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

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there were 10,396 admissions in 1989. Eleven psychiatrists and two clinical psychologists were responsible for treating the 4,436 patients admitted into northern hospitals; 37 psychiatrists and 18 clinical psychologists were responsible for 5,960 in the south. The major limitation imposed by the dearth <strong>of</strong> qualified manpower is the inability to give sufficient individual attention to patients. Treatment centers around prescription <strong>of</strong> neuroleptics and administration <strong>of</strong> electroconvulsive therapy for a wide array <strong>of</strong> problems. Individual and group therapies are rare (Ikwuagwu et al. 1993; Ohaeri and Odejide 1993). The second problem in the treatment <strong>of</strong> drug abuse in Nigeria is its historical association with psychiatric hospitals and, consequently, with “madness.” For an average African, “madness” involves weird behaviors (e.g., walking naked) that normally do not accompany drug abuse. Because they generally are tolerant <strong>of</strong> and accommodating to minor behavioral deviations, alcoholism and other forms <strong>of</strong> drug abuse are not regarded as mental disorders (unless accompanied by frank psychotic reactions) (Obot 1989); hence, only very serious cases <strong>of</strong> drug abuse will be seen in psychiatric hospitals. This situation requires alternative treatment facilities, especially therapeutic communities (TCs) and other private initiatives, in order to avoid the stigma <strong>of</strong> “madness.” At present, there is only one well-known TC in the country that handles all types <strong>of</strong> drug-dependence cases. There is hope that the number will increase in the immediate future, since nonpr<strong>of</strong>it organizations are beginning to show interest in drug abuse treatment. Another insufficiently explored area is the role <strong>of</strong> traditional healers and churches. There is continued hope by some experts that these areas may expand the limited scope <strong>of</strong> drug abuse treatment in Nigeria and other African countries, even though the roles they provide are only ancillary to the treatment process (Nzewi 1989). Like treatment and rehabilitation, prevention is in the early stages <strong>of</strong> development. There is general acceptance by experts and policymakers that much more needs to be done in the area <strong>of</strong> prevention. The Government agency responsible for the prevention <strong>of</strong> drug abuse in Nigeria is the Demand Reduction Unit <strong>of</strong> the <strong>National</strong> Drug Law Enforcement Agency. As a unit within an agency devoted to interdiction and other supply reduction activities, it lacks the independence needed to develop a successful program and is faced with the problem <strong>of</strong> poor 187
funding. However, by encouraging the formation <strong>of</strong> drug-free clubs in secondary schools, the unit slowly is making its presence felt. Private, nonpr<strong>of</strong>it organizations also are involved in prevention. However, few have a well-coordinated program <strong>of</strong> activities. Most <strong>of</strong> their activities are sporadic and poorly funded. There are indications, though, that the situation will change in the near future, as more and more pr<strong>of</strong>essionals with requisite training in public health and the behavioral sciences participate in prevention at the community level. NOTE 1. These figures should be treated with caution. The authors <strong>of</strong> the report warn that many <strong>of</strong> the respondents may have misunderstood the question: “They appeared not to have appreciated that what was being asked was whether they had ever ingested these substances and not whether they had ever used them in other ways” (International Council on Alcohol and Addictions 1988, p. 14). REFERENCES Adelekan, M.L.; Abiodun, O.A.; Obayan, A.O.; Oni, G.; and Ogunremi, O.O. Prevalence and pattern <strong>of</strong> substance use among undergraduates in a Nigerian university. Drug Alcohol Depend 29:255-261, 1992. Asuni, T. Socio-psychiatric problems <strong>of</strong> cannabis in Nigeria. Bull Narc 16(2):17, 1964. Haworth, A. A preliminary report on self-reported drug use among students in Zambia. Bull Narc 34(3&4):45-60, 1982. Ikwuagwu, P.U.; Ikwuagwu, M.D.; Isichei, H.U.; and Ajeh, C.O. “Drug <strong>Abuse</strong> Among Teenage In-Patients: A Four-Year Review.” Paper presented at the Center for Research and Information on Substance <strong>Abuse</strong> Second Biennial <strong>National</strong> Conference on Alcohol, Tobacco, and Other Drugs, Jos, Nigeria, June 24, 1993. International Council on Alcohol and Addictions. Report <strong>of</strong> a Research Project on Substance <strong>Abuse</strong> in Some Urban and Rural Areas <strong>of</strong> Nigeria. Lausanne: Author, 1988. Lambo, T.A. Medical and social problems <strong>of</strong> drug addiction in West Africa (with special emphasis on psychiatric aspects). West Afr Med J 14(6):236-254, 1965. 188
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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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had inhaled the vapor from lacquer
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FIGURE 4. Numbers of</stron
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TABLE 3. Age appeared to consultati
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TABLE 5. Present occupational situa
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FIGURE 5. SOURCE: Longitudnal patte
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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 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
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: THE NEED FOR MORE RESEARCH ON INHAL
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 207 and 208: of the youthful po
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
Page 223 and 224: TABLE 4. United Kingdom VSA-related
Page 229 and 230: NATIONAL VSA STATISTICS The only <s
Page 233 and 234: TABLE 7. Local surveys giving infor
Page 235 and 236: TABLE 7. Local surveys giving infor
Page 237 and 238: presented as a confidential “Scho
Page 239 and 240: TABLE 8. Surveys of</strong
Page 241 and 242: 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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