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

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The types <strong>of</strong> initiatives that have been undertaken by each <strong>of</strong> these institutions is discussed in turn, together with an indication <strong>of</strong> the extent <strong>of</strong> knowledge about the effectiveness <strong>of</strong> the various policies that have been initiated. Business Business-sponsored associations such as the Solvent <strong>Abuse</strong> Foundation for Education (SAFE) and the Chemical Specialties Manufacturers Association (CSMA) state that they strongly oppose abusive use <strong>of</strong> their products. For most products abusive use constitutes a negligible fraction <strong>of</strong> sales, but the bad publicity associated with abuse can be quite damaging. However, business even more strongly resists legislation <strong>of</strong> business regulatory approaches to reducing inhalant abuse. They favor policies such as prevention and education campaigns and advocate placing warning labels on abusable products. Representatives <strong>of</strong> business argue that regulation <strong>of</strong> almost any kind would be burdensome to business and would result in poorer quality, more costly products for the vast majority <strong>of</strong> users <strong>of</strong> these products who purchase and use them safely. It is pointed out that there are thousands <strong>of</strong> abusable substances incorporated into tens <strong>of</strong> thousands <strong>of</strong> products and worth about $80 billion per year. The most ubiquitous and valuable <strong>of</strong> these products is gasoline. Business does undertake actions voluntarily to address inhalant abuse. Warning labels voluntarily are affixed to many abusable products (although regulatory agencies require labels on certain types <strong>of</strong> products). Labeling also is in the self-interest <strong>of</strong> manufacturers since putting labels on products may help to indemnify manufacturers against product liability suits when serious consequences result from abuse <strong>of</strong> their products. While manufacturers’ representatives such as SAFE and CSMA state that businesses have won all higher court decisions <strong>of</strong> product liability cases associated with deliberate abuse <strong>of</strong> their inhalable products, such cases sometimes are filed and <strong>of</strong>ten are settled out <strong>of</strong> court, albeit with no finding or admission <strong>of</strong> wrongdoing by the manufacturer or distributor. A very few manufacturers <strong>of</strong> glue and typewriter correction fluid have added irritants such as “oil <strong>of</strong> mustard” to their products in order to discourage their abuse and have found that reported deaths and injuries subsequently declined. Still, businesses believe that voluntary 281
eformulation <strong>of</strong> products <strong>of</strong>ten is difficult to justify since a single manufacturer that reformulated its product would be at a major financial disadvantage, both from bearing the cost <strong>of</strong> reformulation and from consumer resistance to a product that performed poorly compared to those <strong>of</strong> competitors. Businesses—through their own efforts and associations such as SAFE and CSMA—sponsor both inhalant abuse-targeted and general substance abuse prevention and education initiatives. CSMA has developed a videotape and print material about the dangers <strong>of</strong> inhalant abuse, and it has provided a copy <strong>of</strong> these to the 15,000 school districts across the Nation. These are good faith efforts by private business to assist in the effort against inhalant abuse. Still, the cumulative efforts <strong>of</strong> these two associations are no more than a few million dollars per year. These efforts are quite small in contrast to the Federal Government’s investment <strong>of</strong> over $1.5 billion in drug prevention and education services per year and an additional $150 million per year in related research (Office <strong>of</strong> <strong>National</strong> Drug Control Policy 1992). The Federal Government The Federal Government has undertaken several specific actions that have limited the availability <strong>of</strong> particular abusable products over the past 25 years. These actions include: 1. A regulatory decision by the FDA in 1968 to return amyl nitrite to prescription status from over-the-counter status because it was being abused; 2. A decision by the Federal Trade Commission in 1969 to ban devices using CFCs to chill beverage glasses; 3. A decision by the FDA in 1974 to require that a warning label be affixed to pressurized cans <strong>of</strong> edible cooking oils and personal care products; 4. FDA establishment <strong>of</strong> standards for food products for purity and concentration <strong>of</strong> nitrous oxide; 5. Passage <strong>of</strong> an act <strong>of</strong> Congress in 1988 that banned use <strong>of</strong> butyl nitrites in room odorizers because they were <strong>of</strong>ten purchased for inhalation: and 282
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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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TABLE 2. United Kingdom VSA-related
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TABLE 4. United Kingdom VSA-related
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NATIONAL VSA STATISTICS The only <s
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TABLE 6. National
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TABLE 7. Local surveys giving infor
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Page 241 and 242: Children’s Act 1989: Section 17 r
Page 243 and 244: problem would go away like other te
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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
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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
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Page 275 and 276: number usually is advertised in tel
Page 277 and 278: REFERENCES Beauvais, F. Volatile so
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Page 281 and 282: predominated, but it seems clear th
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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
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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
Page 323: NIH Publication No 95-3831 Printed
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