Rising to the Challenges of Inhalant Abuse

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NIDA Acting Director, Glen R. Hanson

In the last 10 years, drug abuse research has greatly expanded the range of approaches available to prevent and treat abuse of cocaine, opiates, marijuana, and nicotine. Research also has responded quickly to newer threats to our Nation's youth, such as those posed by MDMA and other "club drugs." During this decade of achievement, however, we have been noticeably less successful in advancing scientific knowledge and understanding of a persistent public health problem that has long affected young people all over the world: inhalant abuse -- the dangerous practice of inhaling fumes from a variety of widely available products to obtain an intoxicating effect.

In the United States, very young children and adolescents can readily find such products as spray paint, glues, and cleaning fluids at home and are among those most likely to abuse these extremely toxic substances. The 9.1 percent of 8th-graders who said they had used inhalants during 2001 was more than double the 4.5-percent rate reported by 12th-graders, according to the annual NIDA-supported Monitoring the Future (MTF) study of drug use among schoolchildren. (See Tearoff, "Inhalant Abuse Among Young People," for data.)

Inhalants are accessible, inexpensive, and subject to abuse by an unusually diverse range of people, including very young children.

In other areas of the world also, inhalant abuse is concentrated among young people, particularly those who suffer the ills of poverty, including malnutrition, lack of health services, and homelessness. In 2000, a multi-national meeting sponsored by NIDA and the World Health Organization reported that inhalant abuse is a major problem among the tens of millions of children and adolescents who live on the streets of the world. Meeting participants agreed to develop research-based policies and programs for these vulnerable children that can help prevent abuse of inhalants and other harmful substances.

Many challenges have slowed the development of scientific responses to inhalant abuse. Inhalants are the only abused substance classified solely by their means of administration -- abusers take them by breathing in vapors from volatile substances. Thus, researchers must try to characterize a wide variety of substances and chemicals found in hundreds of common household, industrial, commercial, and medical products that can be inhaled to produce a psychoactive effect. These products are accessible to everyone, inexpensive, and subject to abuse by an unusually diverse range of people, including very young children, young adults in assorted occupations, and homeless adolescents and adults. This complex mix of substances and abusers, the technical difficulties of developing animal models that replicate human patterns of abuse, and ethical limitations on studying such toxic substances in humans have confounded attempts to clarify the addictive and toxic effects of inhalants and develop appropriate prevention and treatment interventions.

In spite of these challenges, there is some good news in the United States in that annual levels of inhalant abuse have declined since 1995, according to MTF. To what can we attribute this reduction? Research indicates that if young people believe they can suffer serious harm from abusing any substance, they are less likely to do so. Schoolchildren's perceptions of inhalants' risks began to increase between 1995 and 1996, and the downward trend in use began the following year.

We believe that educational efforts by NIDA and our partners in the National Inhalant Prevention Coalition to inform parents and young people about the many ways inhalants can harm their health and well-being may have played a role in increasing the percentages of 8th- and 10th-graders who see great risk in using these substances. NIDA's educational materials describe how unconsciousness and sudden death can result from a single session of sniffing fumes from such commonplace products as spray paints, gasoline, and propane. Our recently revised Research Report on inhalants also has detailed the extremely harmful consequences of chronic abuse that can include severe long-term damage to the brain, liver, and kidneys; impaired cognition; movement disorders; and other neurologic dysfunction.

This year, we intensified our inhalant information efforts by issuing two "art cards" targeted to children and adolescents. These high-impact postcards, featuring graphics from the National Inhalant Prevention Coalition Web site, courtesy of GSD&M, a Texas advertising agency, dramatically evoke the possible brain-damaging and heart-stopping effects of sniffing inhalants. In conjunction with NIDA's participation in National Inhalants and Poisons Awareness Week activities last March, we distributed 12,500 of these cards to hundreds of surf, skate, and ski shops around the country.

While we are encouraged by recent trends in inhalant abuse, scientific research can and must do more to counter the continuing threat to the health and well-being of young people that inhalant abuse poses. Therefore, late last year, NIDA earmarked $2 million to expand inhalant research. We anticipate funding a range of research studies under this broad request for applications by October of this year. These studies will provide much-needed new knowledge about

  • the biological and behavioral underpinnings of inhalant abuse;
  • the nature and extent of inhalant use and abuse;
  • the risk factors in general populations and vulnerable groups that affect initiation of inhalant use;
  • approaches to preventing inhalant use in these groups;
  • the neurological, behavioral, and cognitive consequences of inhalant abuse; and
  • effective ways to engage and treat individuals who chronically abuse inhalants.

For too long, the daunting challenges of studying inhalant abuse have discouraged new research and left us without adequate responses to this problem. Now, science is rising to the challenge. Our research initiative has yielded 30 proposals to study topics ranging from the molecular mechanisms of inhalants through new research-based prevention and treatment approaches. The breadth and depth of this response assures me that we will soon be bringing the full panoply of modern scientific tools and techniques to bear on inhalant abuse. I have no doubt that this focused effort will succeed, as it has with other drugs of abuse, in reducing the tremendous toll of this public health problem in the United States and around the world.