Aims & Objectives Aims Objective(s) Reduce solvent abuse by young people Reduce associated problems Objective(s) Reduce availability Support youth & families Improve case management Re-integrate youth Manage problems such as intoxication on the street, anti-social behaviour Mobilise community action Maintain community action Consider listening (using reflective techniques) to possible distress of participants regarding solvent inhalation before using these slides AIMS Aims could also include maximise well being of youth, restore community stability, etc depending upon situation OBJECTIVES Re-integration and support for solvent using youth may be difficult for those who would prefer punishment & banishment as primary interventions. Rationale can be found in slide 6 (failure & rejection as reasons for use) MAINTAIN ACTION Useful to make the point that these are often complex problems which develop over time. Quick fix solutions are likely to be as effective as the quick fix solution of drug user. Short and Long-term solutions, possibly including some structural changes are required. Discussed in Slide?

Overview of Areas Effects Harms Protective Factors Types of Users Reasons for Abuse Possible Interventions OVERVIEW Overview helps to orientate participants to what is coming. Could possibly be used as an opportunity to contract with group about any other areas. Participants may choose this as a time to vent frustrations - ie “are we going to talk about how such & such isn’t doing enough…” Reflect back the content & emotional aspect of the issue. Then possibly contract to work through these issues with the person/group during the planning part of the session (if one exists).

Effects - Short Term Similar to alcohol but quick Differences depending upon drug, individual, & environment Intoxication in 1-5 minutes, wears off in 3-40 minutes (unless topped-up) About half have visual illusions Possibly, red eyes, runny nose, nausea, headache SHORT-TERM EFFECTS SIMILAR TO ALCOHOL ask participants to describe the effects of alcohol & compare with solvents DRUG INDIVIDUAL ENVIRONMENT Note differences depending upon drug (dose, other substances etc) individual (physical & psychological) & environment (family, peers,resources, situation) TOLERANCE to solvents can develop meaning that the user will require more substance for the same intoxicating effect. WEARS OFF ON 3-40 MINUTES Does not include hangover effect of headache May be longer if used with other drugs which is common VISUAL ILLUSIONS Perceptual distortions similar to hallucinations by not as marked. ‘Group illusions’ are shared distortions based on a suggestion by one group member. Often scary but enjoyed in the same way as a horror movie. RASH Some talk about a rash on the face - generally rare and most likely to be Acne rather than solvent related.

Harms Accidents when intoxicated Anti-social behaviour (disruption, stealing, vandalism, etc) May affect short-term memory & impulsivity (mostly reversible) Brain damage mostly from petrol sniffing - generally rare from other substances Sudden Sniffing Death (Butane & Aerosols) - rare Suffocation from plastic over head, spray directly into mouth, inhale vomit - rare Weight loss (long-term use) ACCIDENTS Motor vehicle, drowning, burns (particularly if using toluene, petrol or exploding aerosol cans) ANTISOCIAL BEHAVIOUR Not caused by solvents themselves as is the case with alcohol. Often associated with truanting SHORT-TERM MEMORY & BRAIN DAMAGE Reversible message should be encouraged with users as it is with smokers - if you continue you increase the risk of permanent damage, but if you stop now, likely effects reversed. This supports change rather than further failure. SUDDEN SNIFFING DEATH Heart failure (fibrillation) when solvent mixes with bodies adrenaline like substances which are produced by stress, exertion, excitement & anxiety SUFFOCATION DEATHS These have some harm reduction implications. However, use caution before discussing these. Note group norms as well as particular methods and situations of use - may not be especially relevant.

Protective Factors Most young people don’t use (positive peer pressure) Seen as ‘gutter drug’ by most youth Unpleasant smell & after effects Generally, easy detected Used in public Feared by most youth as harmful Not advertised or glamorised Short-term intoxication Most grow out of use with no harm MOST YOUNG PEOPLE DON’T USE Reframe use statistics as about 9 in 10 youth will never use solvents. Of those who experiment with solvents, it’s likely that at least 9 in 10 will come to no harm and will not become dependent (ie more than 99 in 100 youth will not come to harm and not become dependent on solvents) Very important to understand why this is so and not disturb those factors which are keeping the majority of youth safe. Also to possibly mobilise the positive energy of the majority of youth . EASILY DETECTED This is true of most solvents (smell & evidence like paint on face) but not for some such as under-arm aerosols, butane. Need to take care not to publicise the less detectable substances as they are more harmful. USED IN PUBLIC Public use represents a threat to disorder & should be managed as per intoxication on the street (see slide 10). However, this use is protective in that it is easily identified and accessed by services. Further, use by self in dangerous situations is more likely to result in harm. SHORT-TERM INTOXICATION Allows for quick sobering-up. Easily able to regulate dose

Types of Users Experimental, Social, Dependent, Chaotic Come from all groups (Aboriginal, Non-Aboriginal, rich, poor) Some groups more visible Some have underlying problems some don’t Mostly aged 12 - 16 Some younger & older users  EXPERIMENTAL, SOCIAL, DEPENDENT, CHAOTIC These distinctions are important in the context of interventions and likely harms associated. Chaotic refers to those users who will tend to use anything at any time to get intoxicated.  COME FROM ALL GROUPS - SOME MORE VISABLE However, there does tend to be a higher representation from Aboriginal and lower socio-economic groups (may be mostly to do with lower socio-economic rather than Aboriginal). Use in public amplifies this trend.  SOME HAVE UNDERLYING PROBLEMS - SOME DON’T Some solvent users are reasonably well adjusted while others are not. Their reasons for use, problems associate with use and interventions may be different (see slide 6).  MOSTLY AGED 12-16 Peak age range is 13-15 yrs. Differs for different communities. Best to ask local community about their age range before putting up this point. Some older people may use solvents because they are cheap and available. Older people may buy solvents and provide to younger persons in exchange for money or sexual favours.

Reasons for Abuse Same as why adults use alcohol: To challenge adults fun, socialise, effect, available To challenge adults To copy adults (intoxication) Feelings of failure (lack of success) Cover up bad feelings Show they don’t care about themselves Show they are hurting & to get attention A form of self-harm Be successful at being bad &/or sad Join with other ‘outcasts’  SAME AS WHY ADULTS USE ALCOHOL Ask group why adults use alcohol before revealing “fun, socialise, etc”  TO CHALLENGE ADULTS A developmental step around being different from parents and setting new boundaries. Need to explore alternative ways youth can challenge adults and take risks without harming themselves.  TO COPY ADULTS Modelling behaviour is a powerful teacher. If parents use drugs like alcohol to socialise and to cope, their children are likely to also seek intoxication. It may also seem to be a ‘grown-up’ thing to do.  FEELINGS OF FAILURE (LACK OF SUCCESS) May not simply be to cheer up someone who is sad. Some youth identify with solvents as being gutter drugs and dangerous and use them to demonstrate their distress. The dynamic can be similar to that of self-harm and/or suicide. Those who have been ‘unsuccessful’ at home (eg violence, neglect, sex abuse), at school (poor literacy & school performance) or with peers (unpopular, rejected by mainstream) may choose solvent use as a way of being the best at being bad (or sad).

Interventions - Overview Retailer Interventions Youth Support Family Support Managing Intoxication Agency Support & Agency Resources Media Management What Not to Do Community Action  INTERVENTIONS - OVERVIEW Aim to show a range of actions can be taken (reduce helplessness and blame), There should be something for everyone Don’t go into detail yet  Possibly provide options in group clusters: What young people can do What solvent users can do What families can do What LDAGs can do What professional agencies can do What businesses can do

Interventions Retailer Interventions Retailers Acting Against Solvent Use Kit Point of sale restrictions Use of signs Staff training Display & placement of products Protocols between retailers, police, youth workers, & other welfare workers Advantages for retailers  RETAILER KIT Most of the interventions are in the Retailers Acting Against Solvent Use Kit (ring WADASO if you do not have some of these). Certificates should only be given after retailers have taken some action. Possibly attached to positive publicity (caution in accidentally advertising solvents - see slide 4)  POINT OF SALE RESTRICTIONS Legally and socially able to refuse sale of solvents if believed to be using for the purpose of intoxication. Signs will support this as will staff training.  DISPLAY & PLACEMENT OF PRODUCTS Use dummy containers, possibly in locked containers or in sight of check-out. Video surveillance if affordable.  PROTOCOLS BETWEEN RETAILERS, POLICE, ETC: These are designed to protect retailer staff, to maintain order and to provide opportunities for the welfare sector to support these youth and their families. Consider youth-worker intervention prior to police intervention.  ADVANTAGES FOR RETAILERS: Could brainstorm this: Possibly, less theft, feelings of social responsibility, reduced staff and customer harassment, improved public perception & possibly sales.

Interventions Youth Support Aim to reintegrate back into the community Emotional Support & Monitoring click here for more info Inter-agency case management for long-term users with multiple issues Generic youth activities Recreation, Sport, Youth Centre, Dances... eg Community Construction Playground School Drug Education Project Curriculum, Policy, Truancy, School Services Staff Pause Prompt & Praise Program Peer support programs   YOUTH SUPPORT Can be split into youth who are solvent users and general youth support strategies.  AIM TO REINTEGRATE INTO THE GENERAL COMMUNITY Rather than ‘punishment & banishment’ aim to find opportunities to reward pro-social behaviour. Real fear of these youth ‘infecting’ others with negative behaviours. Need for creative strategies to prevent this.  EMOTIONAL SUPPORT & MONITORING Research Institute on Addictions (Barnes 1995) (http://www.ria.org/summaries/rib/rib955.html - see last slide for definitions & examples) This research also contains info on what doesn’t work: physical discipline and reasoning  GENERIC YOUTH ACTIVITIES - Community Construction Playground at Karawara - Successful supervised program for 8-14 yr olds building cubbies etc - Short video available from Next Step  SCHOOL DRUG EDUCATION PROJECT Are local schools participating?? Ring Richard Crane (08) 9264 4743 E-mail: Richard.Crane@eddedpt.wa.edu.au Or Derek Bilton on same number (For info in School Services Staff Project). Also note “The Students at Educational Risk Project” (08) 9264 5276 PAUSE PROMPT & PRAISE FOR PARENTS & PEERS Ring Dr Steve Houghton @ UWA Education Dept or Girrawheen High School  PEER PROGRAMS- Phone Justine Hanson 9586 1746 for Mandurah Project

Interventions Family Support Parent support groups Parent drug education Teach Emotional Support & Monitoring PDIS “Family Fun Day” Respite care Management of parent alcohol and other drug use  FAMILY SUPPORT Treating the family as the unit of intervention may be useful to de-emphasise solvent use (which may be acting as a dysfunctional family & community scapegoat for other issues). However, caution in not blaming parents or family members - reframe as support.  PARENT SUPPORT GROUPS Possibly al-anon or nar-anon or form a new self-help group. Call PDIS (Lisa Knight) or Claudia Houareau @ S. Metro CDST on how to set up parent self-help. Normally requires professional support to get things moving.  PARENT DRUG EDUCATION Generic such as Drugs In Perspective from schools or specific to solvents. Should contain more than drug info and include skills and strategy development.  EMOTIONAL SUPPORT & MONITORING Generic parent training such as offered by FCS Parent Help Centres. Should not presume these skills. FCS web address for parent skills: http://www.fcs.wa.gov.au/parenting/default.htm  FAMILY FUN DAY As conducted by the Midland Local Aboriginal Advisory Group

Interventions Managing Intoxication Police use of 138B of Child Welfare Act Community Patrol “Safe House” to sober up and to assist Police and Community Patrol Do not chase or scare intoxicated person Remove solvents  MANAGING INTOXICATION Aim to demonstrate to youth & the community that this behaviour is not acceptable and that firm but supportive measures are in place.  138B OF CHILD WELFARE ACT Police (& designated welfare officers) currently have the right to pick up solvent users and take them to a responsible adult. Protocols between families, community members and welfare agencies should be developed which provide police with satisfactory placement options.  SAFE HOUSE A number of private homes or youth accommodation services may be willing to provide overnight safe accommodation for intoxicated homeless youth (note that solvent intoxication is not long lasting, however, abusive accommodation is).  DO NOT CHASE OR SCARE INTOXICATED PERSONS Danger of sudden sniffing death  REMOVE SOLVENTS Professional duty of care issues suggest that solvents which are used for intoxication should be removed from abusers. Ideally, they should then be handed to the police for storage or disposal.

Interventions Health & Welfare Agency Support Solvent abuse training Inter-agency protocols re shared case management & youth drug use Drug management web site support Click here for DrugNet if internet access Click here for Info on Volatile Substances from CEIDA CDST consultancy support ADIS consultancy support  HEALTH & WELFARE AGENCY SUPPORT Should not presume that health & welfare agencies know how to manage this issue. Can lead to high stress and burn out of staff. Can also lead to conflict between agencies if not well managed.  SOLVENT ABUSE TRAINING Professional staff training useful to provide common knowledge and language for dealing with solvents. Also an opportunity to consolidate inter-agency approaches if several agencies involved in training.  INTER-AGENCY PROTOCOLS RE SHARED-CASE MANAGEMENT Contact WADASO (08) 9483 8204 for a copy of Inner City Youth Partnership Protocols for Coordinated Service Delivery. Alternatively, contact Kalgoorlie FCS for copy of their Inter-Agency project around solvent abuse.  DRUG MANAGEMENT WEB SITE DrugNet for professionals only. http://www.drugprac.wa.gov.au [User Name:] drugprac [Password:] aod CEIDA for public use: http://www.ceida.net.au/druginfo/factsheets/volatile.html

Interventions Agencies & Resources Local Drug Action Group Community Drug Service Team ADIS & PDIS telephone supports Education, AMS, FCS, Police, MoJ, Sport & Rec, Local Council Youth accommodation services Other youth services Other general services & organisations Service groups  AGENCIES & RESOURCES Generally refers to people, services, dollars, other resources such as pamphlets, notice boards etc. Brainstorm of what is generally available is useful here before putting up this list of Agencies (which are designed to prompt).  Consider the WADASO Web site lists of services http://www.wa.gov.au/drugwestaus/html/cast/frames/services.html

Interventions Media Management Provide good news stories about youth Develop a relationship with media Request limit sensational solvents stories, no naming of products or methods of use Provide local contact point & ADIS number Use local notice board to post good news stories, photographs & youth project updates  MEDIA MANAGEMENT Generally falls into two areas: 1. Reduce accidental advertising around solvents via news stories 2. Increase positive news stories about youth Media is use here to include all forms of media including print and electronic media as well as other forms such as pamphlets and notice boards. Media management training may be helpful. See Reference: Rose & Midford “Media reporting of glue sniffing: Traps for the naïve expert” PRO-ED Vol 10 No 1 Jan-June 1994 p 23

Interventions What Not to Do (Remember Protective Factors) Don’t advertise solvents to others who otherwise might not be interested Don’t have special solvents lessons in schools Don’t use solvent abuse as the criteria for special attention - may reinforce the solvent abuse Don’t physically punish solvent abusers Don’t chase or scare solvent abusers  WHAT NOT TO DO These points are primarily designed to maintain the protective factors which are responsible for the majority of young people either not using solvents or not being harmed by their use. All interventions should consider whether or not they compromise the protective factors and if so should be given careful consideration in weighing up benefits and costs.

Community Action Link up with others Acknowledge any distress Identify key stake-holders 1:1, small and large group meetings Acknowledge any distress hear & reflect back emotional content mobilise energy into action What’s happening? How much abuse What actually is the problem who’s doing what, what’s helped & hindered  LINK UP WITH OTHERS Working together is more powerful than working alone Not everyone needs to be together at the same time  ACKNOWLEDGE ANY DISTRESS Solvent inhalation can generate a lot of emotional energy. This needs to be heard and reflected back before moving on - it may contain accusations and blame - simply reflect back emotional component first. Then use the energy generated to mobilise action. Ask how important the issue is and then get a commitment of their time & energy to take action.  WHAT’S HAPPENING Aim to get a clear picture by asking for specific examples of generalities. Also identify what’s working as well as what’s not - no use in re-inventing the wheel!

Community Action (Cont) Make a plan S.M.A.R.T. Goals (Specific, Meaningful, Realistic, Assessable, Time-Bound) How would it look if the problem was fixed? Who, What, How, By When Identify supports Make a start Small steps Review action Use telephone, e-mail & face to face What happened, what was learned, what next?  MAKE A PLAN Setting clear goals is a key to community action. The Solution Focused Brief Therapy question “How would it look if the problem was fixed” helps to identify tangible goals (See SFBT in the DrugNet web site)

Community Action (Cont) How to maintain action Complex problems require short and long-term solutions DO spend time to identify all the positive thing which have happened DO make public success via media or through personal rewards DO plan to meet regularly Expect energy to drop off - revive with imaginative mini projects DON’T gossip or fight - there always room for different approaches. Everyone doesn’t have to agree on everything.  HOW TO MAINTAIN ACTION Probably the biggest challenge to community work. May be useful for the community to consider a local community project which has run over a period of time and consider what were the successful factors which maintained it. May also require a hand-over phase if initiated by someone outside of the community or someone who is unable to sustain momentum.

_____________________________________ Support & Monitoring http://www.ria.org/summaries/rib/rib955.html INSTRUCTIONS For this article on the Web if you have internet access, click on the above Icon or address while in Slide Show (View menu then Slide Show) Alternatively, read the article by clicking on the text box below in Slide View (View menu then Slide) September 1995 Parents Can Help Prevent Teen Alcohol, Drug Use Support, Monitoring Key to Prevention, Study Finds Parents can help prevent teenage alcohol and drug use and other problem behaviors by being emotionally supportive of their children and by closely monitoring them, according to a multi- year study in progress at the Research Institute on Addictions. Interim data from the study of 699 adolescents and their families in the Buffalo, New York, metropolitan area reveals that adolescents whose parents supervise their friendships and activities are less likely to engage in problem behaviors, including drinking and illegal drug use. This protective factor is enhanced by a family climate of support and nurturance, the study shows. Associations between these parental behaviors and low levels of problem behaviors in teenagers were found among boys as well as girls, blacks as well as whites, and higher-income as well as lower-income teens. What works "Monitoring is the key factor," said the study's director, sociologist Grace M. Barnes, Ph.D., a senior research scientist at RIA. "Monitoring means knowing where your kids are, who their friends are, when they are coming in, and so on. We found that it's important for all adolescents and especially for the older kids. Parents might think that when the kids get older they don't need as much supervision, but they do." Monitoring was found to be more common in supportive families, Dr. Barnes said. She explained that a "supportive" family is one in which parents openly show affection, give their children praise and encouragement, maintain open communications, and do things with their children which both parents and kids enjoy. "A supportive environment makes the kids more receptive to monitoring, but it has to come earlier in the developmental span for it to have an effect." What doesn't work Attempting to control teenagers through physical discipline is not effective, the study indicated. "Coercive control, such as slapping and hitting, is associated with more problem behaviors, but we can't say whether it causes the problem behaviors or whether the problem behaviors tend to bring out this kind of response from the parents," Dr. Barnes said. She added that the study also debunked the value of trying to influence adolescent behaviors only by reasoning with them, a parenting style known as inductive control. "This approach was popular in the 60s and 70s. It's where the parent sits down with the teenager and uses rational, logical explanations for why he or she should or should not do something. We found that this has no effect on adolescent behaviors per se. Clear, concrete guidelines seem to work best." Differences between whites and blacks, boys and girls Of the 699 adolescents originally enrolled, 489 are white and 210 are black, closely mirroring the population of the Buffalo area. The study found that black adolescents have lower rates of alcohol and illegal drug use and other problem behaviors, despite having lower incomes and higher rates of single-parent families. "Being a member of a religion that preaches against alcohol use may help protect some black youngsters," Dr. Barnes observed. In addition, the study confirmed that males are more likely than females to drink, use drugs, or engage in crime. "Males have more problem behaviors, but they are monitored less," Dr. Barnes explained. "So it's especially important for parents to monitor boys." Future directions Dr. Barnes began the federally-funded study in 1989 with a sample of 13 to 16 year olds representative of the general population. Each year since, her research team has interviewed the teenagers, their parents, and adolescent siblings to gather information that sheds light on how families and peers influence teenage substance use and other problem behaviors. By the time the participants were 15 to 18 years old, 71 percent were occasionally using alcohol and 10 percent were heavy drinkers, defined as drinking at least once a week and having five or more drinks in a single sitting. About 30 percent reported using one or more illegal drugs in the past year, and close to one third had engaged in three or more instances of major delinquency, such as theft, assault, credit card fraud, or check forgery. Dr. Barnes has received additional federal funds to follow the participants into early adulthood, tracing the changes in drinking and drug use that occur during later adolescence and the young adult years. The research is supported by a grant from the National Institute on Alcohol Abuse and Alcoholism. The Research Institute on Addictions is part of the New York State Office of Alcoholism and Substance Abuse Services. Dr. Barnes was assisted by co-investigator Michael Farrell, Ph.D., project administrator Lois Uhteg, research scientists Barbara Dintcheff and Alan Reifman, Ph.D., and post-doctoral fellow George Thomas, Ph.D. Interviewers and research assistants were Brian Greene, Michael Sacilowski, Robin Jann, Cindy Tworek, Sandra Leifer, Michael Stokes, Mary Walawander, Kim Jackson, and Jorge Antonetti. _____________________________________ For more information, contact: Grace M. Barnes, Ph.D. The Research Institute on Addictions 1021 Main Street Buffalo, New York 14203-1016 E-mail: barnes@ria.org. New York State Office of Alcoholism and Substance Abuse Services Jean Somers Miller, Commissioner New York State George E. Pataki, Governor Questions / Comments to webmaster@ria.org This file contains the text of the September 1995 issue of Research in Brief (ISSN 1047-8418), a newsletter published six times a year by the Research Institute on Addictions, a component of the New York State Office of Alcoholism and Substance Abuse Services. Permission to reproduce this material is granted with the condition that users identify the Research Institute on Addictions as the source. For more information, contact: RIA Public Communications, 1021 Main Street, Buffalo , N.Y. 14203-1016. Please follow the instructions in the slide view to read this slide. This slide is not meant for either presentation or printing but has been included as an important reference to aid in parental strategies of what to do and not to do with their children.