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An Overview <strong>of</strong> <strong>Inhalant</strong> <strong>Abuse</strong> in Selected Countries <strong>of</strong> Asia and the Pacific Region Foong Kin and Vis Navaratnam INTRODUCTION The inhalation <strong>of</strong> volatile substances for mind-altering and recreational purposes is a phenomenon <strong>of</strong> recent origin in most countries in Asia and the Pacific region. This could be explained partially by the ready availability and low cost <strong>of</strong> other substances <strong>of</strong> abuse, such as heroin. Australia and the Philippines were among the first countries in the region to report the emergence <strong>of</strong> problems related to the use <strong>of</strong> volatile substances. This form <strong>of</strong> drug abuse has drawn considerable concern in this part <strong>of</strong> the world over the last decade as more countries have noted the increase in incidence <strong>of</strong> inhalant use and abuse among their young population. For example, in Thailand and Singapore an epidemic <strong>of</strong> inhalant abuse was recorded in the 1980s (Association <strong>of</strong> Southeast Asian Nations 1986; Pemgpam et al. 1992). The increased severity <strong>of</strong> this problem in these two nations may be associated with the stringent controls on opiates, mainly heroin. Although the extent <strong>of</strong> the problem <strong>of</strong> inhalant abuse is minimal within the context <strong>of</strong> the national drug abuse problem in countries in the region, concerted efforts have been undertaken in most countries to prevent the further spread <strong>of</strong> this phenomenon. METHODOLOGY A literature review was carried out to examine available publications and reports on inhalant use and abuse in the region. Concurrently, an open-ended questionnaire was developed. The questionnaire was sent to regional countries through <strong>of</strong>ficial agencies, as well as the respective national nongovernmental organizations affiliated with the International Federation <strong>of</strong> Non-Governmental Organizations Against Substance <strong>Abuse</strong> (IFNGO). 29
Epidemiologic data were obtained for nine countries: Australia, Brunei Darussalam, Hong Kong, Malaysia, New Zealand, Philippines, Republic <strong>of</strong> Korea, Singapore, and Thailand. Most <strong>of</strong> the other countries in the region have difficulties in describing the situation <strong>of</strong> inhalant use and abuse because <strong>of</strong> lack <strong>of</strong> information. Based on the responses as well as on published literature, a country-by-country summary has been prepared. The sources <strong>of</strong> information on inhalant abuse vary between the countries. They include data from justice systems (in the case <strong>of</strong> Malaysia and Korea), school surveys (Australia and New Zealand), high-risk groups (New Zealand and Australia), observational studies (Australia), clinical settings (Thailand and the Philippines), and reporting systems (Singapore and Hong Kong). Each source provides an indication <strong>of</strong> a specific type <strong>of</strong> inhalant abuser. For example, school surveys most likely will include beginners and experimenters, while cases contacted in clinical settings will be the more severe abusers. Comparability was limited due to variations in sources <strong>of</strong> data. Caution was exercised in attempting to compare observations <strong>of</strong> different countries. Another limiting factor in conducting a regional analysis is the representativeness <strong>of</strong> the data collected for each country. Most <strong>of</strong> the countries’ assessments <strong>of</strong> the problem are based mainly on selected samples and groups that may or may not be generalizable to the total inhalant abuser population in each country. Another limitation is associated with the variations in method or tools that were used to gather data and the different ways in which questions were constructed. This restricts the cross-cultural comparability <strong>of</strong> the results. Furthermore, prevalence rates were not available for most countries. In spite <strong>of</strong> these differences, some common features can be inferred from the available information. It is very apparent from this regional analysis that there is a need for more systematic epidemiological studies to determine the extent and nature <strong>of</strong> the problem <strong>of</strong> inhalant abuse and to establish appropriate and feasible information-gathering mechanisms that can monitor this problem over time. This chapter presents an overview <strong>of</strong> the extent and nature <strong>of</strong> the problem <strong>of</strong> inhalant use and abuse in selected countries in this region, A description <strong>of</strong> the problem in each country is presented first, followed by an overall analysis <strong>of</strong> the problem in the region. General trends and patterns 30
Page 1 and 2: National I
Page 3 and 4: ACKNOWLEDGMENT This monograph is ba
Page 5 and 6: Treatment Strategies for Volatile S
Page 7 and 8: extent of inhalant
Page 9 and 10: agencies. Dr. Carlini-Cotrim conclu
Page 11 and 12: prevalence, after alcohol and tobac
Page 13 and 14: Inhalant Use in th
Page 15 and 16: FIGURE 1. Lifetime prevalence for 1
Page 17 and 18: Reliability of the
Page 19 and 20: use beginning in 1987 when the surv
Page 21 and 22: TABLE 2. Current use of</st
Page 23 and 24: TABLE 3. Use of in
Page 25 and 26: TABLE 4. Inhalant
Page 27 and 28: TABLE 5. Lifetime prevalence and cu
Page 29 and 30: TABLE 7. Inhalant
Page 31 and 32: CONCLUSION Unlike other drugs in th
Page 33: AUTHORS Ruth W. Edwards, Ph.D. Rese
Page 37 and 38: perception of the
Page 39 and 40: Malaysia In Malaysia, the abuse <st
Page 41 and 42: The primary method of</stro
Page 43 and 44: them at least two to three times pe
Page 45 and 46: Curiosity is the most popular motiv
Page 47 and 48: Inhaling from a plastic bag: The vo
Page 49 and 50: (between US $0.04 and US $0.80) a d
Page 51 and 52: truant, who have money, and who are
Page 53 and 54: Edmondson, K. Review of</st
Page 55 and 56: Inhalant A
Page 57 and 58: Children working in the streets 280
Page 59 and 60: (1986), collected data on the preva
Page 61 and 62: Anecdotal information suggests that
Page 63 and 64: FIGURE 3. Psychological process mod
Page 65 and 66: ehavior. A secondary aim has been u
Page 67 and 68: REFERENCES ABC Communication. Consu
Page 69 and 70: Inhalant Use Among
Page 71 and 72: TABLE 1. Lifetime prevalence <stron
Page 73 and 74: TABLE 3. Lifetime prevalence <stron
Page 75 and 76: TABLE 4. Solvent use found for 1,83
Page 77 and 78: however, rarely is taken into consi
Page 79 and 80: TABLE 7. Weekly use (at least once
Page 81 and 82: TABLE 9. Use of dr
Page 83 and 84: 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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Page 227 and 228:
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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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Market and Opinion Research Interna
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Streete, P.J.; Ruprah, M.; Ramsey,
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Treatment Strategies for Volatile S
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that they chose solvents not only b
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Medical management and detoxificati
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challenges to a healthy readjustmen
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REFERENCES Beauvais, F. Social and
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Gathering Epidemiologic Information
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DIRECT POPULATION SURVEYS Cross-sec
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The findings in the two surveys wer
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TABLE 1. Recent use a of</s
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are due to the fact that inhalants
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number usually is advertised in tel
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REFERENCES Beauvais, F. Volatile so
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Inhalants: A Polic
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predominated, but it seems clear th
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classes containing these substances
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justify their positions more on pri
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eformulation of pr
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with abuse potential, and additiona
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TABLE 2. Type of l
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TABLE 3. Type of d
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TABLE 4. Type of b
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TABLE 5. Specified products regulat
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TABLE 6. Prevention curricula and i
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appear to enter treatment that prog
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Policy Alternative 1: Change Produc
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outcome evaluations. Ideally, such
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Mata, A.G., Jr., and Andrew, S.R. <
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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
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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