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Therefore, to prevent misuse, a small modification to the valve could limit access to the propellant (D. Roberts, British Aerosol Manufacturers’ Association, personal communication, 1990). Gas canisters that have a screw-on valve require the possession <strong>of</strong> an appliance to gain access to the contents. Disposable cigarette lighter refills are attractive to misusers because the butane gas is accessible without use <strong>of</strong> an appliance. Anecdotal reports suggest that cigarette lighter refills most <strong>of</strong>ten are used by clenching the plastic nozzle between the teeth and pressing to release the gas. If the cylinder inadvertently is tipped up, very cold fluid (below -40°C) rather than gas is expelled. This can cause pulmonary edema or even death from vagal inhibition (Shepherd 1989). Modification <strong>of</strong> the valve on cigarette lighter refills should be considered to reduce this practice. <strong>Abuse</strong> <strong>of</strong> disposable cigarette lighters themselves, although <strong>of</strong>ten referred to, is unlikely because they contain very little gas (typically 4 ml <strong>of</strong> liquid) and the flow rate is restricted. The flammability <strong>of</strong> butane gives rise to the risk <strong>of</strong> bums resulting from misuse, usually when an intoxicated youngster decides to smoke and sniff butane at the same time (Scerri et al. 1992). Elliott (1991) reports cold bums (i.e., frostbite) <strong>of</strong> the mouth <strong>of</strong> a soldier who had inhaled a propellant containing propane and dichlorodifluoromethane (FC 12). The international control <strong>of</strong> the manufacture <strong>of</strong> halogenated compounds suspected <strong>of</strong> depleting stratospheric ozone (table 1) will necessitate changes in the formulation <strong>of</strong> some products abused by inhalation. Typewriter correction fluids, as well as cleaning and degreasing agents, will no longer contain 1, 1, 1-trichloroethane, which is relatively safe during chronic occupational exposure. It can be expected that the more toxic trichloroethylene and, perhaps, dichloromethane will be substituted in some applications. On the positive side, bromochlorodifluoromethane (BCF, FC 12B1) probably will be replaced by carbon dioxide in fire extinguishers. Based on mortality data and anecdotal reports, gasoline is not commonly misused in the United Kingdom, in contrast to the United States, where gasoline vied with glue as the top “ever used” product in the 1991 <strong>National</strong> Household Survey on Drug <strong>Abuse</strong> (Sharp 1992). It perhaps is more understandable that populations such as native Australians (Brady 1991) and the aboriginal populations <strong>of</strong> some other countries (Smart 1988), who do not have access to consumer products, should use this, the only readily available volatile compound. The hazard from lead additives 207
TABLE 1. Phase-out schedule for ozone-depleting organochlorine, as agreed by the European Council <strong>of</strong> Ministers December 1992 and the Montreal Protocol. Substance EC regulation Montreal protocol Cut by Phased out by Cut by Phased out by CFCs 85% by 1/1 1/1 75% by 1/1 1/1 Carbon tetrachloride 85% by 1/1 1/1 85% by 1/1 1/1 Halons — 1/1 — 1/1 1, 1, 1-Trichloroethane 50% by 1/1 1/1 50% by 1/1 1/1 SOURCE: Department <strong>of</strong> the Environment, 2 Marsham Street, London (press release, January 1993).
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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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(Hughes et al. 1980). The system ha
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TABLE 2. National
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TABLE 3. National
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FIGURE 1. National
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FIGURE 3. Drug Registry System (SRI
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TABLE 5. National
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TABLE 6. National
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TABLE 7. National
Page 161 and 162: TABLE 9. National
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 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
Page 205 and 206: working with children living in the
Page 207 and 208: of the youthful po
Page 209 and 210: Lucchini, R. “Niños Callejeros y
Page 211: least as far back as 1983. However,
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
Page 243 and 244: problem would go away like other te
Page 245 and 246: Children ages 14-16 “should have
Page 247 and 248: contributions from many small group
Page 249 and 250: Chadwick, O.; Anderson, R.; Bland,
Page 251 and 252: Market and Opinion Research Interna
Page 253 and 254: Streete, P.J.; Ruprah, M.; Ramsey,
Page 255 and 256: Treatment Strategies for Volatile S
Page 257 and 258: that they chose solvents not only b
Page 259 and 260: Medical management and detoxificati
Page 261 and 262: 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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