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

inquisitorial, unlike the procedure in ordinary courts <strong>of</strong> law. The Coroner
can summon a jury in most cases. Scotland has its own legal system and
a different <strong>of</strong>ficer, the Procurator Fiscal, who is responsible for death
investigation. Northern Ireland has a system similar to that <strong>of</strong> England
and Wales. The Channel Islands and the Isle <strong>of</strong> Man have yet other
systems but have very small populations.
The difficulty in collecting data on VSA-related deaths by conventional
methods arises not only from the many volatile compounds and products
that may be abused, thus causing death, but also from the many possible
circumstances leading to death. Consequently, analysis <strong>of</strong> death data
coded using International Classification <strong>of</strong> Diseases codes usually results
in a gross underestimation <strong>of</strong> the problem. There are several reasons for
this, among which are the lack <strong>of</strong> mention on some death certificates <strong>of</strong>
the substance responsible and the variety <strong>of</strong> codes to which deaths may
be assigned (Anderson et al. 1982). However, Coroners now are advised
that an appropriate verdict is “death by solvent abuse” or something
similar, rather than the less informative one <strong>of</strong> death by drug abuse (R v.
Inner South London Coroner (ex parte Kendall) [1989] 1 All ER 72, DC).
Since 1983, VSA-related mortality data have been collected at St.
George’s Hospital Medical School in the ways shown in figure 2 and
listed on the following page.
FIGURE 2. United Kingdom VSA-related deaths: Data collection
and dissemination methods.
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