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

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community-based programs are the most effective for the majority <strong>of</strong> young people. The Philippines In the Philippines, the abuse <strong>of</strong> organic solvents has gained popularity since the early 1970s. This was believed to be partly related to the decline in the availability <strong>of</strong> illicit drugs such as heroin and morphine. Information on inhalant abuse is collected from community- and schoolbased surveys and reports from drug treatment and rehabilitation centers. In 1981, only 42 cases were detected, but this figure increased to 133 in the first 11 months <strong>of</strong> 1985 (Navaratnam 1988). In 1992 alone, a 79-percent increase in the abuse <strong>of</strong> a local brand <strong>of</strong> household glue was reported compared to the previous year (D.V. Varela, personal communication, May 21, 1993). A recent study <strong>of</strong> drug abusers admitted into drug treatment facilities in Manila in 1992 shows that 5.5 percent <strong>of</strong> 310 clients admitted last year primarily were inhalant users (Dangerous Drugs Board, unpublished data). There has been a steady increase in the number <strong>of</strong> reported cases <strong>of</strong> inhalant abuse, particularly the abuse <strong>of</strong> household glue, from various inpatient and outpatient rehabilitation facilities in the past 5 years. One brand <strong>of</strong> household glue was included in a list <strong>of</strong> the 10 most commonly abused drugs in the Philippines in 1992 (Dangerous Drug Board, unpublished data). Solvent abusers in this country predominantly are males who are out <strong>of</strong> school or school dropouts. They primarily are engaged in street jobs such as selling newspapers, rugs, or flowers and come from very poor families. They are about 6 years younger than the general population <strong>of</strong> drug abusers, as indicated by their mean age <strong>of</strong> 15 years old. Moreover, a significant percentage (40 percent) are involved in antisocial activities such as stealing and prostitution. A recent study <strong>of</strong> the social, psychological, and demographic pr<strong>of</strong>iles <strong>of</strong> 64 self-confessed inhalant abusers referred to the Treatment and Rehabilitation Division <strong>of</strong> the Dangerous Drugs Board showed that the inhalant abusers are emotionally laden and have a strong need for acceptance, affection, trust, and confidence (Dangerous Drugs Board, unpublished data). This may be related to the fact that most <strong>of</strong> them were brought up by single parents or were abandoned completely by both parents and relatives. They are persons with low self-esteem who are evasive towards people in authority and have limited interpersonal relationships. A majority <strong>of</strong> the abusers are considered as regular or compulsive users <strong>of</strong> volatile substances, using 37
them at least two to three times per week (D.V. Varela, personal communication, May 21, 1993). In the Philippines, inhalant abuse primarily is a peer-perpetuated activity. Peer influence represents a significant factor, particularly in initiating inhalant use. Furthermore, easy availability and affordable price are the other reasons reported for starting and continuing the use <strong>of</strong> such substances. In addition, favorable effects experienced by the user such as “lightness,” numbness <strong>of</strong> the whole being or body, absence <strong>of</strong> hunger pains, and fullness <strong>of</strong> the stomach contribute to the continued use <strong>of</strong> inhalants. Household glue is the most widely abused volatile substance. Other available volatile substances include nail polish remover, acetone, paint, lacquer, thinner, floor polisher, insecticide spray, and gasoline. The most common methods <strong>of</strong> inhaling these substances is through the use <strong>of</strong> plastic bags (particularly for household glue) and use <strong>of</strong> rugs or cotton cloth for such volatile substances as solvent and acetone. There are instances when such substances are hand held and sniffed directly from the container. Most Filipino solvent abusers are polydrug abusers. Marijuana appears to be the favorite drug <strong>of</strong> abuse, followed by cough preparations. Alcohol and tobacco use also are very common among this group. Although there has been no medical research on the health effects <strong>of</strong> inhalant abuse in the Phillippines, the problem <strong>of</strong> inhalant abuse has become a serious cause <strong>of</strong> concern among those involved in the prevention and control <strong>of</strong> drug abuse. It has precipitated the establishment <strong>of</strong> more treatment facilities for inhalant-abusing street children. In Manila, there are three inpatient facilities operating in the city and accredited by the Dangerous Drugs Board that provide a home to street children. These programs provide residential care, social services, medical services, psychiatric and psychological services, educational and vocational training, sports and recreation opportunities, talent development, job placement, and involvement in income-generating projects. Preventive approaches adopted include a nationwide drug information campaign that covered solvent-inhalant abuse and provided street-based counseling services. The Government, through the Department <strong>of</strong> Social Welfare, has provided livelihood opportunities for street children who are inhalant abusers. Presidential Decree 1619, which was promulgated in 38
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 and 34: AUTHORS Ruth W. Edwards, Ph.D. Rese
Page 35 and 36: Epidemiologic data were obtained fo
Page 37 and 38: perception of the
Page 39 and 40: Malaysia In Malaysia, the abuse <st
Page 41: The primary method of</stro
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
Page 85 and 86: RESULTS Prevalence Rates The findin
Page 89 and 90: Incidence Rates Data from the surve
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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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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
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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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