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

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embarrassment <strong>of</strong> reporting such a practice in a person-to-person survey situation are factors that may contribute to extraordinarily low rates <strong>of</strong> “ever use” among adults, even though 20 percent <strong>of</strong> adolescents report the practice. In an upcoming survey, there will be sensitivity to this issue. Instead <strong>of</strong> simply asking, “Have you ever in your lifetime tried an inhalant to get high or feel good?” as was done in the past, the question will be worded, “Have you ever in your lifetime, even as a child, tried an inhalant to get high or feel good? INDIRECT INDICATORS Direct surveys <strong>of</strong> the population can be extremely useful in estimating prevalence and incidence and in identifying populations at risk. Given the expense and time necessary to conduct surveys, surveys are conducted only every 5 years or so in New York State. In the interim and in an ongoing fashion, trends are tracked in a variety <strong>of</strong> indirect indicators <strong>of</strong> substance abuse. These are largely indicators <strong>of</strong> consequences associated with the drug involved, such as arrests, hospital emergency room episodes, deaths, and admissions to treatment programs. Emergency room episodes and deaths are the strongest leading indicators, identifying sudden outbreaks and new or changing patterns <strong>of</strong> use. Treatment admissions are the strongest lagging indicator, surfacing usually at a later stage in a cycle <strong>of</strong> drug-using behavior. Arrests as an indicator are likely to occur somewhere in the middle <strong>of</strong> the cycle. Of course, drug-related arrests depend on the type <strong>of</strong> drug involved, associated laws, and police awareness. Each <strong>of</strong> these indicators has been helpful in tracking and describing cocaine, heroin, and marijuana trends. In an effort to identify trends in inhalant use or the consequences <strong>of</strong> inhalant use or abuse, however, these indicators have little utility. For instance, the Federal Drug <strong>Abuse</strong> Warning Network reporting <strong>of</strong> drug-involved hospital emergency room episodes finds that less than one-half <strong>of</strong> 1 percent <strong>of</strong> the approximately 400,000 episodes in 1992 involved inhalants; none were reported for the two metropolitan areas represented in New York State (<strong>National</strong> <strong>Institute</strong> on Drug <strong>Abuse</strong> 1992). Among admissions to treatment programs in New York State, about one-half <strong>of</strong> 1 percent (33 admissions) <strong>of</strong> 56,000 admissions in 1992 reported inhalants as the primary drugs <strong>of</strong> abuse (New York State Office <strong>of</strong> Alcoholism and Substance <strong>Abuse</strong> Services 1993). These low numbers, despite the medical consequences, probably 267
are due to the fact that inhalants as a category <strong>of</strong> substances are not easily or routinely screened for, not inquired about, and, possibly because <strong>of</strong> embarrassment, not even reported by patients or associates. ETHNOGRAPHIC STUDY Given the hidden, stigmatized, and illegal nature <strong>of</strong> drug using and selling, ethnographic study <strong>of</strong>ten yields insights that are not gathered easily by other research methods. Nevertheless, aspects <strong>of</strong> inhalant use make even ethnographic strategies difficult to use. OASAS, for example, has maintained a Street Studies Unit for more than 15 years. This unit consists <strong>of</strong> several men and women—African- American, white, and Hispanic—who have had a history <strong>of</strong> drug abuse. Much <strong>of</strong> their job entails the use <strong>of</strong> observation and semistructured interviewing at the major drug copping areas throughout New York City. Over the years, they have identified trends in the availability and patterns in the use <strong>of</strong> cocaine, heroin, marijuana, hallucinogens, and a variety <strong>of</strong> psychoactive prescription drugs. Most inhalants, especially glue, solvents, and gasoline, are available through legal channels and are not sold at drug-copping sites and, therefore, are difficult to observe. However, there are tell-tale sequelae that members <strong>of</strong> the Street Studies Unit have observed in recent years that do indicate some inhalant activity. This involves, most recently, cartridges <strong>of</strong> nitrous oxide found in the street. These cartridges are available in head shops or paraphernalia shops, as well as department stores, selling for less than $5.00 for a box <strong>of</strong> 10. They have been popular in Greenwich Village and can be found around colleges located in the City. Otherwise, the Street Studies Unit has had little contact with inhalant users around town. RECOMMENDATIONS FOR IMPROVING THE QUALITY OF RESEARCH Obviously, many ways in which epidemiologic research is carried out do not yield sufficient data for tracking and gathering meaningful information on inhalant use and abuse. Improvement and change surely can take place. Improvements can be made in research methods currently in use, as well as in the pursuit <strong>of</strong> some new and innovative approaches that may be more suitable to this and, perhaps, other categories <strong>of</strong> drug use. 268
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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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Lucchini, R. “Niños Callejeros y
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least as far back as 1983. However,
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TABLE 1. Phase-out schedule for ozo
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inquisitorial, unlike the procedure
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UNITED KINGDOM VSA-RELATED MORTALIT
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FIGURE 5. United Kingdom VSA-relate
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Page 225 and 226: FIGURE 6. United Kingdom VSA-relate
Page 227 and 228: FIGURE 9. United Kingdom VSA-relate
Page 229 and 230: NATIONAL VSA STATISTICS The only <s
Page 231 and 232: TABLE 6. National
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
Page 267 and 268: DIRECT POPULATION SURVEYS Cross-sec
Page 269 and 270: The findings in the two surveys wer
Page 271: TABLE 1. Recent use a of</s
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 285 and 286: justify their positions more on pri
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
Page 293 and 294: TABLE 3. Type of d
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
Page 311 and 312: AUTHORS Zili Sloboda, Sc.D. Nichola
Page 313 and 314: 26 42 50 52 53 54 56 61 62 THE BEHA
Page 315 and 316: 80 82 83 84 85 87 88 89 92 NEEDLE S
Page 317 and 318: 102 106 107 108 109 111 112 113 ANA
Page 319 and 320: 124 NEUROBIOLOGICAL APPROACHES TO B
Page 321 and 322: 138 139 140 141 142 143 IMAGING TEC
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NIH Publication No 95-3831 Printed
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