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always are combined with alcohol. Alcohol is the most abused legal drug in Hungary. Beside prescription drugs, youngsters use poppy tea or homemade preparations <strong>of</strong> poppy straw, mainly administered intravenously. The age <strong>of</strong> drug abusers ranges from 18 to 30 years. From the middle to late 1960s, glue was the most commonly abused substance among youngsters (Cseme 1991; Farkasinszky et al. 1976; Forgacs 1990; Racz 1992). The first drug-related deaths and police cases were reported in 1969 (Levai 1991). Volatile substances were easily accessible, although several products were withdrawn from the market because <strong>of</strong> either overdose or sudden deaths occurring among adolescents following their use. By 1990, within a 10-year-period, 55 drug-related deaths due to volatile substance abuse were registered. By the end <strong>of</strong> the 1970s, young people became addicted to polydrugs, including glue, prescription drugs, and alcohol; this continues even today (Gryneusz and Pressing 1986). There always are new prescription drugs being discovered by abusers for their narcotic effects. In the 1970s, a specific antiparkinsonian prescription drug, trihexyphenidyl hydrocholoride, was abused and consequently taken <strong>of</strong>f the market because <strong>of</strong> its hallucinogenic effects (Kisszekelyi 1973). Today’s most popular hypnotic prescription drug is glutethimide, which has severe withdrawal effects when abused. Since the 1980s, homemade preparations <strong>of</strong> poppy straw have become very popular along with stimulants, and the trend <strong>of</strong> abuse certainly is on the rise. Meanwhile, volatile substance abuse has decreased, almost vanishing in certain areas, while in other regions it has been maintained. HUNGARIAN RESEARCH ON DRUGS While the drug problem was noticed in the early 1970s in Hungary, it took a long time for policymakers to support research to better understand the nature <strong>of</strong> deviant behaviors and social maladaptation (Andorka 1985). A few studies were conducted on a sporadic basis at that time. These studies were descriptive in nature and were based on clinical observation. These few descriptive studies showed that a problem existed, but the information was limited and could not lead to a deep understanding <strong>of</strong> why and how inhalant abuse emerged and spread and who got involved. 101
The lack <strong>of</strong> epidemiologic research and expertise on treatment and public awareness <strong>of</strong> the hazards <strong>of</strong> glue sniffing and other solvent abuse and the ignorance <strong>of</strong> the governing political power led to widespread substanceabusing behavior by the end <strong>of</strong> the 1970s. A group <strong>of</strong> scientists attempted to draw the attention <strong>of</strong> the Government to socially deviant behaviors such as suicide, delinquency, substance abuse, and mental disturbances, but there was a minimal response taken to prevent such behaviors. In this way, Hungary delayed facing these social problems for at least 15 years. Such problems first were criminalized and later medicalized. Medical doctors, psychiatrists and psychologists, and sociologists were pioneers in dealing with these clients, counteracting the traditions, the rules, and the law. This is why there currently are only a limited number <strong>of</strong> experts, epidemiologists, and other researchers in the drug field. Not only were epidemiologic studies not performed, but neither was there research conducted in treatment outcome. Very little attention has been paid to the legal side <strong>of</strong> the abuse <strong>of</strong> volatile substances. It is noticeable that data collection is fairly incomplete in the drug field, not only for the health care system but also for other nongovernmental agency contacts, such as the various churches (Forgacs and Katona 1990). The retrospective studies, conducted mainly by clinicians, are based on their observations, which do not always meet international requirements for research on drug abuse. In this chapter, various examples <strong>of</strong> episodic and local-regional patterns and trends <strong>of</strong> volatile abuse in Hungary will be presented. The studies were conducted using different methodologies, demonstrating that no common concept or perception <strong>of</strong> the problem or reliable measurement exists, potentially leading to misinterpretation <strong>of</strong> the problem. These studies were conducted at different periods in time and at different sites. They were conducted during the 1970s and 1980s, and several are very recent. The studies were conducted in four different cities representing two cultural-traditional-religious backgrounds rooted in the Middle Ages, when the country was conquered by the Turks (the Ottoman Empire) and the Habsburgs (the Austro-Hungarian Empire), and this way it was divided into two separate parts. This historical background may partly explain why the findings are so different at various locations, concerning not only inhalant abuse but other deviant behaviors such as alcoholism, suicide, and delinquency. The data are not generalizable because the criteria <strong>of</strong> examination and observation varies from investigator to investigator. Data on the general population based on household surveys are not available. 102
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National I
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ACKNOWLEDGMENT This monograph is ba
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Treatment Strategies for Volatile S
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extent of inhalant
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agencies. Dr. Carlini-Cotrim conclu
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prevalence, after alcohol and tobac
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Inhalant Use in th
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FIGURE 1. Lifetime prevalence for 1
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Reliability of the
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use beginning in 1987 when the surv
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TABLE 2. Current use of</st
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TABLE 3. Use of in
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TABLE 4. Inhalant
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TABLE 5. Lifetime prevalence and cu
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TABLE 7. Inhalant
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CONCLUSION Unlike other drugs in th
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AUTHORS Ruth W. Edwards, Ph.D. Rese
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Epidemiologic data were obtained fo
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perception of the
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Malaysia In Malaysia, the abuse <st
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The primary method of</stro
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them at least two to three times pe
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Curiosity is the most popular motiv
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Inhaling from a plastic bag: The vo
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(between US $0.04 and US $0.80) a d
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truant, who have money, and who are
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Edmondson, K. Review of</st
Page 55 and 56: Inhalant A
Page 57 and 58: Children working in the streets 280
Page 59 and 60: (1986), collected data on the preva
Page 61 and 62: Anecdotal information suggests that
Page 63 and 64: FIGURE 3. Psychological process mod
Page 65 and 66: ehavior. A secondary aim has been u
Page 67 and 68: REFERENCES ABC Communication. Consu
Page 69 and 70: Inhalant Use Among
Page 71 and 72: TABLE 1. Lifetime prevalence <stron
Page 73 and 74: TABLE 3. Lifetime prevalence <stron
Page 75 and 76: TABLE 4. Solvent use found for 1,83
Page 77 and 78: however, rarely is taken into consi
Page 79 and 80: TABLE 7. Weekly use (at least once
Page 81 and 82: TABLE 9. Use of dr
Page 83 and 84: Oetting, E.R.; Edwards, R.W.; and B
Page 85 and 86: RESULTS Prevalence Rates The findin
Page 87 and 88: TABLE 2. Use of in
Page 89 and 90: Incidence Rates Data from the surve
Page 91 and 92: TABLE 7. Use of in
Page 93 and 94: FIGURE 2(a). Proportion and number
Page 95 and 96: TABLE 8. Regression analysis: Use <
Page 97 and 98: TABLE 10(a). Mean age at first inha
Page 99 and 100: TABLE 13. Percentage of</st
Page 101 and 102: FIGURE 3. Opinion on health consequ
Page 103 and 104: The conduct of con
Page 105: Inhalant A
Page 109 and 110: FIGURE 1. Substance abusers treated
Page 111 and 112: FIGURE 2. Drug used at initiation <
Page 113 and 114: The registered inhalant abusers ran
Page 115 and 116: medication, and jumping from a tall
Page 117 and 118: (with the main psychoactive compone
Page 119 and 120: In 1990, a World Health Organizatio
Page 121 and 122: FIGURE 7. Number of</strong
Page 123 and 124: of an epidemic, wh
Page 125 and 126: Oetting, E.R.; Beauvais, F.; and Ed
Page 127 and 128: FIGURE 1. Arrests for drug statute
Page 129 and 130: had inhaled the vapor from lacquer
Page 131 and 132: FIGURE 4. Numbers of</stron
Page 133 and 134: TABLE 3. Age appeared to consultati
Page 135 and 136: TABLE 5. Present occupational situa
Page 137 and 138: FIGURE 5. SOURCE: Longitudnal patte
Page 139 and 140: FIGURE 7. Longitudinal pattern <str
Page 141 and 142: Epidemiology <stro
Page 143 and 144: TABLE 1. National
Page 145 and 146: (Hughes et al. 1980). The system ha
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Page 153 and 154: FIGURE 3. Drug Registry System (SRI
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TABLE 6. National
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TABLE 7. National
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TABLE 9. National
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TABLE 9. National
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TABLE 10. National
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TABLE 10. National
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The longest running institution, th
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Several programs have been develope
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Thus, substance abuse research has
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3. Alcohol and tobacco were not con
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Leal, H., and Pacheco, G. Estrategi
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Division of <stron
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mind the fact that a sizeable numbe
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Adults and Older Students I
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Method Participants. Participants w
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TABLE 6. Types of
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TABLE 9. Sources of</strong
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THE NEED FOR MORE RESEARCH ON INHAL
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funding. However, by encouraging th
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AUTHOR Isidore Silas Obot, Ph.D., M
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abuse and their biomedical, social,
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nitrites—is virtually unknown in
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TABLE 3. Frequency of</stro
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TABLE 5. Lifetime prevalence and cu
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working with children living in the
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of the youthful po
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Lucchini, R. “Niños Callejeros y
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least as far back as 1983. However,
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TABLE 1. Phase-out schedule for ozo
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inquisitorial, unlike the procedure
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UNITED KINGDOM VSA-RELATED MORTALIT
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FIGURE 5. United Kingdom VSA-relate
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TABLE 2. United Kingdom VSA-related
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TABLE 4. United Kingdom VSA-related
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NATIONAL VSA STATISTICS The only <s
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TABLE 6. National
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TABLE 7. Local surveys giving infor
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TABLE 7. Local surveys giving infor
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presented as a confidential “Scho
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TABLE 8. Surveys of</strong
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Children’s Act 1989: Section 17 r
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problem would go away like other te
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Children ages 14-16 “should have
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contributions from many small group
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Chadwick, O.; Anderson, R.; Bland,
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Market and Opinion Research Interna
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Streete, P.J.; Ruprah, M.; Ramsey,
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Treatment Strategies for Volatile S
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that they chose solvents not only b
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Medical management and detoxificati
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challenges to a healthy readjustmen
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REFERENCES Beauvais, F. Social and
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Gathering Epidemiologic Information
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DIRECT POPULATION SURVEYS Cross-sec
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The findings in the two surveys wer
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TABLE 1. Recent use a of</s
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are due to the fact that inhalants
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number usually is advertised in tel
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REFERENCES Beauvais, F. Volatile so
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Inhalants: A Polic
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predominated, but it seems clear th
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classes containing these substances
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justify their positions more on pri
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eformulation of pr
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with abuse potential, and additiona
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TABLE 2. Type of l
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TABLE 3. Type of d
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TABLE 4. Type of b
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TABLE 5. Specified products regulat
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TABLE 6. Prevention curricula and i
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appear to enter treatment that prog
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Policy Alternative 1: Change Produc
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outcome evaluations. Ideally, such
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Mata, A.G., Jr., and Andrew, S.R. <
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Recommendations and Conclusions Zil
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AUTHORS Zili Sloboda, Sc.D. Nichola
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26 42 50 52 53 54 56 61 62 THE BEHA
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80 82 83 84 85 87 88 89 92 NEEDLE S
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102 106 107 108 109 111 112 113 ANA
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124 NEUROBIOLOGICAL APPROACHES TO B
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138 139 140 141 142 143 IMAGING TEC
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NIH Publication No 95-3831 Printed
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