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

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abusing youth, because <strong>of</strong> the extent <strong>of</strong> chemical effects. Solventabusing patients must have their treatment readiness time for detoxification. It also is imperative that the treatment providers keep their expectations for solvent-abusing youths realistic during this time. Otherwise, the result is frustration and burnout for the provider. These youths initially may be slower to respond to treatment but, given the current therapeutic opportunities and considerations, they do respond, and early reports indicate treatment success. Families <strong>of</strong> solvent abusers <strong>of</strong>ten are highly dysfunctional, which increases the need for a thorough assessment <strong>of</strong> family stability, structure, and dynamics (Oetting and Webb 1992). Treatment planning must include the family, significant caretakers, or both. Interventions with the family might be focused on providing “reparenting,” social bonding skills, discipline, and communication issues. Anecdotal reports from providers indicate that they hold regular “family weekends,” times when the family receives intense therapeutic intervention along with the patient who is in treatment. One also must consider that, when the youth leaves treatment, he or she <strong>of</strong>ten returns to a family <strong>of</strong> substance users and may feel alienated if he or she abstains from drug use (Jumper-Thurman and Beauvais 1992). This type <strong>of</strong> conflict can precipitate a quick relapse. It also must be considered that, if the family situation is too unstable to support the youth, the most effective treatment goal may be to work toward foster care or transitional placement for the discharged youth. Peers have a powerful influence on adolescent drug use (Oetting and Beauvais 1986). Usually the peer clusters <strong>of</strong> solvent abusers are highly deviant, making them even more impervious to positive social influences (Oetting and Webb 1992). Assessment must consider both the structure and norms <strong>of</strong> the abuser’s peer cluster so that treatment goals can be established to weaken or break those social bonds and replace the cluster with a more constructive group <strong>of</strong> peers. Use <strong>of</strong> the peer patient advocate appears to hold potential as a successful treatment intervention and turns a potential liability into a therapeutic asset. It is clear that the peer structure is powerful for these youths and that essential needs are met by affiliation with the peer group. Therefore, creative interventions, though sometimes difficult to conceptualize, are necessary components <strong>of</strong> effective treatment. The period in which youths return to the community following treatment can be a critical time. They require intensive assistance in establishing a healthy environment. Both home and school settings may present 255
challenges to a healthy readjustment. It will be difficult to remain separate from many <strong>of</strong> the people with whom they previously associated. Their absence from the school and community for treatment may cause some difficulty. Therefore, it is important to include community resources and educational staff (i.e., teachers and counselors) early in treatment. This liaison should be strengthened throughout the therapeutic process and used intensively in discharge planning. It is essential that the youths and families have an awareness <strong>of</strong> the community resources available to them; they also should feel comfortable using these services. Knowledge about treatment outcome is extremely limited with this population since only a few facilities specific to solvent treatment have been established. Certainly there is a clear need for objective and tight evaluation <strong>of</strong> treatment effects, as well as additional research on treatment outcome. Finally, when working with children and adolescents, it is essential to recognize that the effectiveness <strong>of</strong> the treatment providers is paramount to success (Jumper-Thurman and Plested, submitted). Care <strong>of</strong> and therapy for solvent-abusing youth are challenging jobs. Such tasks require clinical judgement, common sense, a good sense <strong>of</strong> humor, patience, intelligence, and most <strong>of</strong> all a basic understanding <strong>of</strong> how to work with solvent-abusing adolescents. The general nature <strong>of</strong> treatment is the caring for and healing <strong>of</strong> others. Given that definition, there <strong>of</strong>ten is the tendency to overlook one’s own needs or to “put them on the back burner.” When working with solventabusing youth, the demands are many. Providers tell us that self-care becomes paramount. Providers not only have a right to self-care; ethically, there is an obligation to self-care. In summary, what constitutes effective treatment for solvent abusers? Recognizing the many obstacles facing youths who have abused solvents, a comprehensive treatment plan should include: (1) adequate time for detoxification or treatment readiness and physical recovery; (2) use <strong>of</strong> a peer patient advocate system; (3) thorough assessment <strong>of</strong> physical, cognitive, and neurological functioning; (4) recognition and building <strong>of</strong> existing strengths and skills; (5) development <strong>of</strong> new strengths; (6) treatment-provider training specific to solvent-abusing patients; (7) addressing <strong>of</strong> personal and family issues; and (8) cultivation <strong>of</strong> the resources necessary to initiate a healthy transition back into the home community (Jumper-Thurman and Plested, submitted). Often treatment, 256
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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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TABLE 10. National
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TABLE 10. National
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The longest running institution, th
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Several programs have been develope
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Thus, substance abuse research has
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3. Alcohol and tobacco were not con
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Leal, H., and Pacheco, G. Estrategi
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Division of <stron
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mind the fact that a sizeable numbe
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Adults and Older Students I
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Method Participants. Participants w
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TABLE 6. Types of
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TABLE 9. Sources of</strong
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THE NEED FOR MORE RESEARCH ON INHAL
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funding. However, by encouraging th
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AUTHOR Isidore Silas Obot, Ph.D., M
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abuse and their biomedical, social,
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nitrites—is virtually unknown in
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TABLE 3. Frequency of</stro
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TABLE 5. Lifetime prevalence and cu
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working with children living in the
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of the youthful po
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Page 211 and 212: least as far back as 1983. However,
Page 213 and 214: TABLE 1. Phase-out schedule for ozo
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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
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Page 229 and 230: NATIONAL VSA STATISTICS The only <s
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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: Medical management and detoxificati
Page 263 and 264: REFERENCES Beauvais, F. Social and
Page 265 and 266: Gathering Epidemiologic Information
Page 267 and 268: DIRECT POPULATION SURVEYS Cross-sec
Page 269 and 270: The findings in the two surveys wer
Page 271 and 272: TABLE 1. Recent use a of</s
Page 273 and 274: are due to the fact that inhalants
Page 275 and 276: number usually is advertised in tel
Page 277 and 278: REFERENCES Beauvais, F. Volatile so
Page 279 and 280: Inhalants: A Polic
Page 281 and 282: predominated, but it seems clear th
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Page 287 and 288: eformulation of pr
Page 289 and 290: with abuse potential, and additiona
Page 291 and 292: TABLE 2. Type of l
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Page 295 and 296: TABLE 4. Type of b
Page 297 and 298: TABLE 5. Specified products regulat
Page 299 and 300: TABLE 6. Prevention curricula and i
Page 301 and 302: appear to enter treatment that prog
Page 303 and 304: Policy Alternative 1: Change Produc
Page 305 and 306: outcome evaluations. Ideally, such
Page 307 and 308: Mata, A.G., Jr., and Andrew, S.R. <
Page 309 and 310: 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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