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

Medical management and detoxification are two issues <strong>of</strong> particular
importance in the early phases <strong>of</strong> solvent abuse treatment (Jumper-
Thurman and Beauvais 1992). Depending on the length and intensity <strong>of</strong>
solvent use, there may be dysfunction in a number <strong>of</strong> body systems
including the kidneys, liver, and blood (Rosenberg and Sharp 1992).
Acute medical intervention may be needed for these problems, but there
also may be subclinical patterns that will be resolved over time with
cessation <strong>of</strong> solvent use. The acute neurological effects also may take a
considerable amount <strong>of</strong> time to resolve. Unless a sufficient amount <strong>of</strong>
time is allowed for detoxification, the individual will not be capable <strong>of</strong>
engaging in the therapeutic aspects <strong>of</strong> treatment. This problem is only
exacerbated by the emotional turmoil that is demonstrated early in
treatment. Treatment providers indicate that newly admitted youths are
apprehensive and angry about being in a treatment environment, anxious
about leaving family and friends behind, and most importantly are unable
to function at the cognitive level needed for attendance in school and in
group and individual sessions.
For solvent abusers, there is a need for an extended period <strong>of</strong> “treatment
readiness” that lasts for a minimum <strong>of</strong> 4 weeks but may last much longer
(E. Fredlund, personal communication, September 30, 1993); this time
allows the body to detoxify from the chemical effects <strong>of</strong> inhalant abuse.
During this time the emphasis should be on basic supportive care,
including nutrition, exercise, sleep, and a calm environment. Some
providers have suggested that patients not initially attend school, then
attend a quarter or half <strong>of</strong> the time and work up to full school hours.
They are allowed to observe group sessions but not required to
participate. Time spent in individual therapy is <strong>of</strong> shorter duration, and
more recreation time is provided. They also spend time with their peer
advocate and participate in assessment and testing. Providers indicate
that this is a very important time for youths to become better acquainted
with staff and that it provides facilitation and preparation for more
intensive treatment.
Many treatment centers still are reluctant to accept solvent-abusing youth.
Many providers still believe that these youths are brain damaged and that
there is no hope. Yet, these youths do have strengths, and there is hope;
there is some emerging evidence that the neurological damage incurred
through solvent use is not permanent and a great deal <strong>of</strong> function can be
restored (N. Rosenberg, personal communication, August 2, 1993).
However, newly admitted solvent-abusing youths usually are not able to
function as well as other classes <strong>of</strong> substance abusers, such as alcohol-
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