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

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Introduction Zili Sloboda, Nicholas Kozel, and Mario R. De La Rosa The abuse <strong>of</strong> the class <strong>of</strong> substances that include volatile solvents and inhalants is an endemic problem worldwide. The abuse <strong>of</strong> such substances, however, is not a new or novel behavior, but one that has been observed by epidemiologists for decades throughout the full array <strong>of</strong> cultural settings. There is no doubt that these substances have the potential to cause major physiological and neurological damage that, in many cases, cannot be remedied. The severe organic damage associated with inhalant abuse has been documented extensively, but the difficulties in controlling abuse through environmental regulations and mechanical means have perplexed public health <strong>of</strong>ficials. These issues <strong>of</strong> regulation as well as the epidemiology and consequences <strong>of</strong> inhalant abuse as an international problem are addressed in this volume. Research directions on inhalant abuse in the early 1990s have begun to focus on exploring the psychosocial and cultural factors responsible for the use <strong>of</strong> inhalants and the physical consequences associated with the use <strong>of</strong> different classes <strong>of</strong> volatile solvents. Despite these research efforts, information on the epidemiology and etiology <strong>of</strong> inhalant abuse in the United States and other countries is limited. The lack <strong>of</strong> systematic information on the extent and nature <strong>of</strong> inhalant use and abuse limits the development <strong>of</strong> effective, culturally relevant prevention and treatment programs to address this problem in the United States and other countries <strong>of</strong> the world. The chapters presented in this monograph are the result <strong>of</strong> a technical review meeting titled “<strong>Inhalant</strong> <strong>Abuse</strong>: An International Perspective,” sponsored by the Division <strong>of</strong> <strong>Epidemiology</strong> and Prevention Research, <strong>National</strong> <strong>Institute</strong> on Drug <strong>Abuse</strong> (NIDA), and the United States Information Agency. The major objective <strong>of</strong> this meeting was to review the state <strong>of</strong> knowledge about the nature and extent <strong>of</strong> the problem in countries that represent various regions <strong>of</strong> the world, as well as to describe the characteristics <strong>of</strong> those involved and, where data permit, discuss the etiology <strong>of</strong> the behavior. Prior prevention efforts in the United States to address inhalant abuse were reviewed, and recommendations were made for future prevention programming. In addition, issues relative to the treatment <strong>of</strong> inhalant abuse were raised and discussed, as were recommendations for future research on the nature and 1
extent <strong>of</strong> inhalant abuse in the United States and other countries in the world. The chapters in this volume describe the nature <strong>of</strong> inhalant abuse in countries representing the regions <strong>of</strong> the world: North America, Asia, Europe, Latin America, and Africa. The final section <strong>of</strong> the book presents chapters that address the prevention <strong>of</strong> inhalant abuse, methodological issues related to the conduct <strong>of</strong> epidemiologic research on inhalants, and policy issues concerning inhalant abuse. The most extensive data regarding the abuse <strong>of</strong> inhalants that are available are those for the United States. However, despite the ready availability <strong>of</strong> descriptive information on the extent <strong>of</strong> inhalant abuse, the nature <strong>of</strong> the many substances involved and the characteristics <strong>of</strong> the abusing population increase the difficulties <strong>of</strong> such assessments. Drs. Ruth W. Edwards and E.R. Oetting in their chapter, “<strong>Inhalant</strong> Use in the United States,” lay out the issues related to the collection <strong>of</strong> epidemiologic information on inhalant abuse. The definitional issue is addressed, and the authors suggest several approaches that can be used in data collection instruments. They state, “There does not appear to be a simple solution to the problem <strong>of</strong> definition <strong>of</strong> inhalants, but various conventions have emerged in the field and in the literature.” These “conventions” are discussed and put into the frame <strong>of</strong> the survey questionnaire. Comparisons are made among various question formats, and the authors demonstrate how such formats will elicit differing forms <strong>of</strong> response that may have divergent degrees <strong>of</strong> reliability and, <strong>of</strong> particular concern, validity. This introduction sets the stage for a presentation <strong>of</strong> the findings regarding inhalant abuse from several national and local area studies in the United States and from around the world. These studies are presented to show the differing patterns <strong>of</strong> inhalant abuse across demographic groups including age, gender, ethnicity, geographic area (rural versus urban), and school status (dropouts). Finally, it is pointed out that for some populations, inhalants are gateway drugs leading to the initiation <strong>of</strong> illicit drugs. Drs. Foong Kin and Vis Navaratnam provide an overview <strong>of</strong> inhalant abuse in countries <strong>of</strong> Asia and the Pacific region, including Australia, Brunei Darussalam, Hong Kong, Malaysia, New Zealand, the Philippines, the Republic <strong>of</strong> Korea, Singapore, and Thailand. As noted in the chapter, data on the overall incidence, prevalence, correlates, and consequences <strong>of</strong> inhalant abuse in the Asian region are limited and vary widely between countries. Some countries, such as the Philippines, have 2
Page 1 and 2: National I
Page 3 and 4: ACKNOWLEDGMENT This monograph is ba
Page 5: Treatment Strategies for Volatile S
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 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
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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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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
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138 139 140 141 142 143 IMAGING TEC
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NIH Publication No 95-3831 Printed
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