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

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1. By subscription to a press clipping agency that monitors all British publications (national and local newspapers and magazines) and “abstracts” (i.e., clips) any mention <strong>of</strong> a VSA-related death; 2. By writing regularly to all 158 Coroners in England and Wales, the Crown Office in Scotland, and the Lord Chancellor’s Department for Northern Ireland; and 3. By maintaining liaison with the Office <strong>of</strong> Population Censuses and Surveys (OPCS). Press cuttings also are compared with the <strong>Institute</strong> for the Study <strong>of</strong> Drug Dependence (ISDD) and the British Aerosol Manufacturers’ Association (BAMA), and there is liaison with the Health and Safety Executive and the Railways Inspectorate over deaths in the workplace. Newspaper reports are not used to provide detailed data but to indicate that a death has occurred and to provide the name <strong>of</strong> the deceased and the location. Details <strong>of</strong> the case then are obtained from the Coroner’s <strong>of</strong>fice. Copies <strong>of</strong> the following are collected when available: 1. The inquest proceedings, 2. The pathologist’s report, 3. The toxicology report, and 4. The death certificate. Methods <strong>of</strong> data collection have been the same since 1983, although the data extends back to 1971. It is unlikely that deaths, particularly in teenagers, escape attention nowadays unless the facts deliberately are concealed. This is not impossible, though, since a family doctor can sign a death certificate without a post mortem examination under certain circumstances. However, because deaths from any cause are rare in teenagers, the OPCS can attach additional coding data manually (“associated digit” coding system). It perhaps is more difficult to be so confident about deaths among the older population, where VSA is less likely to be suspected. However, regular letters from St. George’s Hospital Medical School to all Coroners should prompt them to keep the possibility in their minds. 211
UNITED KINGDOM VSA-RELATED MORTALITY DATA Almost all the data on VSA in the United Kingdom come from mortality statistics (Taylor et al. 1993). There has been an increase from at least 2 deaths in 1971 to 122 in 1991, the last year for which data are available (figure 3). The highest number recorded in any one year was 151 in 1990. This represents an average annual increase <strong>of</strong> 5.4 percent from 1983 to 1991. Data on 1,237 VSA-related deaths occurring from 1971 to 1991 have been compiled in the United Kingdom. FIGURE 3. United Kingdom VSA-relafed deaths: Deaths by year, 1971-1991 (N=1,237). Age at Death The most common age at death by VSA is 15 or 16 years <strong>of</strong> age, with the youngest recorded at 9 and the oldest at 76 (figure 4). In all, 73.2 percent <strong>of</strong> deaths occurred in people who were under 20 years old. The age distribution is remarkably similar to that associated with the practice all over the world (see other chapters, this volume). Sex Eighty-eight percent <strong>of</strong> persons suffering VSA-related deaths are males. This finding has not changed significantly over the period for which data 212
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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
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TABLE 9. National
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TABLE 9. National
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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 and 212: least as far back as 1983. However,
Page 213 and 214: TABLE 1. Phase-out schedule for ozo
Page 215: inquisitorial, unlike the procedure
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
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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
Page 263 and 264: REFERENCES Beauvais, F. Social and
Page 265 and 266: 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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