1. Inhalants: Nothing to Sniff At
Har-Bur Middle School

2. Overview Statistics & facts Products & ways to abuse
The high, health effects & treatment considerations
Inhalants vs. other drugs of abuse
About the CT Inhalant Task Force
Inhalant prevention messages, resources, strategies

3. What have you heard about inhalant abuse?

4. What is Inhalant Abuse?
Definition
“The deliberate inhalation of fumes, gases or vapors for the purpose of intoxication.”

5. Nearly 22.3 million Americans have used inhalants at least once in their lives
Source: 2008 Monitoring the Future Study, National Institute of Drug Abuse

6. In 2005, 1 out of 5 teens have tried an inhalant.
This is 20% !!!!!
Inhalants are unique among abused substances because a) they are universally available & legally obtained/sold. Because of these unique qualities, inhalants need unique prevention messages & approaches. Inhalants are one of the few substances abused more by younger children than by older ones.
Source, “Teens and Inhalant Abuse.”
Teens 2005 Partnership Attitude Tracking Study (PATS)
Partnership for a Drug Free America. April 2006
* = Students surveyed in grades 7 through 12.

7. 12 Year Olds Are More Likely to Use Inhalants Than Cigarettes or Marijuana
Source: Lifetime Inhalant Rate, National Surveys on Drug Use and Health, SAMHSA

8. from inhalant abuse, over
Of the persons who die
from inhalant abuse, over
one-third die
the first time
they ‘sniff’.
St. George’s, Division of Community Health Sciences, University of London, 2005
“Trends in Death Associated with Abuse of Volatile Substances”
M.E. Field-Smith, B.K. Butland, J.D. Ramsey, and H.R. Anderson, Report 20, July 2007
(40%) This data was obtained from death records kept by the United Kingdom, where every death undergoes an elaborate investigation and parents do not have control over listing the cause of death. In the U.S., inquests on all deaths are not required and parents have the ability to designate the cause of death on the death certificate. For example, if their child died of inhalants, the cause of death could be accidental, suicide, or drug overdose.

9. Common Ways to Abuse Inhalants
Aerosol inhalation = directly spraying into mouth or nose
Sniffing or snorting = Inhaling directly from product’s container
Examples: paint can, cologne bottle
Huffing = Inhaling from a saturated substance
Examples: nasal mask, handkerchief,
scarf, shirt cuff, fingernails
Bagging = Inhaling from a secondary container/device
Examples: a balloon, a soda can, a plastic or paper bag (placed over the head)

10. Examples of Abusable Products

11. All legal substances
Have widespread legitimate uses for which they are legal.
Illegal to use as a drug in some states.
Legal manufacturing and distribution system
Use of these products in many and varied environments
Over 1,400 products can be abused

12. Examples of Abusable Products
For Adults Only
Aerosols
Hair spray
Air freshener
Deodorant
Cleaners
Fabric Protectors
Lubricants
Paints, especially metallic
Adhesives
Cooking sprays
Nitrites
Amyl nitrite
Butyl nitrite
Cyclohexyl nitrite
Solvents
Correction Fluid & Thinner
Markers
permanent
dry erase
Contact & Rubber Cement
Model Glue
Dry Cleaning Fluids
Gasoline
Charcoal Starter Fluid
Degreasers
Carburetor Cleaner
Car Starter Fluid
Nail Polish Remover
Paint
Paint or Lacquer Thinners
mineral spirits
Paint Removers & Strippers
Sterno
Gases
Butane
cigarette lighters
lighter fluid
Computer Duster
Flat Tire Repair/Inflator
Freon from air conditioners
Halon from fire extinguishers
Nitrous oxide
balloons & tanks
“whippets” (mini-tanks)
whipped cream cans
Propane
barbeque grills
portable torches
Refrigerant

13. Common Terms Bagging Chroming Whippets Heart-on Amys Boppers Rush
Poppers Oz
Huff
Thrust
Whiteout
Glading
Huffing
Bolt

14. What Are Not Inhalants Smoking marijuana, tobacco, crack, opium, etc.
Snorting cocaine, heroin
Strong smelling vapors
- ammonia cleaner, bleach,
- fruit flavored magic markers and water-based glues
Inert gases
- helium (note: deaths have been recorded due to embolisms and ruptured lungs caused by pressurized tanks.)

15. Signs & Symptoms of Inhalant Abuse
It is often hard to detect youth that are under the influence of inhalants, but here are some things to watch for:
Chemical odors on clothes or breath
Paint stains on face & hands
Empty inhalant containers; such as: lighters, aerosol spray cans, whipped cream cans, computer keyboard cleaners, etc.
Oil or paint stains on backpacks
Red spots around nose or mouth
Frequent nosebleeds
Scarves or rags with chemical odors
Supplies of air filter masks
Missing or ‘always empty’ household sprays or school supplies

16. Current Facts Death can occur on the first use
There are few laws that restrict sales to minors
Over 29% of 8th graders have tried inhalants at least once
Most youth who try inhalants try before age 13
Younger = higher % of females, Older = higher % of males
Sustained use more common w/ males
Most students are unaware of risks

17. In 2008, inhalants were the most frequently reported illicit drug used in the past year among 12 year olds. Three times higher than marijuana.
Inhalants are one of the few substances abused more by younger children than by older ones
Percentages of Past Year Illicit Drug Use Among Adolescents Aged 12-14: , National Survey on Drug Use & Health, March 2008, Inhalant Use Across the Adolescent Years

18. Inhalant users ages 12 and 13, 45.5 % ! That is almost 1 of every 2.
Percentages of Past Year Illicit Drug Users
Aged 12-17: , By Age Group
Inhalant users ages 12 and 13, % ! That is almost 1 of every 2.
Again, Inhalants are one of the few substances abused more by younger children than by older ones
Some older data
In 2004, Inhalants moved to number 1 over marijuana as the most frequently abused substance by youth age 12 & According to DHHS ‘Monitoring the Future’ survey
In 2003, 1 out of 4 6th & 8th graders had tried inhalants –
Source,
“New Findings on Inhalants: Younger Adolescents the Most Vulnerable.” from Teens 2003: Partnership Attitude Tracking Study by Partnership for a Drug Free America. March 18, 2004

19. Clips from A&E’s Intervention

20. What is the High Like? Central nervous system depressant, like alcohol
Seems more euphoric or intense than alcohol
Rapid onset, usually running it’s course in minutes.
Range is a few seconds to hours for some gases
Sensations of floating, spinning, and numbness
Hallucinations are common, visual more than auditory
Loss of inhibitions
User often risks daring feats involving violence, extreme risks, property destruction, and other behaviors indicating a loss of judgment

21. What Teens Like About Inhalants
Users like the trippy feeling of the high
Inhalant abuse is easy to hide, doesn't arouse suspicions
Products can be legally obtained
Product’s are readily available; free or inexpensive
High takes effect quickly, and is over quickly
Users perceive that they have control over the high
Source: MA Inhalant Focus Group Project , 1994

22. Examples of Physiologic Effects
Physical addiction
Salt/electrolyte imbalances
Damage to the liver, kidney and bone marrow (sometimes reversible)
Severe headaches
Breathing problems
Weight loss
Nausea

23. Examples of Neural Effects
Seizures and tremors
Brain damage: diffuse cerebral, cerebellar and brainstem atrophy
Nystagmus: the rapid, involuntary oscillation of the eyeballs
Deterioration of the myelin sheath
Loss or dulling of the senses, including:
vision problems, loss of hearing, sense of smell
Slowed and slurred speech
Muscle coordination impairment, unsteadiness of gait

24. Brain Damage In A Toluene User
Brain images show marked atrophy (shrinkage) of brain tissue in a toluene abuser, picture B, as compared to a non-abusing individual, picture A.
Note the smaller size and the larger, empty (dark) space within the toluene abuser’s brain.
Source, National Institute on Drug Abuse, courtesy of Neil Rosenberg, M.D.

25. How Inhalants Cause Death
Estimated Yearly US Deaths: 1,000
Respiratory Failure
Central nervous system depressant
Asphyxia
Suffocation
Vomit
Coats lungs with solids from aerosol cans
Reckless Behavior
Accidents
Fires
Explosions
Sudden Sniffing Death Syndrome (SSDS)
Heart arrhythmia + scared (adrenaline)

26. Sudden Sniffing Death
Can cause an unshockable, irreversible rhythm that is fatal:
CNS depression
Decreased respiration
Irregular heartbeat
Increased excitement
Adrenaline release
Heart muscle sensitivity

27. What to Do When Someone is Abusing Inhalants
Remain calm and do not panic
Do not excite the person or argue
Call for medical help
Stay in a well-ventilated area
Check the area for clues to what was used
After the episode seek professional help for the abuser

28. Video
Interview with Officer Jeff Williams

29. Treatment: Assessment & Referral Overview
Different treatment modality
Not often picked up in assessments
Often younger and sometimes too young for the traditional drug treatment centers
No treatment providers specifically provide treatment services for inhalant abuse
Does your intake assessment include specific questions about inhalant use?

30. How it affects the family
Affects the family at a time when you don’t think of dealing with such a problem, they are so young - use typically peaks in 8th grade
Huffing is often covert and well-masked – this leads to delayed realization of problem by adults and prolonged exposure to inhalants
Lowest of the low in terms of substances that are abused - Use often carries a stigma, even among substance users – family may also feel stigmatized and be reluctant to seek help
Dealing with a problem that they may have never heard of before, or have very limited knowledge of. Lack of accurate info may lead to lack of action

31. Inhalants vs. other substances of abuse
Similarity: inhalants are used to get high (e.g., the movie, “13”), most often by adolescents
Differences:
Inhalants are toxins – a single use can be deadly or cause severe neurological damage
Are readily available, legal household products, safe when used as directed
Use often carries a stigma, even among substance users
Use typically peaks in 8th grade (vs. often increasing throughout high school for alcohol and marijuana)

32. Implications Interdiction is extremely difficult
Inhalant abuse tends to be hidden, especially from adults
Most adults (and many youth) are not well-informed about inhalant abuse, its signs, and best practices for prevention
Prevention messages need to be crafted differently for adults and youth
Simply informing parents and adults who work with kids can have a powerful preventive effect

33. About the CT Inhalant Task Force
Contact information:
For more info on the experience of task force members:

34. Inhalant Prevention Messages, Resources, Strategies
Why Talk to Adults & Children About Inhalants?

35. Parent Perception of Children’s Inhalant Abuse
Only 5% of parents believe their child has ever abused inhalants. Parents are not aware or are in denial about the prevalence of inhalant abuse among teens. Teens are four times more likely to report inhalant abuse than parents think. Also, in % of parents believe their teen sees great risk in abusing inhalants, down 17% since 2003.
Source: Partnership Attitude Tracking Study (PATS), Teens & Inhalant Abuse, 2005,
Partnership for a Drug-Free America

36. Key Messages for Children
Inhalants are poisons, toxins, pollutants, and fire hazards.
Products are designed for a specific purpose
Follow directions on the label
Dangerous when used in unintended ways
They contain poisons, toxic chemicals and gases
They pollute
They were never intended to go inside your body
They are a fire and explosion danger
They are created from petroleum, that is, “crude oil”
New approaches for prevention education!

37. New approaches for prevention education!
Messages to Avoid
Avoid creating a “how to” primer
for experimenters and substance abusers.
Avoid discussing...
Inhalants as a drug
(Unless you are targeting a group where there are primarily inhalant abusers or children knowledgeable about inhalants)
Euphoric effects--Avoid talking about the “high”
What products can be abused
How to abuse these products & paraphernalia
New approaches for prevention education!

38. Tips for Talking with Kids Ages 6 - 11
Talk about poisons and their effects
Talk about oxygen
Discuss the purpose of household chemicals and products
Read labels together with an adult
Model behavior – use proper ventilation
Educate children about the dangers

39. Tips for Talking with Kids Ages 12 - 18
Ask pre-teens & teens what they know
Reinforce peer resistance skills
Encourage teens to talk with a trusted adult
Be clear about the dangers
Encourage parents to monitor their teen’s activities – keep their eyes open
Educate teens about the dangers
Emphasize that their safety is your concern

40. Text: Some of the most dangerous drugs aren’t on the street
Text: Some of the most dangerous drugs aren’t on the street. They’re under your sink. Spray paint, hairspray, glue, cleaning solvents, household products like these can cause brain damage, heart damage, and even death the first time. Don’t let there be a first time. Call . . .Protect your kids. Tell them never to sniff inhalants. Set rules. They’ll listen. Communication: The Anti-Drug

41. Group Activity Move into small groups & choose a reporter
Read the scenario
Discuss ways to deal with the scenario and what steps you would take
Report back to the larger group

42. Key Messages for Adults
More than 1,000 everyday products, including cleaning, office, and art supplies, solvents, gases, and shop chemicals have the potential to be abused as inhalants.
Inhalants are actually poisons, pollutants, toxins, and fire hazards. They are made of crude oil and were never meant to be inhaled.
These products are safe when used as directed, but when vapors are concentrated and breathed in, they can become dangerous and deadly.
There is no safe level of inhalant use. 33% of deaths are the result of first time use (UK data). Therefore, no use should be tolerated and any use should be followed up by a professional alcohol and drug assessment and education about the dangers of inhalant abuse.

43. Key Messages for Adults
Inhalants can be addictive, both psychologically and physically. There are roughly as many inhalant abusers and addicts as heroin abusers and addicts in this country.
Inhalants can cause permanent damage to the nervous system, lungs, liver, and kidneys.
More children are using inhalants than adults think – and at earlier ages. Nationally, nearly one out of four 6th and 8th graders has intentionally inhaled to get high (PDFA, 2003).
Because of all these reasons, inhalant abuse should be on your RADAR. Be alert for the signs of inhalant abuse: suspicious use of products, chemical odors, rash around the mouth and nose, weight loss, paraphernalia (plastic bags, empty containers, and smelly rags).

44. Resources Resources are videos, pamphlets, curricula, etc
Resources Resources are videos, pamphlets, curricula, etc., that contain messages
Janet L. Hayes
Event Planner/Resource Specialist
Connecticut Clearinghouse
    a program of Wheeler Clinic, Inc.
334 Farmington Avenue
Plainville, CT 06062 or

45. Choosing the Right Materials
Who is your target audience and what materials are a good match?
Print
Video
Visuals/Images

46. Images

47. Add pix here of display board
Sam[le of a BAD add for materials.
It could be a bad sign when the ad for the video shows a child demonstrating inhalant abuse techniques.
If you read closely, this material is probably good (explicitly not a “how to “ video, says inhalants are poisons, not drugs, which is the right message).

48. Add other pix here
Ask: How about this to use as a display at a health fair or school?

49. The king of ‘bad’ brochures
The king of ‘bad’ brochures.  The three pix show: 1) a display of sample products to abuse, 2) a demonstration of how to abuse inhalants, and 3) a pix of materials you can buy to make your own paraphernalia for abusing inhalants.  Possible Group Exercise
distribute other brochures and have group discuss if they present the old or new prevention message

50. Resources
Inhalant Prevention Resource Guide, Virginia Dept. of Education
CT online interactive parent training
Alliance for Consumer Education
Inhalant Abuse Prevention Kit (for adults)
CT Poison Control Center
“Product Safety: Be Safe Around Poisons” lesson plan paired with “Danger! Toxic Chemicals” video

51. Resources National Inhalant Prevention Coalition
New England Inhalant Prevention Coalition
CT Inhalant Task Force
CT Poison Control Center
poisoncontrol.uchc.edu
CT Clearinghouse

52. Strategies
Messages
Target
Resources
Strategies
Strategies are systems of using resources to deliver messages to targeted audiences.

53. What Communities Can Do:
Because inhalants are everywhere, everyone needs to be informed and contribute: school health office, administrators, SRO, D.A.R.E. officers, parents, teachers/coaches, doctors, dentists, retail workers, social workers, criminal justice professionals, and other youth-serving professionals
Become aware.
Help inform others. Educate about the indicators and dangers of inhalant abuse. Talk to other parents about the dangers of inhalants. Ask pediatricians & clergy if they know about inhalants. Schedule an inhalant presentation at your clubs, organizations or employee groups.
Is inhalant abuse on your RADAR???

54. What Communities Can Do:
Educate office managers, purchasing personnel, retailers and parents about buying less toxic products.
Are facilities reducing access to inhalants?
Purchase non-aerosol products or water-based products (markers, white-out)
Supervise use of solvent based products
Use low-odor markers for whiteboards
Coordinate with purchasing personnel about buying solvent-free and non-aerosol products

55. What Communities Can Do:
Incorporate inhalants into existing curriculum in schools and other venues.
For preschoolers & young children, stress that inhalants are dangerous poisons.
For school children, address inhalant’s poisonous effect on the environment in earth studies or science class, and on the body in basic biology or health class.
Look for teachable moments
Look for topics with natural connections to inhalants

56. What parents & teachers can do:
Make sure kids are getting the message about the dangers of inhalant abuse
Check out your school’s policies on substance abuse and make sure inhalants are incorporated
If you are suspicious about a child’s behavior, be sure to follow up
Don’t tolerate any experimentation
Contact the CT Inhalant Task Force for ideas, help, resources

57. What parents can do:
Follow the instructions on product labels regarding ventilation. Have your child read the instructions to you, then follow them. Remember… they do what you do. Your example will reinforce the message that these products are poisonous.
In the garage: keep your paints, pesticides, lighter fluid, propane tanks, WD 40 , etc. in a well locked cabinet & keep the key in a secure place.
In the kitchen & bathroom: switch to solid, pump-spray or non-aerosol air fresheners and cleaners.
Be aware when products run out too quickly. If you just bought an item, filled a propane tank, etc. and it has run-out before it should than it could be time to talk to your children.

58. What action step are you going to take to put inhalant abuse on the RADAR?