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

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<strong>Inhalant</strong>s in Perú Roberto Lerner and Delicia Ferrando INTRODUCTION Drug use and abuse is a problem that seems to haunt all societies. Every culture deals with mind-altering substances that allow people to escape routine life. Technology and continuous change, the loss <strong>of</strong> traditional values, and the economic and social marginality experienced by many have led to massive and dysfunctional drug use. It is within this changing world that heroin, cocaine, and synthetic substances have become increasingly available in the streets. This increased use <strong>of</strong> illicit substances has created serious public health problems with economic and geopolitical consequences. Many societies, sensing impending doom and anticipating social disintegration, have reacted in a frenzied fashion in trying to solve the drug problem. These approaches to the drug problem have been more akin to religious wars than to rational problem-solving. BACKGROUND The history <strong>of</strong> drugs and their relationship to society have been studied from a variety <strong>of</strong> viewpoints. The most serious approaches take into account multiple variables and try to place drug use patterns within the context <strong>of</strong> culture, analyzing the ways informal and formal controls, shared social representations, the media, and the State influence drug use (Bachman and Cope1 1989; Escohotado 1989; McKenna 1992; Musto 1973). More recently others even have tried to rethink the answers society has been giving to drug problems, considering alternatives to the current legal status <strong>of</strong> psychoactive substances (Benjamin and LeRoy Miller 1993; Trebach 1987). In none <strong>of</strong> the comprehensive studies about drugs, however, do inhalants appear as a significant issue. This matter has been <strong>of</strong> interest to clinicians and scientists since the pioneering report on inhalant use and abuse published by Clinger and Johnson (1951). However, it was not until the late 1970s that a serious effort to understand inhalant abuse was undertaken systematically by drug abuse researchers (Crider and Rouse 1988; Sharp and Brehm 1980; Sharp and Carroll 1978). In Latin America, most <strong>of</strong> the investigations conducted into inhalant use and 191
abuse and their biomedical, social, and epidemiologic dimensions have been in Mexico, a country that has hosted international conferences about inhalant use and abuse as well as produced a considerable amount <strong>of</strong> scientific research (Chavailli-Arroyo et al. 1988; Contreras 1977). This is understandable given the fact that inhalants are, with marijuana, the most abused illicit psychoactive substance in that country (Chavailli- Arroyo et al. 1988). Data concerning inhalant abuse in Peru will be presented in this chapter, including its epidemiology, public perceptions, and the actions that society has taken to cope with the consequences <strong>of</strong> inhalant abuse. DRUG ABUSE IN PERÚ Interest in drug use outside the medical community in Perú has developed fairly recently. Most likely, the initiatives concerning drug abuse research and prevention that began in the mid-1980s have more to do with the fact that Perú produces approximately 60 percent <strong>of</strong> the coca leaf available worldwide—a sociopolitical issue—with public health and epidemiologic consequences (Lerner 1991). Whatever the real motivations, Peruvians have become intensely concerned with the problem <strong>of</strong> drug abuse. Currently, a number <strong>of</strong> institutions are conducting research into the patterns <strong>of</strong> drug use, the effectiveness <strong>of</strong> public awareness campaigns, and the impact <strong>of</strong> prevention programs on the drug-using behaviors <strong>of</strong> Peruvians. The first epidemiological study on drug use in Peru focused on collecting data on the alcohol-using behavior <strong>of</strong> individuals living in the capital, Lima (Carbajal et al. 1980). This study found that alcohol was the most consumed drug and that the illicit substances had low lifetime prevalences (i.e., 3.2 percent for marijuana and 1.2 percent for coca paste). More recently, Jutkowitz and colleagues (1987) conducted a nationwide household survey. Findings from this survey (shown in the following tables) were confirmed by another national survey (Ferrando 1990). Table 1 shows the very high lifetime prevalence <strong>of</strong> illicit or socially accepted psychoactive substances and the relatively low figures for illicit drugs. 192
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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
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Epidemiology <stro
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TABLE 1. National
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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
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Page 181 and 182: mind the fact that a sizeable numbe
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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: AUTHOR Isidore Silas Obot, Ph.D., M
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
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Page 229 and 230: NATIONAL VSA STATISTICS The only <s
Page 233 and 234: TABLE 7. Local surveys giving infor
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Page 239 and 240: TABLE 8. Surveys of</strong
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Page 243 and 244: problem would go away like other te
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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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