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

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students and to be ineffectual (Tobler 1986). The major approaches in prevention interventions have combined objective knowledge about drugs and their effects with peer resistance skills, self-esteem, and other social skills that help youth deal with developmental challenges. These skills presumably help adolescents to avoid or resist use <strong>of</strong> substances ranging from alcohol and tobacco to marijuana, cocaine, and inhalants. Still, it is unknown whether omission <strong>of</strong> information about inhalants weakens the impact <strong>of</strong> prevention programs in general or on inhalant abuse specifically. OVERVIEW OF POLICY OPTIONS There is no articulated national or Federal approach to the inhalants problem. Federal policy has evolved by omission or analogy, rather than commission. The <strong>National</strong> Drug Control Strategy barely mentions inhalants and contains no policy initiatives or recommendations specific to inhalants. There are product and occupational safety agencies (CPSC, FDA, OSHA, and EPA) with policies that address inhalant abuse only indirectly. The nationwide Drug-Free Schools program has resulted in a rapid proliferation <strong>of</strong> school-based prevention since it was passed in 1986 (Office <strong>of</strong> <strong>National</strong> Drug Control Policy 1993), but the Drug-Free Schools and Communities Act does not address inhalants, and many <strong>of</strong> the curricula being used by schools also leave out inhalants. Finally, there has been virtually no research on treatment for inhalant abuse. In contrast, States have been very active in promulgating statutory initiatives against inhalants. These efforts, however, seem unlikely to have had significant impacts. Most State efforts have been product or supply reduction oriented, including criminalizing use <strong>of</strong> inhalants and making business regulations designed to limit accessibility <strong>of</strong> products. These policies have not been evaluated, but perhaps more importantly they generally are not enforced. Few States have undertaken prevention and treatment initiatives, such as the effort in Texas, but there is not even anecdotal evidence <strong>of</strong> effectiveness. In general, there is insufficient information about the effectiveness, benefits, and costs <strong>of</strong> the four policy alternatives (i.e., change products; restrict access to abused products; implement targeted prevention; provide treatment) to make recommendations between the alternatives. 297
Policy Alternative 1: Change Products This seems like a deceptively easy policy approach: Ban or limit the use <strong>of</strong> particular substances with abuse liability. However, there are thousands <strong>of</strong> substances and products with abuse potential. It conceivably would cost billions <strong>of</strong> dollars to reformulate these products, and then it seems probable that the products would be both less effective and more expensive. Many observers believe (although it is not proven) that users will switch to abusing other products if only the products found to be preferred by abusers are singled out for reformulation. Several manufacturers have put additives or irritants into products. This may have reduced their abuse, but this possible outcome has not been rigorously studied or documented. Several State government efforts to mandate use <strong>of</strong> additives in abusable products failed because safe and acceptable additives could not be identified. However, it should be noted that there have not been significant efforts to identify or develop such additives. Policy Alternative 2: Restrict Access to Abusable Products States have enacted such restrictions a number <strong>of</strong> times. These provisions appear not to be enforced and probably are not enforceable without great expense. Policy Alternative 3: Implement Prevention Efforts Targeted at <strong>Inhalant</strong> <strong>Abuse</strong> The Drug Free Schools and Communities Act (DFSCA) requires each school district receiving Federal funding to implement comprehensive substance abuse programs for kindergarten through grade 12. Virtually all school districts have some kind <strong>of</strong> program in place. The DFSCA does not specify what should be in the programs. This study reviewed selected prevention curricula and found that inhalants are addressed by about half <strong>of</strong> the curricula and that very little information is conveyed in those programs. In fact, there is virtually no research base to justify whether or how inhalants should be dealt with in school-based prevention programs. There is a great need for pr<strong>of</strong>essional consensus-building on both whether and how to include inhalants in such programs, as well as good research on these same topics. 298
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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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TABLE 7. Local surveys giving infor
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presented as a confidential “Scho
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TABLE 8. Surveys of</strong
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Children’s Act 1989: Section 17 r
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problem would go away like other te
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Children ages 14-16 “should have
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contributions from many small group
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Chadwick, O.; Anderson, R.; Bland,
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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
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Page 271 and 272: TABLE 1. Recent use a of</s
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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 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 297 and 298: TABLE 5. Specified products regulat
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Page 301: appear to enter treatment that prog
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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