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

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and testing <strong>of</strong> validity and reliability <strong>of</strong> instruments and methodological approaches for the study <strong>of</strong> drug abuse. Various methods were developed and used to study different populations and different aspects <strong>of</strong> the problem. The first drug abuse epidemiologic surveys were conducted in the 1970s. School-based surveys, studies among imprisoned populations, and studies with an anthropological emphasis included solvents among the substances investigated. At this same time, a national network <strong>of</strong> specialized treatment centers, CIJ, were started. Thus, statistics from patients in treatment have been available since then. Three national school surveys have been undertaken, one in 1976 (Chao and Castro 1976), one in 1985 (Castro et al. 1986), and most recently in 1993 (Medina-Mora et al. 1993). The first two were conducted in urban cities, and the most recent is the first that includes both rural and urban populations and provides data statewide. Biannual studies also have been conducted in Mexico City since 1976. In 1974, the first household survey was conducted in Mexico City and, through 1986, six other cities have been included. In 1986, a national household survey was undertaken among urban populations <strong>of</strong> the country by the DGE and the IMP (Medina-Mora et al 1989; Tapia et al. 1990). Also during that year, the Ministry <strong>of</strong> Health conducted the second national household survey. Epidemiologic studies with an anthropological emphasis focused on the social and cultural problems related to drug use and the rates <strong>of</strong> use among hidden populations and among children working on the streets. In 1987, Ortíz and colleagues (1993) initiated a drug abuse reporting system (SRID) that has been in operation since that time and has collected data on 5,098 drug users. This system has provided the capacity to monitor trends in the problem and has served as an early warning system. During a 2-month period each year, it gathers information on antecedents <strong>of</strong> drug use among all populations in 44 health and justice institutions, regardless <strong>of</strong> the subjects’ reason for entering the institutions. In 1990, the DGE developed SISVEA and, in 1992, CONADIC developed a register <strong>of</strong> cases in treatment called SINTRA. 167
Thus, substance abuse research has a lengthy history in Mexico, and solvents always have been included as a drug <strong>of</strong> concern. More research is needed among high-risk groups in cities outside <strong>of</strong> the capital, where most research efforts and funds have concentrated. It also is important to standardize core items to be used in the protocols to allow comparability <strong>of</strong> data. Major efforts have been made to maintain comparability through the adoption <strong>of</strong> core items proposed by WHO (Hughes et al. 1980; Smart et al. 1980). However, the most recent surveys will not be strictly comparable to what has been produced by different institutions in the country in the previous 20 years. HEALTH AND SOCIAL POLICIES Substances with psychotropic effects that have no therapeutic use and commonly are used in industry are viewed as a separate group <strong>of</strong> volatile solvents 7 in the health laws—at least since 1973—and continue to be regulated in the <strong>National</strong> Health Law <strong>of</strong> 1984. It is stated that their use needs to be authorized and regulated by the Ministry <strong>of</strong> Health. Several regulations have been developed that mainly are aimed at protecting workers, and these are well implemented in the industry. However, a problem still remains with familial industries. Other regulations include restrictions <strong>of</strong> the type <strong>of</strong> substances that may be contained in end products that are subject to abuse, their packaging, and commercialization. The end products that contain these substances should have a warning label, and their sale to minors under 18 years <strong>of</strong> age is restricted. Several drug programs also have been implemented in the past to address substance abuse in the country. The most comprehensive ones were established in the last decade. Since 1986, the Ministry <strong>of</strong> Health has coordinated a <strong>National</strong> Program Against Addictions that includes three levels <strong>of</strong> prevention carried out through CONADIC and State Councils. These councils were formed by representatives from the different sectors <strong>of</strong> the Government, as well as from the social and private sectors. Contributions <strong>of</strong> each sector were integrated into the <strong>National</strong> Program Against Addictions. It contains actions for control <strong>of</strong> both availability and demand at the three levels <strong>of</strong> prevention including: (1) control and regulation <strong>of</strong> availability; (2) prevention <strong>of</strong> use and <strong>of</strong> risks associated with the use in circumstances that endanger the individual or the society; (3) measures oriented to increasing the awareness <strong>of</strong> the population <strong>of</strong> the importance <strong>of</strong> the preventive measures proposed through programs <strong>of</strong> 168
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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
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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
Page 151 and 152: FIGURE 1. National
Page 153 and 154: FIGURE 3. Drug Registry System (SRI
Page 169 and 170: The longest running institution, th
Page 171: Several programs have been develope
Page 175 and 176: 3. Alcohol and tobacco were not con
Page 177 and 178: Leal, H., and Pacheco, G. Estrategi
Page 179 and 180: Division of <stron
Page 181 and 182: mind the fact that a sizeable numbe
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 209 and 210: Lucchini, R. “Niños Callejeros y
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
Page 221 and 222: 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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