Epidemiology of Inhalant Abuse - Archives - National Institute on ...
Epidemiology of Inhalant Abuse - Archives - National Institute on ...
Epidemiology of Inhalant Abuse - Archives - National Institute on ...
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Volatile Substance <str<strong>on</strong>g>Abuse</str<strong>on</strong>g> in the<br />
United Kingdom<br />
John Ramsey, Jennifer Taylor, H. Ross Anders<strong>on</strong>, and<br />
Robert J. Flanagan<br />
INTRODUCTION<br />
The deliberate misuse <str<strong>on</strong>g>of</str<strong>on</strong>g> volatile compounds by inhalati<strong>on</strong> in order to<br />
achieve intoxicati<strong>on</strong> has been a major problem in the United Kingdom<br />
since the early 1980s. Comm<strong>on</strong>ly referred to as “glue sniffing” or<br />
“solvent abuse,” the term “volatile substance abuse” (VSA) has now<br />
gained acceptance.<br />
Volatile compounds were inhaled to achieve intoxicati<strong>on</strong> even before<br />
their anaesthetic properties were recognized. Pseudoscientific<br />
dem<strong>on</strong>strati<strong>on</strong>s <str<strong>on</strong>g>of</str<strong>on</strong>g> the intoxicati<strong>on</strong> caused by nitrous oxide inhalati<strong>on</strong><br />
were a comm<strong>on</strong> stage act in the mid-1800s both in Britain and in the<br />
United States. Diethyl ether and chlor<str<strong>on</strong>g>of</str<strong>on</strong>g>orm also were freely available at<br />
this time and were inhaled or ingested comm<strong>on</strong>ly as alcohol substitutes.<br />
Nagle (1968) has surveyed the history <str<strong>on</strong>g>of</str<strong>on</strong>g> abuse <str<strong>on</strong>g>of</str<strong>on</strong>g> the early anaesthetic<br />
agents. It was not until the review by Press and D<strong>on</strong>e (1967) and the<br />
paper by Bass (1970) <strong>on</strong> sudden “sniffing” deaths that the true nature and<br />
magnitude <str<strong>on</strong>g>of</str<strong>on</strong>g> the modem problem in the United States came to the<br />
attenti<strong>on</strong> <str<strong>on</strong>g>of</str<strong>on</strong>g> more than a handful <str<strong>on</strong>g>of</str<strong>on</strong>g> pathologists and toxicologists.<br />
In 1975, Joyce Wats<strong>on</strong> first reported her experiences treating glue sniffers<br />
in Lanarkshire, Scotland (Wats<strong>on</strong> 1975). In the late 1970s the United<br />
Kingdom’s <str<strong>on</strong>g>Nati<strong>on</strong>al</str<strong>on</strong>g> Pois<strong>on</strong>s Informati<strong>on</strong> Service received an increasing<br />
number <str<strong>on</strong>g>of</str<strong>on</strong>g> requests for informati<strong>on</strong> about VSA (Francis et al. 1982), and<br />
toxicology laboratories analyzed samples from several deaths that had<br />
resulted mainly from the abuse <str<strong>on</strong>g>of</str<strong>on</strong>g> adhesives c<strong>on</strong>taining toluene or<br />
typewriter correcti<strong>on</strong> fluids c<strong>on</strong>taining halogenated solvents. This led to<br />
the recogniti<strong>on</strong> that VSA was becoming a major problem in the United<br />
Kingdom. A multidisciplinary workshop was held at Guy’s Hospital in<br />
1981 to collate all available informati<strong>on</strong>. The results were reported by<br />
Volans and colleagues (1982). More importantly, a formal method <str<strong>on</strong>g>of</str<strong>on</strong>g><br />
collecting VSA-related mortality data was established that addressed the<br />
shortcomings <str<strong>on</strong>g>of</str<strong>on</strong>g> the established methods (Anders<strong>on</strong> et al. 1982).<br />
C<strong>on</strong>sequently, the United Kingdom has c<strong>on</strong>sistent mortality data from at<br />
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