Epidemiology of Inhalant Abuse - Archives - National Institute on ...

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Unfortunately, the type <strong>of</strong> attention provided by treatment institutions in the country is segmented in nature; that is, there are hospitals where the addict is detoxicated, other institutions where pharmacological and psychiatric treatment is provided, and so on. At the moment, no referral system is in place, with the result that addicts receive the treatment <strong>of</strong> the facility in which they are placed instead <strong>of</strong> treatment tailored to patients’ needs. Efforts now are being made to address this situation. PROGRAMS FOR STREET CHILDREN The phenomenon <strong>of</strong> working children has been a major problem in Mexico City and other urban areas <strong>of</strong> the country. Through the years, various efforts have been made to address the needs <strong>of</strong> these minors. These children include both “children <strong>of</strong> the street” (children who live in the streets) and “children in the street” (children who, though living within the families, work in the streets). The first documented program for children working in the streets that included as a concern the prevention <strong>of</strong> inhalations <strong>of</strong> substances was begun in the 1970s. At this time, the Mexican Center on Studies <strong>of</strong> Drug <strong>Abuse</strong> (CEMEF) (Leal et al. 1977) conducted longitudinal research <strong>of</strong> minors who made their living in the streets (i.e., children <strong>of</strong> the street) in a sector <strong>of</strong> Mexico City traditionally known for the high prevalence <strong>of</strong> violence and delinquency. The research included a component <strong>of</strong> treatment evaluation coordinated by CIJ (Leal and Pacheco 1988) that was based on principles <strong>of</strong> self-determination and token economy. Children were motivated to stop inhaling and to use their incomes to improve their living conditions. Other research protocols undertaken by CEMEF and later by the IMP, in collaboration with the <strong>National</strong> University, evaluated residential and nonresidential treatment alternatives for inhalers based on social learning theory (Ayala et al. 1981; Mata 1984). Governmental organizations traditionally have <strong>of</strong>fered institutionalized housing for children who for one reason or another cannot live with their families. They provide housing and school for sons <strong>of</strong> prisoners, victims <strong>of</strong> abuse, and street children. The last type usually are institutionalized against their will, convinced by workers, picked up by special cars during the night, or taken by the police. It is common for them to run away. 165
Several programs have been developed for children over the years. In the mid- 1970s the government <strong>of</strong> Mexico City founded a program that included a special house for children (for both children in the street and <strong>of</strong> the street) that had no antecedents. This program proposed that these children could be rehabilitated before becoming part <strong>of</strong> the street subculture and that placement <strong>of</strong> the children in existing institutions would put them in contact with the street culture. An evaluation <strong>of</strong> children living in the two types <strong>of</strong> houses differed in many aspects, inhalation <strong>of</strong> substances being a major difference. Only 37 percent <strong>of</strong> the first type <strong>of</strong> minors exhibited the behavior, in contrast to 75 percent <strong>of</strong> the minors living in traditional institutions (Caudillo 1982). NGOs also play an important role in the care <strong>of</strong> these children. Most NGOs are religious organizations and can be characterized as “closeddoor institutions.” Some <strong>of</strong> these programs provide food and care for street children as a nonresidential service. Children then are <strong>of</strong>fered the opportunity to enter the residential program. These institutions have staff known as street educators, who interact with the children in their working and living environments. They gradually try to convince the children to get involved in the programs. Though institutionalization has been the traditional response to the drug abuse problem, new alternatives have emerged since the 1980s. Deeper understanding <strong>of</strong> needs <strong>of</strong> the street children has resulted in a new type <strong>of</strong> program called open-door institutions. The role <strong>of</strong> international organizations such as the United Nations International Children’s Emergency Fund, International Labor Organization, CHILD HOPE, and Sweden Action for Infant Development <strong>of</strong> Mexico and Central America has been <strong>of</strong> major importance. These types <strong>of</strong> programs are <strong>of</strong>fered by governmental organizations and NGOs and provide services such as <strong>of</strong>fering children places where they can go to eat, sleep, or participate in recreational activities. Children are free to enter and leave as they desire but must observe rules that include curfews, no fighting, and no use <strong>of</strong> drugs inside the facilities (Gutierrez et al. 1993). METHODOLOGICAL ISSUES Drug abuse epidemiologic research was initiated formally in the beginning <strong>of</strong> the 1970s with the establishment <strong>of</strong> CEMEF, an organization founded by the Government; the organization later became the IMP. The research strategy followed has included the development 166
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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
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Inhalant A
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Children working in the streets 280
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(1986), collected data on the preva
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Anecdotal information suggests that
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FIGURE 3. Psychological process mod
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ehavior. A secondary aim has been u
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REFERENCES ABC Communication. Consu
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Inhalant Use Among
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TABLE 1. Lifetime prevalence <stron
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TABLE 3. Lifetime prevalence <stron
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TABLE 4. Solvent use found for 1,83
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however, rarely is taken into consi
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TABLE 7. Weekly use (at least once
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TABLE 9. Use of dr
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Oetting, E.R.; Edwards, R.W.; and B
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RESULTS Prevalence Rates The findin
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TABLE 2. Use of in
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Incidence Rates Data from the surve
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TABLE 7. Use of in
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FIGURE 2(a). Proportion and number
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TABLE 8. Regression analysis: Use <
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TABLE 10(a). Mean age at first inha
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TABLE 13. Percentage of</st
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FIGURE 3. Opinion on health consequ
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The conduct of con
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Inhalant A
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The lack of epidem
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FIGURE 1. Substance abusers treated
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FIGURE 2. Drug used at initiation <
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The registered inhalant abusers ran
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medication, and jumping from a tall
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(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
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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
Page 151 and 152: FIGURE 1. National
Page 153 and 154: FIGURE 3. Drug Registry System (SRI
Page 169: The longest running institution, th
Page 173 and 174: Thus, substance abuse research has
Page 175 and 176: 3. Alcohol and tobacco were not con
Page 177 and 178: Leal, H., and Pacheco, G. Estrategi
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Page 183 and 184: Adults and Older Students I
Page 185 and 186: Method Participants. Participants w
Page 187 and 188: TABLE 6. Types of
Page 189 and 190: TABLE 9. Sources of</strong
Page 191 and 192: THE NEED FOR MORE RESEARCH ON INHAL
Page 193 and 194: funding. However, by encouraging th
Page 195 and 196: AUTHOR Isidore Silas Obot, Ph.D., M
Page 197 and 198: abuse and their biomedical, social,
Page 199 and 200: nitrites—is virtually unknown in
Page 201 and 202: TABLE 3. Frequency of</stro
Page 203 and 204: TABLE 5. Lifetime prevalence and cu
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Page 211 and 212: least as far back as 1983. However,
Page 213 and 214: TABLE 1. Phase-out schedule for ozo
Page 215 and 216: inquisitorial, unlike the procedure
Page 217 and 218: UNITED KINGDOM VSA-RELATED MORTALIT
Page 219 and 220: 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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FIGURE 6. United Kingdom VSA-relate
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FIGURE 9. United Kingdom VSA-relate
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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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