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

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Treatment Strategies for Volatile<br />

Solvent <str<strong>on</strong>g>Abuse</str<strong>on</strong>g>rs in the United<br />

States<br />

Pamela Jumper-Thurman, Barbara Plested, and Fred Beauvais<br />

Treatment for substance abuse dependence has presented a major<br />

challenge in the United States because <str<strong>on</strong>g>of</str<strong>on</strong>g> the complex nature <str<strong>on</strong>g>of</str<strong>on</strong>g> drug<br />

abuse behavior. As treatment has reached greater levels <str<strong>on</strong>g>of</str<strong>on</strong>g> sophisticati<strong>on</strong>,<br />

it is clear that there are distinct differences in the treatment methods that<br />

are needed to treat users <str<strong>on</strong>g>of</str<strong>on</strong>g> the various chemicals effectively. For<br />

instance, people with cocaine addicti<strong>on</strong> appear to have lower relapse<br />

potential if they complete a program with specific implicati<strong>on</strong>s for<br />

cocaine treatment (Rodriguez 1989). Heroin addicti<strong>on</strong> represents yet<br />

another treatment modality with unique c<strong>on</strong>siderati<strong>on</strong>s, particularly<br />

c<strong>on</strong>cerning the use <str<strong>on</strong>g>of</str<strong>on</strong>g> methad<strong>on</strong>e maintenance (Dole and Nyswander<br />

1965).<br />

The treatment and preventi<strong>on</strong> <str<strong>on</strong>g>of</str<strong>on</strong>g> solvent abuse and dependence has<br />

presented a particularly difficult challenge for service providers,<br />

especially given the general lack <str<strong>on</strong>g>of</str<strong>on</strong>g> directi<strong>on</strong> for effective treatment<br />

strategies. In additi<strong>on</strong> to the physiological, neurological, and emoti<strong>on</strong>al<br />

challenges abusers face, volatile solvent-abusing youth frequently bring<br />

with them a multitude <str<strong>on</strong>g>of</str<strong>on</strong>g> other problems—academic, legal, social, and<br />

family issues. Certainly, volatile solvent abusers are am<strong>on</strong>g the most<br />

difficult and refractory people to treat (Jumper-Thurman and Beauvais<br />

1992; Oetting and Webb 1992). In additi<strong>on</strong> to the difficulty in working<br />

with this populati<strong>on</strong>, little practical informati<strong>on</strong> has been available to<br />

meet the specific needs <str<strong>on</strong>g>of</str<strong>on</strong>g> solvent abusers. The informati<strong>on</strong> presented in<br />

this chapter is based <strong>on</strong> interviews and focus groups and also reflects the<br />

treatment and research experience <str<strong>on</strong>g>of</str<strong>on</strong>g> the authors.<br />

The interviews and focus groups included 37 treatment pr<str<strong>on</strong>g>of</str<strong>on</strong>g>essi<strong>on</strong>als<br />

providing treatment for solvent abusers, 14 adult outpatients, and 265<br />

youths who represent inpatient, outpatient, and experimental solvent<br />

abusers. <str<strong>on</strong>g>Inhalant</str<strong>on</strong>g> treatment facilities and schools reporting problems with<br />

inhalant use arranged focus groups and interviews that would provide<br />

informati<strong>on</strong> regarding solvent abuse and factors related to treatment and<br />

preventi<strong>on</strong>. Parental and client c<strong>on</strong>sent was obtained to facilitate 10<br />

250

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