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

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<strong>Epidemiology</strong> <strong>of</strong> <strong>Inhalant</strong> <strong>Abuse</strong> in Nigeria Isidore Silas Obot INTRODUCTION Drug abuse research in Nigeria and other African countries began in earnest in the 1960s. From the beginning, research interest was focused on those drugs that were associated with mental health problems. Cannabis (Indian hemp) was the first <strong>of</strong> such drugs, as it became evident that high proportions <strong>of</strong> young people admitted into psychiatric hospitals had been abusing the drug (Asuni 1964; Lambo 1965). Using hospital admissions data as a measure, cannabis remains the most abused illicit drug today in Nigeria (Obot and Olaniyi 1991). Other drugs soon joined what is now a long list <strong>of</strong> problem drugs in Nigeria. Stimulants (Oviasu 1976), alcohol (Obot 1992), benzodiazepines (Odejide 1982), and tobacco (Obot 1990) now are abused widely in the country and continue to attract the attention <strong>of</strong> researchers and prevention experts. In the early 1980s the country was awakened to the creeping scourge <strong>of</strong> trafficking in and abuse <strong>of</strong> heroin and cocaine. The prevalence <strong>of</strong> abuse <strong>of</strong> these drugs has continued to increase, as shown by hospital records (Obot and Olaniyi 1991). Today there hardly is any drug that is not abused by Nigerians, even though some substances have received little attention from researchers. The inhalants fall into this group. Many <strong>of</strong> the early studies did not report any abuse <strong>of</strong> inhalants, even though there were suspicions that organic solvents were being abused by youths and people in some occupations. In a review <strong>of</strong> epidemiological studies conducted in Nigeria, Pela and Ebie (1982) stated that: The potential abuse <strong>of</strong> volatile solvents in some occupational groups, such as car mechanics, welders, artisans and petrol station attendants cannot be ruled out in view <strong>of</strong> their close contact with such substances and poor emission control regulations. The spread <strong>of</strong> volatile substances to the schools is a logical sequence, bearing in 175
mind the fact that a sizeable number <strong>of</strong> the skilled labour force are young adults and adolescents (p. 94). Not long after this observation, researchers began to show interest in inhalants and included this category <strong>of</strong> drugs in research questionnaires. A recent review reported some use <strong>of</strong> inhalants by undergraduates and added that: Because these substances are inexpensive or can be obtained free from home, the potential for their widespread use is high. There is a need to monitor the pattern <strong>of</strong> solvent use, especially since little is known about the effects <strong>of</strong> these substances [in the country] (Obot 1992, p. 437). PREVALENCE OF INHALANT ABUSE IN NIGERIA Adolescents The earliest study showing more than a passing interest in inhalants was conducted by the International Council on Alcohol and Addictions (1988) in southern Nigeria. In this major survey <strong>of</strong> drug abuse, widespread experience with solvents in some cities was reported. Using a questionnaire designed for the study, respondents were asked whether they had “ever used” and whether they were currently using glue, petrol, or kerosene (as well as other drugs). What constituted current use was not specified, and data on this were not reported. Table 1 shows the extent <strong>of</strong> lifetime abuse <strong>of</strong> solvents and two other drugs commonly abused among students in secondary schools, More than two-thirds <strong>of</strong> the students were 16 years old or less. Reported use <strong>of</strong> solvents is comparable to the abuse <strong>of</strong> cannabis in three <strong>of</strong> the four cities where the survey was carried out. Lifetime abuse <strong>of</strong> solvents in Lagos (the country’s largest city and primary commercial center) was particularly high. 1 Because these figures refer to lifetime or “ever use” <strong>of</strong> the substances by adolescents, the extent <strong>of</strong> current use <strong>of</strong> solvents can be gleaned only from other studies conducted in recent years. In a recent study by Odejide and colleagues (1993) at the <strong>National</strong> Drug Law Enforcement Agency Demand Reduction Unit, current use <strong>of</strong> 176
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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
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FIGURE 7. Number of</strong
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of an epidemic, wh
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Oetting, E.R.; Beauvais, F.; and Ed
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FIGURE 1. Arrests for drug statute
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Page 131 and 132: FIGURE 4. Numbers of</stron
Page 133 and 134: TABLE 3. Age appeared to consultati
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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
Page 169 and 170: The longest running institution, th
Page 171 and 172: Several programs have been develope
Page 173 and 174: Thus, substance abuse research has
Page 175 and 176: 3. Alcohol and tobacco were not con
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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
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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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Page 229 and 230: 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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