent by a child living in Karachi. The numbers are however in parallel to their average income. Further analysis revealed that the maximum proportions (62%) of children interviewed had been using these substances for periods greater than 2 years. A minor Box 3.3---- Techniques used for i nhaling Adhesive Glues It should be noted that it is the vapor given off by the product that is used and the product its elf, e.g. glue, is not ingested into the body. Abusers have reported 3 different techniques through which they inhale the product : The most practiced technique is the use of a solvent from a soaked cloth reported by 80% (329) of the respondents. Typically some of the mat erial (20 gms) is poured into the cloth, which is then rolled in the sh ape of glove. Thi s in local terms is known as ‘Dum’. The ‘dum’ is then sniffed, or kept in the mouth and the fumes are inhaled. The second favourite technique is the inhalation of drug in a plastic bag [17%(71)]. The plasti c bag containi ng the glue is then held over the face and nose and the fumes are inhaled. Inhaling the fumes by putting the solvent in a bott le was also descr ibed by 35 (8.4%) of the respondents. Again the substance is po ured into a bott le, and the bottle is then brought closed to the nose and the fumes are inhaled. In some instances a plast ic pipe (straw) is place d above the level of the solvent, the other end is placed in the mouth and the whole substance is breathed in. Finally, 6.5% (27) of the respondents reported using the solvent directly from the can (tube in rare instances) The majority of cases have reported making a small hole in the can, and then after holding it close to the nose or face and inhaling the fumes until the whole substance is breathed in. proportion initiated drug use in the past year (18.2%) and a similar number (19.7%) had been using it for more than 1 year but not more than 2 years. This is suggestive of the fact that the practice is not a very new phenomenon, but most of the children interviewed were chronic users. However, since a strict case selection criteria was also used, all experimental and sporadic drug users were screened and excluded from the study. 95% of the children stated that they do not face any difficulty in procuring the solvents, and it is easily available from the local market at standard rates. As described by the respondents it is just as simple as going to a shop and asking for an inhalant. More than half of the times (54%) the activity is reported to be a group based activity, in which the money is pooled in by all members of the group and one of the member then buys the substance for the entire group. Box 3.3. describes the various techniques used for inhaling adhesive glues. The illustrations of the mechanism are given in Figures 3.3.3 A & b. 3.4.2 Quantity used Analysis has shown that on an average 80 gms of adhesive glues is being used each day during the past one month. Further analysis revealed that the maximum proportion of children (45.2%) have reported using 280 gms of glue followed by 750 gms (24.8%), 40 gms (19.2%) and 80 gms (10.8%) respectively. Children were inquired about the frequenc y of use, the answers to which are provided in table 3.3.3a. approximately 20% of the children informed that they have been using the solvents only once daily. Almost one fourth of the children reported using these drugs 2 to five times daily, while another 32% reported use upto 10 times a day. A substantial portion of the children (15%) reported that using solvents round the clock. These children use the solvent through a cloth, which always stays with them in their hands, or pocket, and they are continuously busy in inhaling the fumes of the solvent, which is poured into this cloth. 22 23
3.4.3 Effects of Solvent abuse Research has shown that the chemical substances found in the inhalants produce acute effects similar to sub-anaesthetic concentrations of general anaesthetics, as well as to the effects of classical CNS depressant drugs, such as alcohol and barbiturates. Children were inquired of the feeling experienced after solvents are inhaled; the responses are given in Fig 3.3.3a. 140 120 100 80 60 40 20 0 117 Relief of tension Fig. 3.3.3a 111 Euphoria 65 Drowsiness Feelings experienced on using Solvents 36 33 31 Confident & Strong Cannot express Light headedness 19 16 16 A typical episode of solvent abuse as described by children themselves is a mixed Table 3. 3.3a. Frequency of use of solvents Frequency of use n (%) Once daily 02 to upto 05 times daily 06 to upto 10 times daily All the time Agression Section three Nostalgia 80 (19.2) 97 (23.3) 136(32.7) 103(14.7) Others feeling of euphoria and contentment and a relaxed mood followed by a sound peaceful sleep. Children describe the feelings as ones that make them forget their worries and tensions, and feel happy about whatsoever situation they are into. A few children told the interviewers that they are unable to define the feelings, but generally it is a nice feeling. A large number of children reported that use of solvents made them feel strong and powerful enough to overcome all the worries and problems in their lives. A minor proportion also described the feelings as nostalgic which reminded them of their home and the good times of their lives. One of the biggest hazards of compulsive drug use is that it fosters drug dependence and addiction. Users continue to take drugs despite adverse social and medical consequences, and behave as if the effects of the drugs are needed for continued well-being. Although research suggests that the physiological dependence is rare with solvents, the magnitude of the need to repeated usage can vary from a mild desire to a craving or compulsion to use the drug. The respondents were inquired about the feelings they undergo if the solvents are not taken. The responses are shown in Fig 3.3.3b. 160 140 120 100 80 60 40 20 0 142 Anger & Agitation Fig. 3.3.3b 69 Restlessness & Irritability Symp toms r epo rted upo n un availib ility o f solv ents 3.4.4 Reasons for Use 54 Generalized Aches 38 Inability to work 33 30 Abdominal cramps & GIT upsets The respondents were inquired about the various factors associated with the aetiology of solvent abuse. The major factor to lead into the use of solvents reported by more than half of the children (53.4%) was friends and peers. Among other factors reported, neglect, group violence, a way to forget about the past and curiosity were significant as shown in fig 3.3.4. The issue was further explored in groups' discussions, which focused on not only the Headache 22 Depression 14 15 Semiconsciousness Others reasons which led to the initiation of solvent use, but also discussing factors leading to the continuation of these agents. The role-played by peers and group membership not only emerged strongly as the factor initiating the use of solvents but also acted as the leading reason to the continuation of the habit. A large number of children reported that they started drugs as to meet the social norms, which gave them immediate gratification in response. The importance of group membership was highlighted for survival among street children in the previous section (see section 3.2). However, while the peer pressure and social circumstances played a strong role in initiating drug use, the effects of the solvents themselves helped continuous solvent abuse. The feeling of euphoria and happiness that was immediately experienced made the children forget all worries and helped relieve the tension, which these children face. The CNS depressing effects of the drugs made the children enjoy sound sleep for longer duration. Thus it can be deduced that, solvent or drug abuse work as an anaesthesia, decreases physical and emotional pain, induce sleep, decrease appetite (one of the factors leading to malnutrition), increases energy levels and adds excitement. It also provides 24 25
Page 1 and 2: This publication is available from:
Page 3 and 4: This research study would not have
Page 5 and 6: 3.2 Living Conditions & group dynam
Page 7 and 8: e felt on use of the solvent drugs.
Page 9 and 10: BACKGROUND & INTRODUCTION Section o
Page 11 and 12: Section one 1.2 Solvent Abuse Defin
Page 13 and 14: RESEARCH & METHODOLOGIES Section tw
Page 15 and 16: Section three involved in providing
Page 17 and 18: Section three from where these chil
Page 19: Section three Results show that a l
Page 23 and 24: Section three 3.4.6 Treatment When
Page 25 and 26: Section three 3.6 Magnitude of the
Page 27 and 28: Section four 36 treatment methodolo
Page 29 and 30: REFRENCES Section four Formative o

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