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CORK Bibliography: Inhalants

111 citations. January 2009 to present

Prepared: September 2012

Armstrong KE; Bush HM; Jones J. Television and Video game viewing and its association with substance use by Kentucky elementary school students, 2006. Public Health Reports 125(3): 433-440, 2010. (20 refs.)

Objective. We sought to determine if the number of hours elementary school students viewed television (TV) and video games is associated with substance use. Methods. We distributed the California Healthy Kids Survey Elementary School Questionnaire to elementary schools in Kentucky in 2006. A total of 4,691 students, primarily fourth and fifth graders, completed the survey. The students provided responses to questions on topics such as drug use, alcohol use, TV and video game viewing time, and their home life. We analyzed the survey using Chi-square tests and logistic regression. Results. Approximately one-third of respondents indicated substance use, which was defined as alcohol use, illegal drug use, smoking/tobacco use, or sniffing solvents. Significantly more children (28% of those watching >= 3 hours of TV/video games compared with 20% of those watching greater than zero but <= 2 hours of TV/video games) reported alcohol use (p<0.05). Similar results were seen for sniffing solvents, with 9% of those watching >= 3 hours of TV/video games reporting they sniffed solvents compared with 4% who watched TV/video games for greater than zero but 2 hours (p<0.05). The results of the logistic regression indicated that the odds of drinking alcohol (odds ratio [OR] = 1.48, 95% confidence interval [CI] 1.23, 1.79) and sniffing solvents (OR=1.97, 95% Cl 1.42, 2.75) were significantly higher for those watching >= 3 hours of TV/video games compared with those who watched TV/video games for greater than zero but >= 2 hours. Conclusions. The hours of TV and video games viewed were associated with alcohol use and sniffing solvents for our sample. However, limitations exist due to the inability to separate TV viewing from video game viewing.

Copyright 2010, Association of Schools of Public Health

Austin AE; van den Heuvel C; Byard RW. Causes of community suicides among indigenous South Australians. Journal of Forensic and Legal Medicine 18(7): 299-301, 2011. (18 refs.)

A retrospective review of suicides occurring among Aboriginal people in the community in South Australia over a 5-year period was undertaken from January 2005 to December 2009. Twenty-eight cases were identified, consisting of 21 males (age range 16-44 years, mean 29.9 years) and 7 females (age range 23-45 years, mean 32.0 years). Deaths in all cases were caused by hanging (100%). Toxicological evaluation of blood revealed alcohol (39.3% of cases), cannabinoids (39.3%), benzodiazepines (10.7%), opiates (7.1%), antidepressants (7.1%), amphetamines (3.6%) and volatiles (3.6%). This study has demonstrated that the method of suicide overwhelmingly preferred by indigenous victims in South Australia is hanging. The precise reasons for this preference are uncertain, however, an indigenous person in South Australia presenting as a suicide where a method other than hanging has been used would be exceedingly uncommon, raising the possibility of alternative manners of death.

Copyright 2011, Faculty of Forensic and Legal Medicine.

Baird CA; Furek MW. Adolescents and inhalant abuse: How huffing affects the myelin sheath. Journal of Addictions Nursing 23(2): 129-131, 2012. (14 refs.)

As concern grows over the impact that accidental chemical exposures may have on the long term health of individuals, our young people are deliberately exposing themselves to the effect of neurotoxic chemicals with the intent of feeling high. Over time the result of inhaling these chemicals is often the development of symptoms and behavior that may suggest serious physiological damage. Research is being conducted to examine what the exact nature of the damage might be, especially the impact of inhaled lipophilic chemicals on structures in the brain and other parts of the nervous system. Healthcare professionals responsible for assessing adolescents in all settings need to be aware of the prevalence of inhalant abuse, as well as the chemicals, terminology, and potential symptomatology in order to intervene in the behavior and provide diagnosis and treatment as indicated. Some implications for nursing are included.

Copyright 2012, Informa Healthcare

Balster RL; Cruz SL; Howard MO; Dell CA; Cottler LB. Classification of abused inhalants. Addiction 104(6): 878-882, 2009. (13 refs.)

Many hundreds of household and industrial products can be volatilized readily and are subject to abuse. Inhalant abuse research has been hampered by a lack of consensus on whether or not there are subclassifications of abused inhalants based on chemical structure, form or intended use of the product or pharmacological properties. This paper discusses strengths and weaknesses of various approaches to classification of inhalants and suggests areas for future research in this area. It is concluded that classification of inhalants by form or product types is not useful for scientific purposes; rather, subclassification of inhalants should be based on a yet-to-be-determined combination of chemical and pharmacological similarity and shared patterns of abuse. One of the ways in which we can improve our understanding of inhalant abuse is to obtain more detailed information on individual products and chemicals, their patterns of use and the geographical distribution of their use.

Copyright 2009, Society for the Study of Addiction to Alcohol and Other Drugs

Baydala L. Inhalant abuse. (editorial). Paediatrics and Child Health 15(7): 443-448, 2010. (51 refs.)

Inhalant abuse - also known as volatile substance abuse, solvent abuse, sniffing, huffing and bagging - is the deliberate inhalation of a volatile substance to achieve an altered mental state. Inhalant abuse is a worldwide problem that is especially common in individuals from minority and marginalized populations, and is strongly correlated with the social determinants of health. It often affects younger children, compared with other forms of substance abuse, and crosses social and ethnic boundaries. Inhalants are pharmacologically diverse products that are selected for their low price, legal and widespread availability, and ability to rapidly induce euphoria. Chronic abuse is associated with serious and often irreversible effects. Widespread screening and early referrals to treatment programs have resulted in significant improvements in the mental, physical and social conditions of those affected. The present statement reviews critical aspects of inhalant abuse, highlighting new information and data that pertain to Aboriginal children and youth, and provides recommendations for treatment and prevention.

Copyright 2010, Pulsus

Benotsch EG; Martin AM; Koester S; Cejka A; Luckman D. Nonmedical use of prescription drugs and HIV risk behavior in gay and bisexual men. Sexually Transmitted Diseases 38(2): 105-110, 2011. (56 refs.)

Background: Previous research has demonstrated associations between substance use and sexual risk behavior in men who have sex with men (MSM). Recent trends in substance use show increasing use of prescription medications (e. g., Vicodin) without a physician's prescription, yet associations between the nonmedical use of prescription drugs (NMUPD) and HIV risk behavior have not been well examined in MSM. Methods: MSM attending a gay pride festival completed a self-report measure assessing NMUPD, motivations for use, use of traditional recreational drugs, and HIV risk behavior. Results: More than one-third of the sample (38%) reported lifetime NMUPD and 17% reported NMUPD in the previous 3 months. The most common class of medications used was prescription analgesics. Men reporting NMUPD also reported higher rates of the use of marijuana, poppers, ecstasy, cocaine, methamphetamine, GHB, ketamine, heroin, and rohypnol, and had significantly higher rates of HIV risk behaviors, including more sexual partners and more unprotected sex. Conclusions: A significant minority of MSM are using prescription medications without a doctor's consent. Men who do so are risking negative consequences of such use, including the potential for addiction, potentially dangerous interactions between prescription and recreational drugs, and greater risk for contracting HIV.

Copyright 2011, Lippincott, Williams & Wilkins

Berchtold A; Jeannin A; Akre C; Michaud PA; Suris JC. First use of multiple substances: Identification of meaningful patterns. Journal of Substance Use 15(2): 118-130, 2010. (57 refs.)

Context: Understanding the process through which adolescents and young adults are trying legal and illegal substances is a crucial point for the development of tailored prevention and treatment programs. However, patterns of substance first use can be very complex when multiple substances are considered, requiring reduction into a few meaningful number of categories. Data: We used data from a survey on adolescent and young adult health conducted in 2002 in Switzerland. Answers from 2212 subjects aged 19 and 20 were included. The first consumption ever of 10 substances (tobacco, cannabis, medicine to get high, sniff (volatile substances, and inhalants), ecstasy, GHB, LSD, cocaine, methadone, and heroin) was considered for a grand total of 516 different patterns. Methods: In a first step, automatic clustering was used to decrease the number of patterns to 50. Then, two groups of substance use experts, three social field workers, and three toxicologists and health professionals, were asked to reduce them into a maximum of 10 meaningful categories. Results: Classifications obtained through our methodology are of practical interest by revealing associations invisible to purely automatic algorithms. The article includes a detailed analysis of both final classifications, and a discussion on the advantages and limitations of our approach.

Copyright 2010, Informa Healthcare

Bowen SE. Two serious and challenging medical complications associated with volatile substance misuse: Sudden sniffing death and fetal solvent syndrome. (review). Substance Use & Misuse 46(Supplement 1): 68-72, 2011. (40 refs.)

Volatile substance misuse is a prevalent and often overlooked behavior among adolescents, including reported use among young pregnant women. Several medical repercussions can arise from the improper use of volatile substances, yet they are often underappreciated among scientists and health professionals. This brief review reports on the recent advances made in the preclinical and clinical data about two serious medical complications surrounding volatile substance misuse: sudden sniffing death and fetal solvent syndrome. Suggestions for treatment interventions are discussed. The paper's limitations are noted.

Copyright 2011, Informa Healthcare

Cairney S; Dingwall K. The mysterious practice of petrol sniffing in isolated Indigenous groups. (review). Journal of Paediatrics and Child Health 46(9): 510-515, 2010. (77 refs.)

The practice of petrol sniffing is a unique and poorly understood phenomenon that is associated with substantial morbidity, mortality and social devastation in affected remote Indigenous communities. For these groups and for the wider community, much mystery has surrounded the practice and its effects. Here we introduce the epidemiology of petrol sniffing among Indigenous groups internationally, review its impact on the brain, behaviour and social functions and summarise related interventions.

Copyright 2010, Wiley-Blackwell

Camara-Lemarroy CR; Gonzalez-Moreno EI; Rodriguez-Gutierrez R; Gonzalez-Gonzalez JG. Clinical presentation and management in acute toluene intoxication: A case series. Inhalation Toxicology 24(7): 434-438, 2012. (32 refs.)

Context: Toluene inhalation is a common form of drug abuse throughout the world. Acute toluene toxicity causes neurological changes as well as various metabolic alterations. Hypokalemic paralysis and renal failure are life-threatening complications. Objective: To identify the clinical and metabolic alterations associated with toluene intoxication. Materials and methods: We retrospectively analyzed the records of 22 patients that were admitted to a single center's emergency department from 2006 to 2012 with clinical and metabolic alterations due to toluene inhalation. Results: Of the 22 patients, 77% were male and mean age was 23.5 years (range: 17-30). The main clinical presentation was weakness associated to severe hypokalemia. Severe metabolic acidosis was found in 20 patients. Renal tubular acidosis was diagnosed in five patients. The patients responded to supportive measures and aggressive potassium repletion. Prognosis was generally good. Conclusion: Toluene inhalation is associated with various severe metabolic alterations. Treatment guidelines are needed considering the frequency of toluene inhalation in the population.

Copyright 2012, Informa Healthcare

Capron B; Logan BK. Toluene-impaired drivers: Behavioral observations, impairment assessment, and toxicological findings. Journal of Forensic Sciences 54(2): 486-489, 2009. (14 refs.)

Toluene is an aromatic hydrocarbon solvent frequently abused for its euphoric and intoxicating properties. This report describes a series of six cases involving drivers arrested for driving under the influence who subsequently tested positive for toluene. Case data including driving behavior, physiological signs and symptoms, evidence of impairment, and toxicology findings were reviewed. Blood toluene concentrations in the drivers ranged from 12 to 45 mg/L (median 23 mg/L, mean 25 mg/L, SD 12.1 mg/L). All drivers were determined to be intoxicated, and displayed symptoms including balance problems, confusion and disorientation, loss of coordination, and inability to follow instructions. They also displayed horizontal but not vertical nystagmus, elevated pulse and blood pressure, and lower body temperature. These findings are consistent with prior reports that subjects with blood toluene concentrations above 10 mg/L are invariably under the influence and their driving skills are affected.

Copyright 2009, Wiley-Blackwell Publishing

Chao C; Jacobson LP; Jenkins FJ; Tashkin D; Martinez-Maza O; Roth MD et al. Recreational drug use and risk of Kaposi's sarcoma in HIV- and HHV-8-coinfected homosexual men. AIDS Research and Human Retroviruses 25(2): 149-156, 2009. (50 refs.)

Experimental data suggested that exposure to recreational drugs might adversely affect antitumor immunity, which led us to examine the hypothesis that use of marijuana, cocaine, poppers, and amphetamines might increase the risk of Kaposi's Sarcoma (KS) in HIV- and HHV-8-coinfected homosexual men. We analyzed data prospectively collected from the Multicenter AIDS Cohort Study (MACS) between 1984 and 2002. Among the 1335 HIV- and HHV-8-coinfected white men, 401 KS cases were identified. Multivariable Cox regression models were used to estimate the effects of time-varying recreational drug use on KS risk adjusting for potential confounders. The effects of both recent use (6 months prior) of recreational drugs and lagged exposure (i.e., use from 3 and 5 years prior) were examined. We did not observe any clear association with KS for recent use of any of the four drugs. In the analyses using lagged exposures, KS risk was associated with use of poppers 3-5 years prior [hazard ratio (HR) 3 years prior 1.27, 95% CI (0.97-1.67), HR5 years prior 1.46 (1.01-2.13)]. However, no clear dose-response relationship was observed. These findings do not support a biological association between use of these substances and KS development in HIV- and HHV-8-coinfected homosexual men.

Copyright 2009, Mary Ann Liebert

Charles J; Britt H; Fahridin S. Drug abuse. Australian Family Physician 39(8): 539-539, 2010. (0 refs.)

Between April 2007 and March 2009 in the BEACH (Bettering the Evaluation and Care of Health) program, drug abuse was managed 770 times, at a rate of 0.4 per 100 encounters, suggesting it is managed by general practitioners about 436 000 times per year nationally. This article focuses on illicit drugs such as heroin and marijuana, and includes substances such as glue. Alcohol, tobacco and medicines are not included.

Copyright 2010, Royal Australian College General Practitioners

Chen CY; Storr CL; Anthony JC. Early-onset drug use and risk for drug dependence problems. Addictive Behaviors 34(3): 319-322, 2009. (20 refs.)

There is substantial evidence that alcohol, tobacco, and cannabis dependence problems surface more quickly when use of these drugs starts before adulthood, but the evidence based on other internationally regulated drugs (e.g., cocaine) is meager. With focus on an interval of up to 24 months following first drug use, we examine drug-specific and age-specific variation in profiles of early-emerging clinical features associated with drug dependence. Based upon the United States National Surveys on Drug Use and Health (NSDUH) conducted in 2000-2002, the risk of experiencing drug dependence problems was robustly greater for adolescent recent-onset users of cocaine, psychostimulant drugs other than cocaine, analgesics, anxiolytic medicines. inhalants drugs, and cannabis, as compared to adult recent-onset users (odds ratio = 1.5-4.3, p<0.05). This was not the case for the NSDUH hallucinogens group (e.g., LSD). The adolescent onset associated excess risk was not constant across all clinical features. Our evidence suggests promoting earlier detection and interventions, as well as greater parent and peer awareness of drug dependence clinical features that may develop early among young people who have just started using drugs.

Copyright 2009, Elsevier Science

Cohen LM; Collins FL, Jr; Young A; McChargue DE; Leffingwell TR; Cook KL, eds. Pharmacology and Treatment of Substance Abuse. New York: Routledge, 2009

Given the prevalence of substance abuse in general clinical populations, it is important for healthcare providers to have knowledge and skill in their treatment. This volume is designed as a bridge for practitioners that will provide up-to-date reviews of the evidence as well to implement these. The volume is organized into five parts. Part I, with 5 chapters, provides an overview of the psychopharmacology and neurobiology of alcohol drug use. It includes the chapter on the principles of drug actions, actions of drugs in relationship to their abuse; performance and cognitive alterations; tolerance, sensitization and dependence; and the neurobiology of addiction. Part II focuses on conceptual models and principles of treatment. With four chapters, there is discussion of individualized treatment; group therapy; the Community Reinforcement Approach (CRA) and the CRAFT programs. Part III addresses assessment and treatment. The seven chapters consider evidence-based practices to treat alcohol; nicotine; marijuana; heroin and other opiates; amphetamines; heroin; inhalants; and club drugs. Part IV considers special topics: multidimensional family therapy; drug testing and the workplace; stress as a mechanism of drug use initiation, maintenance, and relapse; behavioural economics; drug therapies; motivational interviewing; and faith-based approaches. The concluding chapter looks to the future of treatment.

Copyright 2010, Project Cork

Cruz SL. The latest evidence in the neuroscience of solvent misuse: An article written for service providers. Substance Use & Misuse 46(Supplement 1): 62-67, 2011. (41 refs.)

This work reviews preclinical and clinical studies published during the past two decades on the cellular and behavioral effects of commonly misused solvents. In animals, acute solvent exposure produces motor impairment and antidepressant- and anxiolytic-like effects. Human intoxication from misusing solvents is similar to that of ethanol; however, hallucinations and sudden sniffing death may occur at high solvent concentrations. Among chronic misusers, there is evidence of impaired memory, increased prevalence of psychiatric disorders, and neurological damage. Solvents facilitate inhibitory neurotransmission and block excitatory mechanisms. Toluene, in particular, increases brain dopamine levels and its effects occur at concentrations that do not dissolve cell membranes; therefore, neuronal damage is not an immediate, unavoidable consequence of solvent misuse.

Copyright 2011, Informa Healthcare

Cruz SL; Dominguez M. Misusing volatile substances for their hallucinatory effects: A qualitative pilot study with Mexican teenagers and a pharmacological discussion of their hallucinations. Substance Use & Misuse 46(Supplement 1): 84-94, 2011. (41 refs.)

This work describes the solvent-induced hallucinatory experiences of 10 male and seven female teenagers in Mexico City from 1998 to 2000. The youth were recruited from public schools through a combined snowball and convenience sampling procedure. Inclusion criteria were: 13-18 years of age, school attendance, living with family, and weekly toluene-based solvent misuse. Interested students were interviewed and transcripts were analyzed. Hallucinations and illusions were common, including changes in color perception, visual, somatic, auditory, and tactile hallucinations. Some users described their hallucinatory experience as being able to be shared by a group and modulated by their environment. The pharmacological linkages with hallucinations are discussed. The study's limitations are noted.

Copyright 2011, Informa Healthcare

d'Abbs P; MacLean S. Volatile Substance Misuse: A Review of the Interventions. National Drug Strategy Monograph No. 65. Sydney: Department of Health and Ageing (Australia), 2009

This monograph addresses volatile (inhalant) substance misuse in Australia. It is organized in two parts. Part I describes the patterns of volatile substance misuse, in the world, within Australia, and among indigenous Australians. Attention then turns to question "Why do some people inhale volatile substances?" This is approached from the perspective of correlates of use, causes and identified reasons, and understandings of this use in indigenous communities. Next there is a discussion of the problems associated with use: by the individual, in terms of immediate and longer-term effects, and a presentation of data on mortality and morbidity. The social effects are then considered, followed by discussion of the problems experienced by families, the local community, and the wider society. Part II examines the possible interventions, in the domains of supply reduction and demand reduction. In terms of supply reduction, the possibilities include the modification of products, the replacement of harmful or psychoactive compounds, addition of deterrent chemicals, package modifications, sales restrictions related to legislative actions and voluntary efforts. Demand reduction includes community approaches, with descriptions of existing programs; education, youth and recreational programs, which includes examples of universal and targeted initiatives, as well as use of the native culture, recreation, and employment initiatives. Treatment is also a means of demand reduction. This chapter considers different settings, both inpatient and outpatient settings, issues related to clinical management, the need for services to those with acquired brain injury, and services tailored to indigenous people. Harm reduction is addressed separately, with emphasis on harm reduction in drug use settings and harm reduction practices for individuals. The final chapter addresses law enforcement initiatives., including preconditions for effective law enforcement, statutory sanctions, legislation which governs police powers, and community-based sanctions.

Copyright 2011, Project Cork

Daniulaityte R; Falck RS; Wang J; Carlson RG. Illicit use of pharmaceutical opioids among young polydrug users in Ohio. Addictive Behaviors 34(8): 649-653, 2009. (38 refs.)

This study, conducted in Columbus, Ohio, identified the predictors of current (past 30 day) illicit use of pharmaceutical opioids among young individuals (n = 402) with a history of MDMA/ecstasy use who were recruited in 2002-2003 using respondent-driven sampling. To be eligible, participants had to be 18-30 years old. not involved in a drug abuse treatment, and report MDMA/ecstasy use at least once in the past 6 months. About 81% reported lifetime, and more than 31% reported current illicit use of pharmaceutical opioids. Logistic regression analysis revealed that illicit use of pharmaceutical tranquilizers and pharmaceutical stimulants were the strongest predictors of illicit use of pharmaceutical opioids. Risk of pharmaceutical opioid use was also greater among those who had higher levels of depressive symptoms and reported current use of hallucinogens and inhalants. Our findings suggest that the non-medical use of pharmaceutical opioids is a part of polydrug use practices that often incorporate illicit use of other prescription drugs. The observed relationship between depressive symptoms and illicit use of pharmaceutical opioids may have important implications for prevention programming and should be examined in future research.

Copyright 2009, Elsevier Science

Dannaway FR. Strange fires, weird smokes and psychoactive combustibles: Entheogens and incense in ancient traditions. Journal of Psychoactive Drugs 42(4): 485-497, 2010. (105 refs.)

This paper seeks to emphasize what may be the most primary mode of altering consciousness in the ancient world: namely, the burning of substances for inhalation in enclosed areas. While there is abundant literature on archaic uses of entheogenic plants, the literature on psychoactive incenses is quite deficient. From the tents of nomadic tribes to the small meditation rooms of Taoist adepts, the smoldering fumes of plants and resins have been used to invoke and banish and for shamanic travels since humanity mastered fire. The text provides details of primary "incense cults" while highlighting some commonalities and shared influences when possible. Further speculation suggests that selective burning of certain substances, such as mercury and sulphur, may have contributed to their lasting use and veneration in alchemy from India and China to the Arabian and European protochemists. This article would have a companion online database for images and further examples of ingredients in various incenses from China to ancient Greece.

Copyright 2010, Haight-Ashbury

Davies AG; Friedberg RI; Gupta H; Chan CL; Shelton KL; Bettinger JC. Different genes influence toluene- and ethanol-induced locomotor impairment in C. elegans. Drug and Alcohol Dependence 122(1-2): 47-54, 2012. (31 refs.)

Background: The abused volatile solvent toluene shares many behavioral effects with classic central nervous system depressants such as ethanol. Similarities between toluene and ethanol have also been demonstrated using in vitro electrophysiology. Together, these studies suggest that toluene and ethanol may be acting, at least in part, via common mechanisms. Methods: We used the genetic model, Caenorhabditis elegans, to examine the behavioral effects of toluene in a simple system, and used mutant strains known to have altered responses to other CNS depressants to examine the involvement of those genes in the motor effects induced by toluene. Results: Toluene vapor brings about an altered pattern of locomotion in wild-type worms that is visibly distinct from that generated by ethanol. Mutants of the slo-1, rab-3 and unc-64 genes that are resistant to ethanol or the volatile anesthetic halothane show no resistance to toluene. A mutation in the unc-79 gene results in hypersensitivity to ethanol, halothane and toluene indicating a possible convergence of mechanisms of the three compounds. We screened for, and isolated, two mutations that generate resistance to the locomotor depressing effects of toluene and do not alter sensitivity to ethanol. Conclusions: In C. elegans, ethanol and toluene have distinct behavioral effects and minimal overlap in terms of the genes responsible for these effects. These findings demonstrate that the C. elegans model system provides a unique and sensitive means of delineating both the commonalities as well as the differences in the neurochemical effects of classical CNS depressants and abused volatile inhalants.

Copyright 2012, Elsevier Science

de Oliveira LG; Barroso LP; Wagner GA; Ponce JD; Malbergier A; Stempliuk VD et al. Drug consumption among medical students in Sao Paulo, Brazil: influences of gender and academic year. Revista Brasileira De Psiquiatria 31(3): 227-239, 2009. (58 refs.)

Objective: To analyze alcohol, tobacco and other drug use among medical students. Method: Over a five-year period (1996-2001), we evaluated 457 students at the Universidade de Sao Paulo School of Medicine, located in Sao Paulo, Brazil. The students participated by filling out an anonymous questionnaire on drug use (lifetime, previous 12 months and previous 30 days). The influence that gender and academic year have on drug use was also analyzed. Results: During the study period, there was an increase in the use of illicit drugs, especially inhalants and amphetamines, among the medical students evaluated. Drug use (except that of marijuana and inhalants) was comparable between the genders, and academic year was an important influencing factor. Discussion: Increased inhalant use was observed among the medical students, especially among males and students in the early undergraduate years. This is suggestive of a specific behavioral pattern among medical students. Our findings corroborate those of previous studies. Conclusion: Inhalant use is on the rise among medical students at the Universidade de Sao Paulo School of Medicine. Because of the negative health effects of illicit drug use, further studies are needed in order to deepen the understanding of this phenomenon and to facilitate the development of preventive measures.

Copyright 2009, Association Brasileira Psiquiatria

Dell CA; Gust SW; MacLean S. Global issues in volatile substance misuse: Introduction. (editorial). Substance Use & Misuse 46(Supplement 1): 1-7, 2011. (31 refs.)

This special issue of Substance Use & Misuse addresses the public health issue of volatile substance misuse (VSM), the inhalation of gases or vapors for psychoactive effects, assessing the similarities and differences in the products misused, patterns, prevalence, etiologies, and impacts of VSM by examining it through sociocultural epidemiology, neuroscience, and interventions research. The Canadian, US, and Australian guest editors contend that, when compared with other drugs used at a similar prevalence, VSM has attracted relatively little research effort. The authors and editors call for further research to develop evidence-based policies and comprehensive interventions that respect culture and context-specific knowledge.

Copyright 2011, Informa Healthcare

Dell CA; Seguin M; Hopkins C; Tempier R; Mehl-Madrona L; Dell D et al. From benzos to berries: Treatment offered at an aboriginal youth solvent abuse treatment centre relays the importance of culture. (review). Canadian Journal of Psychiatry 56(2): 75-83, 2011. (69 refs.)

First Nations and Inuit youth who abuse solvents are one of the most highly stigmatized substance-abusing groups in Canada. Drawing on a residential treatment response that is grounded in a culture-based model of resiliency, this article discusses the cultural implications for psychiatry's individualized approach to treating mental disorders. A systematic review of articles published in The Canadian Journal of Psychiatry during the past decade, augmented with a review of Canadian and international literature, revealed a gap in understanding and practice between Western psychiatric disorder-based and Aboriginal culture-based approaches to treatment and healing from substance abuse and mental disorders. Differing conceptualizations of mental health and substance abuse are discussed from Western psychiatric and Aboriginal worldviews, with a focus on connection to self, community, and political context. Applying an Aboriginal method of knowledge translation-storytelling-experiences from front-line workers in a youth solvent abuse treatment centre relay the difficulties with applying Western responses to Aboriginal healing. This lends to a discussion of how psychiatry can capitalize on the growing debate regarding the role of culture in the treatment of Aboriginal youth who abuse solvents. There is significant need for culturally competent psychiatric research specific to diagnosing and treating First Nations and Inuit youth who abuse substances, including solvents. Such understanding for front-line psychiatrists is necessary to improve practice. A health promotion perspective may be a valuable beginning point for attaining this understanding, as it situates psychiatry's approach to treating mental disorders within the etiology for Aboriginal Peoples.

Copyright 2011, Canadian Psychiatric Association

Dell D; Hopkins C. Residential volatile substance misuse treatment for indigenous youth in Canada. Substance Use & Misuse 46(Supplement 1): 107-113, 2011. (30 refs.)

The Youth Solvent Addiction Program (YSAP) was established in 1996 in response to the misuse of volatile substances among First Nations and Inuit youth in Canada. This article outlines the role of Indigenous culture and its intersection with Western approaches to recovery in YSAP's operation of nine residential treatment centers for youth. Treatment practices and client outcome data are used to illustrate YSAP's approach. Limitations of the article are noted.

Copyright 2011, Informa Healthcare

Demarest C; Torgovnick J; Sethi NK; Arsura E; Sethi PK. Acute reversible neurotoxicity associated with inhalation of ethyl chloride: A case report. Clinical Neurology and Neurosurgery 113(10): 909-910, 2011. (5 refs.)

We present here the case of a 45-year-old HIV positive male who presented to our emergency room on two separate occasions with slurring of speech and difficulty walking. Neurological examination was significant for bilateral up going plantars, symmetrically brisk deep tendon reflexes, bilateral ankle and patellar clonus with a clear sensorium. These signs initiated a major work-up to rule out causes of bulbar and spinal cord dysfunction which were all noncontributory. On his second admission he admitted to sniffing and inhaling Maximum Impact (ethyl chloride). His neurological syndrome resolved rapidly after discontinuation of exposure. Our case highlights the fact that inhalant abuse is increasing and inhalants like ethyl chloride may present with a neurological syndrome comprising non-localizing, non-specific neurologic signs. It is as-of-yet unclear what mechanisms underlie ethyl chloride neurotoxicity. Also unknown is whether patients who recover from ethyl chloride toxicity will have any long-term consequences.

Copyright 2011, Elsevier Science

Ding K; Chang GA; Southerland R. Age of inhalant first time use and its association to the use of other drugs. Journal of Drug Education 39(3): 261-272, 2009. (24 refs.)

Inhalants are the 4th most commonly abused drugs after alcohol, tobacco, and marijuana. Although inhalants are often referred as Gateway Drugs this hypothesis is less examined. Using the 2003 National Survey on Drug Use and Health data, age of first time inhalant use was compared with the age of onset of other drugs among 6466 inhalant users who also used at least one of 14 other drugs. Findings indicated that only 4.2% multiple drug users who used inhalants prior to other drugs, especially alcohol, tobacco, and marijuana. Thus, the theory that inhalants are gateway drugs was not supported.

Copyright 2009, Baywood Publishing

Dingwall KM; Cairney S. Detecting psychological symptoms related to substance use among Indigenous Australians. Drug and Alcohol Review 30(1): 33-39, 2011. (28 refs.)

Introduction and Aims. Substance misuse and psychological comorbidities can be common and may impact negatively on treatment outcomes. However, without appropriate tools, detecting psychological symptoms for Indigenous people can be difficult. This study assessed the appropriateness of an eight-item screening tool (based on Strong Souls) for measuring any relationships between substance use and psychiatric symptoms for Indigenous Australians. Design and Methods. Indigenous Australians attending secondary or tertiary education institutions or substance use rehabilitation facilities in the Northern Territory (n = 407; mean age = 27.82) were assessed for depressive, anxiety and psychotic symptoms. The group represented 45 language groups from 95 urban and remote communities. English comprehension was measured on a scale from 0 (no understanding) to 10 (excellent understanding; M = 7.99, SD = 2.31). Ordinal regression analyses examined any associations between demographic and substance use factors and psychological symptoms. Results. Compared with non-users, current cannabis users were significantly more likely [odds ratios (ORs) = 2.2-4.4] to experience depressive or anxiety symptoms. Frequent cannabis users experienced more symptoms than occasional users. Prior-inhalant users were more likely to feel lonely (OR = 2.18) compared with non-inhalant users. Frequent alcohol users were less likely (OR = 0.44) to feel sad than non-users. These results are interpreted with respect to previous research and methodological limitations. Discussion and Conclusions. Symptoms of depression or anxiety may be common for individuals seeking treatment for substance misuse and with minor improvement, these eight-items may provide a useful screen for psychological symptoms in Indigenous Australians.

Copyright 2011, Wiley-Blackwell

Dingwall KM; Cairney S. Recovery from central nervous system changes following volatile substance misuse. Substance Use & Misuse 46(Supplement 1): 73-83, 2011. (56 refs.)

This review examines cognitive, neurological, and neuroanatomical recovery associated with abstinence from volatile substance misuse (VSM). Articles describing functional or structural brain changes longitudinally or cross-sectional reports comparing current and abstinent users were identified and reviewed. A significant lack of empirical studies investigating central nervous system recovery following VSM was noted. The few case reports and group studies identified indicated that cognitive and neurological impairments appear to follow a progression of decline and progression of recovery model, with the severity of impairment related to the duration and severity of misuse, blood lead levels among leaded petrol misusers, and the duration of abstinence for recovery. By contrast, severe neurological impairment known as lead encephalopathy from sniffing leaded petrol occurred as more catastrophic or abrupt damage to cerebellar processes that may never fully recover. Neuroanatomical damage may not recover even with prolonged abstinence.

Copyright 2011, Informa Healthcare

Dingwall KM; Lewis MS; Maruff P; Cairney S. Assessing cognition following petrol sniffing for indigenous Australians. Australian and New Zealand Journal of Psychiatry 44(7): 631-639, 2010. (33 refs.)

Background: Chronic petrol inhalation can be associated with significant cognitive impairment. While rehabilitation programs can rely on such skills to educate clients and achieve treatment outcomes, cognitive function is rarely assessed on admission. This is particularly true for Indigenous populations where standard assessments are not appropriate. This paper describes a process for assessing cognition in Indigenous Australians. Two studies investigate firstly the demographic factors impacting on cognition for healthy Indigenous Australians and secondly the utility of the assessment process for detecting petrol sniffing related cognitive impairments. Methods: Study One assessed a naturalistic sample of healthy Indigenous Australians from the Northern Territory (N = 206; mean age = 28.03) on computerised tests of psychomotor speed, visual attention, memory, learning, spatial awareness and executive functions. Multiple regression analyses determined the unique contributions of six factors (age, education, gender, familiarity with computers, regular long term cannabis use and locality) to the variance in performance for this group. Study Two examined group differences in cognitive performance on the same tests between healthy Indigenous Australians (N = 96) and Indigenous petrol sniffers (N = 50; both age restricted to < 26 years) while controlling those factors found to impact on performance from Study One. Results: Age, computer familiarity, and education significantly contributed to the variance in performance measures. While controlling these factors, petrol abuse was associated with poorer performance on complex tasks of psychomotor, visual attention, memory, learning, spatial awareness and executive function. Conclusions: This assessment process is useful for detecting substance abuse related impairments in Indigenous Australians and when using this assessment process, age and computer familiarity in particular should be controlled for.

Copyright 2010, Informa Healthcare

Dingwall KM; Maruff P; Fredrickson A; Cairney S. Cognitive recovery during and after treatment for volatile solvent abuse. Drug and Alcohol Dependence 118(2-3): 180-185, 2011. (53 refs.)

Background: Cognitive impairment reflecting CNS disruption in chronic solvent abusers can resolve within two years of abstinence. However, the specific time course for recovery has yet to be determined empirically. This study monitored cognition among solvent (i.e., gasoline) abusers throughout 8 weeks of residential treatment. It also investigated the extent to which solvent-related cognitive impairments persisted following discharge. Methods: Non-drug using healthy controls (n = 33) and solvent abusers (n = 29) who had inhaled gasoline, regularly or episodically, for an average of 4.3 years (SD = 2.7) were assessed. Using linear mixed model analyses, solvent abusers were compared to healthy controls throughout treatment at baseline, two weeks, four weeks and six weeks, on visual motor, attention, learning, memory, and executive function tasks. Ten users who maintained abstinence were reassessed an average of 12 months later (SD = 2.8) and were compared to healthy controls (n = 12) retested at the same time interval using ANCOVA while controlling for age and baseline performance. Results: At baseline, solvent abusers showed cognitive deficits on visual motor, learning and memory, paired associate learning, and executive functions. Paired associate learning performance improved within 6 weeks of abstinence, however, impairments in visual motor speed, learning and memory, and executive function persisted throughout and in some cases beyond treatment. Conclusions: Cognitive deficits exist for solvent abusers upon treatment entry. Some impairments resolve within weeks of abstinence, while memory and executive function improves gradually over months to years of abstinence, and might never fully recover.

Copyright 2011, Elsevier Science

Drumright LN; Gorbach PM; Little SJ; Strathdee SA. Associations between substance use, erectile dysfunction medication and recent HIV infection among men who have sex with men. AIDS & Behavior 13(2): 328-336, 2009. (55 refs.)

We conducted a case-control study to compare illicit substance and erectile dysfunction medication (EDM) use between recently HIV-infected and uninfected men who have sex with men (MSM). Eighty-six recently (previous 12 months) HIV-infected MSM (cases) and 59 MSM who recently tested HIV-negative (controls) completed computer-assisted self-interviews. There were no statistical differences in demographics or number of sexual partners by HIV status. Cases were more likely than controls to report methamphetamine or nitrite use, but not EDM, gamma hydroxybutyrate, 3,4 methylenedioxymethamphetamine, cocaine, or marijuana use, in the previous 12 months and with their last three sexual partners in multivariate logistic regression models. Use of nitrites and amphetamine may increase HIV risk among MSM.

Copyright 2009, Springer

Elekes Z; Miller P; Chomynova P; Beck F. Changes in perceived risk of different substance use by ranking order of drug attitudes in different ESPAD-countries. Journal of Substance Use 14(3-4): 197-210, 2009. (6 refs.)

Data from the surveys in eight countries of the European Schools Project on Alcohol and other Drugs in the years 1995, 1999, and 2003 were available. Changes over time in the perceptions of the risk of using alcohol, cigarettes, cocaine, marijuana, LSD, amphetamines, ecstasy, and inhalants were assessed. On average the overall proportions of the samples seeing use of these substances as 'very risky' fell between 1995 and 2003 in all eight countries as prevalences rose slightly in most of the countries. However, there was a tendency for the gap to widen over time between the proportions seeing regular use of illicit substances as very risky and the proportions seeing occasional use as very risky. Relative to other substances cigarette smoking and heavy weekend drinking were ranked more risky in 2003 than in 1995.

Copyright 2009, Informa Healthcare

Elkoussi A; Bakheet S. Volatile substance misuse among street children in upper Egypt. Substance Use & Misuse 46(Supplement 1): 35-39, 2011. (19 refs.)

This work assessed the extent, patterns, attitudes, motivations, and impacts of volatile substance misuse (VSM) among street children in Upper Egypt. In 2009, a 36-item questionnaire was administered to a randomly selected sample of 120 street children aged 10-18 years. Nearly 91%% (n = 109) reported misusing products containing volatile substances because they are inexpensive, legal, and easy to acquire. Familial neglect and lack of supervision were the main social motivations reported by street youth for misusing volatile substances. One-third (34.2%%, n = 41) reported inhaling "Kolla," a commercial glue; this study identifies its physicochemical, neuropharmacological, and toxicological properties. The study's limitations are noted.

Copyright 2011, Informa Healthcare

Fakier N; Wild LG. Associations among sleep problems, learning difficulties and substance use in adolescence. Journal of Adolescence 34(4): 717-726, 2011. (68 refs.)

This study investigated the relationships among sleep problems, learning difficulties and substance use in adolescence. Previous research suggests that these variables share an association with executive functioning deficits, and are intertwined. The sample comprised 427 adolescents (M age = 16 years) attending remedial schools and 276 adolescents (M age = 15 years) attending a mainstream school in Cape Town, South Africa. Participants completed anonymous self-report questionnaires. Results indicated that adolescents without learning difficulties were more likely to use tobacco, methamphetamine and cannabis, whereas those with learning difficulties engaged in more inhalant use. Adolescents who had more sleep problems were more likely to use tobacco, alcohol, methamphetamine, cannabis, inhalants, cocaine, ecstasy and any other illegal drug. Adolescents with learning difficulties had more sleep problems than those without learning difficulties. However, sleep problems remained independently associated with tobacco, cannabis and inhalant use when learning difficulties were taken into account.

Copyright 2011, Foundation for Professionals in Services for Adolescents

Garland EL; Howard MO. Inhalation of computer duster spray among adolescents: An emerging public health threat? American Journal of Drug and Alcohol Abuse 36(6): 320-324, 2010. (25 refs.)

Background: Anecdotal reports and recent medical examiner and poison control center studies suggest that computer duster spray (CDS) inhalation is an emerging public health threat. However, there is a current dearth of empirical data on CDS use. Objectives: Study aims were to examine the prevalence, frequency, correlates, and modalities of CDS use among a treatment sample of antisocial youth. Methods: A battery of standardized psychosocial instruments was administered via interview of 723 Missouri adolescents in residential care for antisocial behavior. Results: Lifetime CDS use was prevalent (14.7%) in this young service population (97.7% of whom participated). CDS users were significantly more likely to report histories of perinatal injuries or illness, traumatic experiences, suicidality and physician-diagnosed mental illness, and evidenced higher levels of psychiatric symptoms, antisocial attitudes and behaviors, and polydrug use than CDS nonusers. Conclusions and Scientific Significance: CDS use was endemic in this treatment sample of adolescents and associated with a range of clinically significant comorbidities. Current findings describe an underrecognized and potentially dangerous form of substance misuse that has rarely been studied but that may be of growing importance.

Copyright 2010, Taylor & Francis

Garland EL; Howard MO; Perron BE. Nitrous oxide inhalation among adolescents: Prevalence, correlates, and co-occurrence with volatile solvent inhalation. Journal of Psychoactive Drugs 41(4): 337-347, 2009. (54 refs.)

Few studies have examined the prevalence of nitrous oxide (NO) inhalation or co-occurrence of NO and volatile solvent (VS) use in adolescents. Study aims were to (1) describe the independent and conjoint prevalence of NO and VS use in incarcerated youth, (2) compare adolescent users of both NO and VS inhalants (NO+VS) to users of NO-only, VS-only, and nonusers of NO and VS (NO/VS nonusers) with regard to demographic, psychological, and behavioral characteristics, and (3) conduct logistic regression analyses identifying correlates of NO use. Residents (N = 723) of Missouri Division of Youth Services were assessed with standardized psychosocial measures. Participants averaged 15.5 (SD = 1.2) years of age, were ethnically diverse and predominantly male. Lifetime prevalence of NO use was 15.8%. NO+VS users evidenced greater impairments compared to NO+VS nonusers. VS-only users evidenced impairments that were similar in kind but at lower prevalences compared to those displayed by NO+VS users, whereas NO-only youth had profiles that were similar to those of NO/VS nonusers. Psychiatric disorders, polydrug use, and temperamental fearlessness were correlates of NO use. NO+VS users were at high risk for behavioral and emotional problems. Screening and interventions for NO and VS inhalant use should be implemented in juvenile justice facilities.

Copyright 2009, Haight-Ashbury Publishing

Garland EL; Howard MO. Phenomenology of adolescent inhalant intoxication. Experimental and Clinical Psychopharmacology 18(6): 498-509, 2010. (31 refs.)

Although volatile substance inhalation is prevalent in many contexts and presents a serious threat to public health, this pernicious form of substance misuse remains poorly understood. The question of why people seek and misuse inhalants may be addressed by examining phenomenological accounts of inhalant intoxication, yet few investigations of inhalant intoxication experiences are reported in the literature. This investigation employed a structured interview to assess inhalant intoxication experiences of 267 low-, moderate-, and high-frequency inhalant users. Low-frequency inhalant users reported predominately hedonic experiences during inhalant intoxication, whereas high-frequency users reported a mixture of hedonic and aversive experiences. Aversive experiences such as depressed mood, suicidal ideation, and chest pain were commonly reported by high-frequency users but were relatively rare among low-frequency users. High-frequency users also experienced significantly more euphoria, talkativeness, and grandiosity during inhalant intoxication than low-frequency users. Hedonic and aversive experiences during episodes of inhalant intoxication are relatively common among high-frequency adolescent inhalant users.

Copyright 2010, American Psychological Association

Garland EL; Howard MO; Vaughn MG; Perron BE. Volatile substance misuse in the United States. Substance Use & Misuse 46(Supplement 1): 8-20, 2011. (70 refs.)

Volatile substance misuse (VSM) is prevalent in the United States and associated with manifold deleterious outcomes. This review summarizes research on: (1) the prevalence of VSM in the United States and its trends since 1975, (2) population subgroups at an elevated risk for VSM, (3) key correlates of VSM, (4) psychosocial consequences of VSM, including emerging public health threats, and (5) etiological and contextual considerations of VSM use. Implications for future research and practice with volatile substance misusers in the United States are identified.

Copyright 2011, Informa Healthcare

Goel RK. Cigarette prices and illicit drug use: is there a connection? Applied Economics 41(9): 1071-1076, 2009. (14 refs.)

Using cross-sectional data from the United States, this study examines the effects of cigarette prices on the use of marijuana and illicit drugs (including marijuana, cocaine, heroin, inhalants, hallucinogens or any prescription drugs for nonmedical use). Five primary contributions of this work are: First, it provides evidence on the cross-relation between cigarettes and marijuana and illicit drugs. Second, besides the 'standard' control variables used in demand studies (namely, price, education and income), we also control for the influence of employment status and health insurance coverage. Third, this research provides new evidence on the price elasticity of cigarette demand for a recent time period. Fourth, the data used in this study are the latest available. Five, based on our results, implications for drug use policy are provided. Several key points may be noted from our results: (i) Cigarette demand seems to have become elastic in recent years. This is in contrast to findings in earlier years; (ii) Consumers seem to view cigarettes and marijuana as substitutes and cigarettes and illicit drugs as substitutes. (iii) Greater consumer income increases illegal drug use, but does not seem to have a significant impact on smoking and marijuana use; (iv) The unemployment rate and health insurance converge do not seem to significantly affect smoking or drug use; and (v) Policymakers should pay attention to the cross effects among drugs in framing drug use policies.

Copyright 2009, Taylor & Francis

Gruenewald PJ; Johnson K; Shamblen SR; Ogilvie KA; Collins D. Reducing adolescent use of harmful legal products: Intermediate effects of a community prevention intervention. Substance Use & Misuse 44(14): 2080-2098, 2009. (55 refs.)

Purpose: Preliminary results are presented from a feasibility study of a comprehensive community prevention intervention to reduce the use of inhalants and other harmful legal products (HLPs) among adolescents in three Alaskan frontier communities conducted in 2004-2007. The legal products used to get high include over-the-counter drugs, prescription drugs, and common household products. Community mobilization, environmental and school-based strategies were implemented to reduce access, enhance knowledge of risks, and improve assertiveness and refusal skills. Methods: Pre- and post-intervention survey data were collected from 5-7th grade students from schools in three communities using standardized instruments to assess knowledge, assertiveness, refusal skills, perceived availability, and intent to use. The intervention consisted of community mobilization and environmental strategies to reduce access to HLPs in the home, at school, and through retail establishments. In addition, the ThinkSmart curriculum was implemented in classrooms among 5th grade students to increase the knowledge of harmful effects of HLPs and improve the refusal skills. Data were analyzed using hierarchical linear models that enable corrections for correlated measurement error. Results: Significant increases in knowledge of harms related to HLP use and decreases in perceived availability of HLP products were observed. The environmental strategies were particularly effective in reducing the perceived availability of HLPs among 6th and 7th graders. Discussion: Although limited by the absence of randomized control groups in this preliminary study design, the results of this study provide encouragement to pursue mixed strategies for the reduction of HLP use among young people in Alaskan frontier communities.

Copyright 2009, Taylor & Francis

Hall MT; Edwards JD; Howard MO. Accidental deaths due to inhalant misuse in North Carolina: 2000-2008. Substance Use & Misuse 45(9): 1330-1339, 2010. (17 refs.)

This study describes the number and characteristics of accidental deaths associated with recreational inhalant misuse in North Carolina from 2000 to 2008. Inhalant-related deaths were identified via an electronic search of records of the North Carolina Office of the Chief Medical Examiner. Thirty deaths were attributed to recreational inhalant use, and nearly a third involved the inhalation of compressed-air products. Polydrug use and comorbid psychiatric disorders were common among decedents. The types of inhalants most often resulting in death differed from previous studies, as did the somewhat older mean age of decedents. Further research on inhalant-related mortality is warranted.

Copyright 2010, Taylor & Francis

Hall MT; Howard MO. Nitrite inhalant abuse in antisocial youth: Prevalence, patterns, and predictors. Journal of Psychoactive Drugs 41(2): 135-143, 2009. (36 refs.)

The purpose of this study was to examine the prevalence, patterns, and predictors of nitrite inhalant use in antisocial adolescents. Face-to-face interviews were conducted with 723 Missouri youth (M-age = 15.5, SD = 1.2) in residential care for antisocial behavior. The lifetime prevalence of nitrite inhalant use was 1.7% (1.3% for boys; 4.3% for girls,p = .06), a figure somewhat higher than comparable estimates from the MTF and NSDUH national surveys. Most lifetime users reported nitrite use in the prior year (92%) and experienced intoxication (83%) during periods of nitrite inhalation. Nitrite users had significantly higher scores on measures of somatization, obsessive-compulsive traits. interpersonal sensitivity, impulsivity, fearlessness, suicidality, and polydrug use and were significantly more likely to have suffered a serious head injury and to be White than their non-nitrite-using counterparts. Nitrite users also reported significantly higher levels of current psychiatric distress related to periods of faintness or dizziness, hot or cold spells, difficulty making decisions, and their "mind going blank" than did non-nitrite users. Antisocial adolescent nitrite users are at substantially elevated risk for serious functional impairments given their high rates of lifetime head injury, comparatively more varied and intensive levels of involvement with psychoactive drugs, and symptom reports suggestive of psychiatric and cognitive dysfunction.

Copyright 2009, Haight-Ashbury Publishing

Han B; Gfroerer JC; Colliver JD. Associations between duration of illicit drug use and health conditions: Results from the 2005-2007 National Surveys on Drug Use and Health. Annals of Epidemiology 20(4): 289-297, 2010. (60 refs.)

PURPOSE: To estimate and compare prevalence rates of lifetime health conditions by inferred duration of illicit drug use among the general U.S. adult population and to investigate associations between duration of use of each specific illicit drug (marijuana, cocaine, heroin, hallucinogens, or inhalant) and each lifetime health condition after controlling for potential confounding factors. METHODS: Data from respondents aged 35 to 49 (N = 29,195) from the 2005-2007 National Surveys on Drug Use and Health (NSDUH) were analyzed. RESULTS: The prevalence rates of a broad range of health conditions by duration of use of specific illicit drug among persons 35 to 49 years of age in the United States were estimated and compared. After adjustment for potential confounding factors, the results of 20 multivariate logistic regression models indicated positive associations between duration of marijuana use and anxiety, depression, sexually transmitted disease (STD), bronchitis, and lung cancer; between duration of cocaine use and anxiety and pancreatitis; between duration of heroin use and anxiety, hepatitis, and tuberculosis; between duration of hallucinogen use and tinnitus and STD; and between duration of inhalant use and anxiety, depression, HIV/AIDS, STD, tuberculosis, bronchitis, asthma, sinusitis, and tinnitus. CONCLUSIONS: This study provides initial analyses on the relationships between illicit drug use and health conditions based on a large nationally representative sample. These results can help prepare for treating health problems among former and continuing illicit drug users.

Copyright 2010, Elsevior Science

Hickson F; Bonell C; Weatherburn P; Reid D. Illicit drug use among men who have sex with men in England and Wales. Addiction Research & Theory 18(1): 14-22, 2010. (15 refs.)

This article aims to examine patterns of and concerns about drug use among a convenience sample of MSM in 2005, and compare the prevalence of illicit drug use among 1999 and 2005 samples of MSM in England and Wales. It draws on data from cross-sectional surveys of MSM in gay community venues and services across England and Wales, 2480 in 1999 and 3913 in 2005. We report that in 2005, cocaine, cannabis and alkyl nitrites were the drugs most commonly used in the previous year by MSM inside and outside London. Drug use was significantly more common among men who were younger and resided in London, and among those who reported greater numbers of male sexual partners and were HIV-positive. Frequency of use was generally high among those who used a drug, and poly-drug use was also high. A substantial minority of men who used illicit drugs were worried about use. More men in 2005 than in 1999 reported using various drugs including cocaine, ecstasy and ketamine. We conclude that use of drugs is widespread among the MSM surveyed. Exclusive use of any one drug is rare. There is an urgent need for drug prevention and treatment interventions, which are accessible and acceptable to MSM.

Copyright 2010, Taylor & Francis

Howard MO; Bowen SE; Garland EL; Perron BE; Vaughn MG. Inhalant use and inhalant use disorders in the United States. Addiction Science & Clinical Practice 6(1): unpaginated, 2011

More than 22 million Americans age 12 and older have used inhalants, and every year more than 750,000 use inhalants for the first time. Despite the substantial prevalence and serious toxicities of inhalant use, it has been termed "the forgotten epidemic." Inhalant abuse remains the least-studied form of substance abuse, although research on its epidemiology, neurobiology, treatment, and prevention has accelerated in recent years. This review examines current findings in these areas, identifies gaps in the research and clinical literatures pertaining to inhalant use, and discusses future directions for inhalant-related research and practice efforts.

Public Domain

Howard MO; Perron BE; Vaughn MG; Bender KA; Garland E. Inhalant use, inhalant-use disorders, and antisocial behavior: Findings: from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Journal of Studies on Alcohol and Drugs 71(2): 201-209, 2010. (21 refs.)

Objective: Few studies have explored the topography of antisocial behavior in a nationally representative sample of inhalant users. We examined (a) the lifetime prevalence of 20 childhood and adult antisocial behaviors in inhalant users with inhalant-use disorders (IUD+) and without IUDs (IUD); (b) the nature and strength of associations between inhalant use, IUDs, and specific antisocial behaviors in multivariate analyses; and (c) the relationships between inhalant use, IUDs, and antisocial behaviors in a national sample of adults with antisocial personality disorder. Method: The National Epidemiologic Survey on Alcohol and Related Conditions was a multistage national survey of 43,093 U.S. residents. Respondents completed a structured psychiatric interview. Results: IUD+ and IUD respondents were significantly younger and more likely to be unemployed, to be male, to have never married, and to report family and personal histories of alcohol and drug problems than inhalant nonusers. Family histories of alcohol problems and personal histories of drug problems were significantly more prevalent among IUD+ respondents, compared with IUD respondents. In bivariate analyses, IUD+ and IUD respondents evidenced significantly higher lifetime levels of all childhood and adult antisocial behaviors than inhalant nonusers. IUD+ respondents were significantly more likely than their IUD counterparts to report bullying behavior, starting physical fights, using dangerous weapons, physical cruelty to people, staying out all night without permission, running away, and frequent truancy in childhood, as well as greater deceitfulness, impulsivity, irritability/aggressiveness, recklessness, and irresponsibility in adulthood. Multivariate analyses indicated that IUD+ respondents had a significantly elevated risk for childhood and adult antisocial behaviors, compared with inhalant nonusers, with the strongest effects for using dangerous weapons, physical cruelty to animals, and physical cruelty to people. Similarly, IUD+ respondents differed significantly from their IUD counterparts primarily across measures of interpersonal violence. Among persons with antisocial personality disorder, inhalant use and IUDs were associated with greater antisocial behavior, albeit with fewer and weaker effects. Conclusions: Respondents with IUDs had pervasively elevated levels of antisocial conduct, including diverse forms of early-onset and interpersonally violent behavior.

Copyright 2010, Alcohol Research Documentation

Howard MO; Perron BE; Sacco P; Ilgen M; Vaughn MG; Garland E et al. Suicide ideation and attempts among inhalant users: Results from the national epidemiologic survey on alcohol and related conditions. Suicide and Life-Threatening Behavior 40(3): 276-286, 2010. (19 refs.)

Few studies have examined associations of inhalant use and inhalant use disorders (IUDs) to suicide ideation and attempts. We investigated these relationships in the largest comorbidity survey conducted in the United States. Suicidal ideation was significantly more prevalent among inhalant users than nonusers and severity of inhalant use problems was positively related to suicidal ideation. Among persons with IUDs, 67.4% had thought about committing suicide and 20.2% had attempted suicide. Multivariate logistic regression analyses indicated that respondents with IUDs reported significantly higher levels of suicide ideation than inhalant nonusers. Inhalant use is associated with significantly increased risk for suicide ideation, especially among women and persons with DSM-IV IUDs.

Copyright 2010, Guildford Publications

Huepe D; Roca M; Salas N; Canales-Johnson A; Rivera-Rei AA; Zamorano L et al. Fluid intelligence and psychosocial outcome: From logical problem solving to social adaptation. PLoS ONE 6(9): e-24858, 2011. (118 refs.)

Background: While fluid intelligence has proved to be central to executive functioning, logical reasoning and other frontal functions, the role of this ability in psychosocial adaptation has not been well characterized. Methodology/Principal Findings: A random-probabilistic sample of 2370 secondary school students completed measures of fluid intelligence (Raven's Progressive Matrices, RPM) and several measures of psychological adaptation: bullying (Delaware Bullying Questionnaire), domestic abuse of adolescents (Conflict Tactic Scale), drug intake (ONUDD), self-esteem (Rosenberg's Self Esteem Scale) and the Perceived Mental Health Scale (Spanish adaptation). Lower fluid intelligence scores were associated with physical violence, both in the role of victim and victimizer. Drug intake, especially cannabis, cocaine and inhalants and lower self-esteem were also associated with lower fluid intelligence. Finally, scores on the perceived mental health assessment were better when fluid intelligence scores were higher. Conclusions/Significance: Our results show evidence of a strong association between psychosocial adaptation and fluid intelligence, suggesting that the latter is not only central to executive functioning but also forms part of a more general capacity for adaptation to social contexts.

Copyright 2011, Public Library of Science

Hunter L; Gordge L; Dargan PI; Wood DM. Methaemoglobinaemia associated with the use of cocaine and volatile nitrites as recreational drugs: A review. (review). British Journal of Clinical Pharmacology 72(1): 18-26, 2011. (54 refs.)

Methaemoglobinaemia can cause significant tissue hypoxia, leading to severe, potentially life-threatening clinical features and/or death. Over recent years there have been increasing reports of methaemoglobinaemia related to recreational drug use. There have been 25 articles describing methaemoglobinaemia related to recreational use of volatile nitrites (poppers) and more recently, four reports of methaemoglobinaemia in association with recreational cocaine use. In this article we discuss the mechanisms by which methaemoglobinaemia occurs in relation to the use of both volatile nitrites and cocaine, and summarize the published cases of recreational drug-related methaemoglobinaemia. The volatile nitrites can cause methaemoglobinaemia directly through their activity as oxidizing agents. However, with cocaine, methaemoglobinaemia is related to adulterants such as local anaesthetics or phenacetin, rather than to the cocaine itself. Clinicians managing patients with acute recreational drug toxicity should be aware of the potential for methaemoglobinaemia in these patients, particularly in patients with cyanosis or unexplained low oxygen saturations on pulse oximetry, and ensure that appropriate and timely management is provided, including, where appropriate, the use of methylthioninium chloride (methylene blue).

Copyright 2011, Wiley-Blackwell

Hynes-Dowell M; Mateu-Gelabert P; Barros HMT; Delva J. Volatile substance misuse among high school students in South America. Substance Use & Misuse 46(Supplement 1): 27-34, 2011. (22 refs.)

This article summarizes data from a 2004 study of over 300,000 high school students (aged 13-18 years) in nine South American countries. A probabilistic sample targeted urban secondary schools, utilizing a self-administered questionnaire on prevalence and frequency of substance use. Multivariate analysis showed that volatile substances were the first or second most commonly reported substances used after alcohol and cigarettes in all countries (lifetime prevalence range: 2.67%% [Paraguay] to 16.55% [Brazil]). Previous studies have highlighted volatile substance misuse among street children, whereas this study demonstrates that it is common among South American high school students.

Copyright 2011, Informa Healthcare

Ives R. Meeting professionals' needs in the United Kingdom for effective VSM intervention. Substance Use & Misuse 46(Supplement 1): 134-139, 2011. (17 refs.)

An exploratory study examined what professionals needed to support their responses to volatile substance misuse (VSM). Many respondents saw VSM as a problem of unknown dimensions and were uncertain about how to tackle it. Resources for treatment and prevention were seen as outdated. Workers were concerned that VSM was becoming more common among adults, supporting an indication found in a study of VSM-related deaths. Evidence-informed treatment protocols, information on working with clients, assessments of local needs, and the evaluation of existing approaches to VSM would improve the response. A further phase of the research will be reported in 2012.

Copyright 2011, Informa Healthcare

Jackson CE; Currie BJ; Cairney S; Maruff PT; Snyder PJ. Hunger and the perception of the scent of petrol: A potential neurobiological basis for increased risk of petrol inhalation abuse. Addiction Research & Theory 17(5): 518-524, 2009. (31 refs.)

The deliberate inhalation of petrol as a means of intoxication used by underage and marginalized social groups is a growing international problem. This type of abuse has been identified as the cause of severe physical, cognitive, and psychological impairment. Both of these factors have heightened the need for identifying causes underlying why individuals begin abusing petrol. One hundred Australian male adults were surveyed while they were filling their cars with petrol. While the individuals were exposed to ambient petrol, they were asked to rate how pleasant and intense they found the smell of the petrol and the number of hours since they last ate a meal. Significant positive correlations between hunger and ratings of both pleasantness and intensity of petrol odor were identified. The results from this study suggest that hunger, and more specifically saturated fat consumption, may influence an individual's decision to abuse petrol. Suggestions for further research and related public health considerations are discussed.

Copyright 2009, Taylor & Francis

Jamieson LM; Gunthorpe W; Cairney SJ; Sayers SM; Roberts-Thomson KF; Slade GD. Substance use and periodontal disease among Australian Aboriginal young adults. Addiction 105(4): 719-726, 2010. (27 refs.)

Aim: To investigate the effects of tobacco, marijuana, alcohol and petrol sniffing on periodontal disease among Australian Aboriginal young adults. Design: Cross-sectional nested within a long-standing prospective longitudinal study. Setting: Aboriginal communities in Australia's Northern Territory. Participants: Members of the Aboriginal Birth Cohort study who were recruited from birth between January 1987 and March 1990 at the Royal Darwin Hospital, Northern Territory, Australia. Data were from wave III, when the mean age of participants was 18 years. Measurements: Clinical dental examination and self-report questionnaire. Findings: Of 425 participants with complete data, 26.6% had moderate/severe periodontal disease. There was elevated risk of periodontal disease associated with tobacco [prevalence ratio (PR) = 1.59, 95% CI = 1.06-2.40], marijuana (PR = 1.44, 95% CI = 1.05-1.97) and petrol sniffing (PR = 1.83, 95% CI = 1.08-3.11), but not alcohol (PR = 0.92, 95% CI = 0.67-1.27). Stratified analysis showed that the effect of marijuana persisted among tobacco users (PR = 1.47, 95% CI 1.03-2.11). It was not possible to isolate an independent effect of petrol sniffing because all petrol sniffers used both marijuana and tobacco, although among smokers of both substances, petrol sniffing was associated with an 11.8% increased prevalence of periodontal disease. Conclusions: This is the first time that substance use has been linked with periodontal disease in a young Australian Aboriginal adult population, and the first time that petrol sniffing has been linked with periodontal disease in any population. The role of substance use in periodontal disease among this, and other, marginalized groups warrants further investigation.

Copyright 2010, Society for the Study of Addiction to Alcohol and Other Drugs

Johnson KW; Ogilvie KA; Collins DA; Shamblen SR; Dirks LG; Ringwalt CL et al. Studying implementation quality of a school-based prevention curriculum in frontier Alaska: Application of video-recorded observations and expert panel judgment. Prevention Science 11(3): 275-286, 2010. (50 refs.)

This study assesses the implementation quality of Think Smart, a school-based drug prevention curriculum that was designed to reduce use of harmful legal products (HLPs; e.g., inhalants and over-the-counter drugs), alcohol, tobacco, and other drugs among 5th- and 6th-grade students in frontier Alaska. Participating in the study were eight communities that took part in a larger randomized control trial to assess the short-term effects of the Think Smart curriculum. Video-recorded observations of the 12 core and 3 booster lessons were conducted in 20 classrooms. Ninety-five sessions were randomly selected from 228 usable videodiscs, and two pairs of researchers observed each video recording to code level of dosage, adherence to curriculum design, and teachers' delivery skills. Inter-rater reliability for all implementation quality measures was very high. An expert panel consisting of 16 scientists reviewed the results of the implementation study and concluded that the level of dosage and adherence to the curriculum design was at least as high as those yielded by similar studies. However, the panel assessed the delivery quality to be only marginal in comparison to results of other studies. The experts concluded that the implementation quality of the Think Smart curriculum was adequate even though the teachers' delivery skills were only marginal. A bootstrapping analysis, in which 1,000 samples were drawn for each implementation quality result, found the expert judgments to be reliable. The authors conclude that despite some limitations, video-recorded observations, as well as expert judgment, provide strong methodologies that should be considered for future implementation quality studies.

Copyright 2010, Springer Press

Kimber B; Sandell R. Prevention of substance use among adolescents through social and emotional training in school: A latent-class analysis of a five-year intervention in Sweden. Journal of Adolescence 32(6 Special Issue): 1403-1413, 2009. (49 refs.)

The study considers the impact of a program for social and emotional learning in Swedish schools on use of drugs, volatile substances, alcohol and tobacco. The program was evaluated in an effectiveness study. Intervention Students were compared longitudinally with non-intervention students using nonparametric latent class analysis to identify subgroups of students with similar use levels and trajectories. Statistically significant intervention-by-duration interactions, with medium to large effect sizes to the advantage of the SET students were found for all substances in one or more, but not all, of the latent classes. Favorable trajectories were found for non-users/light users of drugs, moderate sniffers, non-users/light users of alcohol, and occasional smokers. Only among heavy smokers was there a possible iatrogenic effect of SET. Such programs, given a duration of two years or more, may dampen increases in use with age and discourage early debut, although they are not specifically targeted at use itself.

Copyright 2009, The Association for Professionals in Services for Adolescents

Klisch Y; Miller LM; Wang S; Epstein J. The impact of a science education game on students' learning and perception of inhalants as body pollutants. Journal of Science Education and Technology 21(2): 295-303, 2012. (33 refs.)

This study investigated the knowledge gains and attitude shifts attributable to a unique online science education game, Uncommon Scents. The game was developed to teach middle school students about the biological consequences of exposure to toxic chemicals in an environmental science context, as well as the risks associated with abusing these chemicals as inhalants. Middle school students (n = 444) grades six through eight participated in the study consisting of a pre-test, three game-play sessions, and a delayed post-test. After playing the game, students demonstrated significant gains in science content knowledge, with game usability ratings emerging as the strongest predictor of post-test content knowledge scores. The intervention also resulted in a shift to more negative attitudes toward inhalants, with the most negative shift occurring among eighth grade students and post-test knowledge gains as the strongest predictor of attitude change across all grade levels. These findings suggest that the environmental science approach used in Uncommon Scents is an efficacious strategy for delivering both basic science content and influencing perceived harm relating to the inhalation of toxic chemicals from common household products.

Copyright 2012, Springer

Konghom S; Verachai V; Srisurapanont M; Suwanmajo S; Ranuwattananon A; Kimsongneun N et al. Treatment for inhalant dependence and abuse. (review). Cochrane Database of Systematic Reviews 12: e-article CD007537, 2010. (13 refs.)

Background: Inhalants are being abused by large numbers of people throughout the world, particularly socio-economically disadvantaged children and adolescents. The neuropsychological effects of acute and chronic inhalant abuse include motor impairment, alterations in spontaneous motor activity, anticonvulsant effects, anxiolytic effects, sensory effects, and effects and learning, memory and operant behaviour (e. g., response rates and discriminative stimulus effects). Objectives: To search and determine risks, benefits and costs of a variety treatments for inhalant dependence or abuse. Search strategy: We searched MEDLINE (1966 - February 2010), EMBASE (Januray 2010) and Cochrane Central Register of Controlled Trials (CENTRAL) (February 2010). We also searched for ongoing clinical trials and unpublished studies via Internet searches. Selection criteria: Randomised-controlled trials and controlled clinical trails (CCTs) comparing any intervention in people with inhalant dependence or abuse. Data collection and analysis: Two reviewers independently selected studies for inclusion, assessed trial quality and extracted data. Main results: No studies fulfilling the inclusion criteria have been retrieved. Authors' conclusions: Implications for practice: due to the lack of studies meeting the inclusion criteria, no conclusion can be drawn for clinical practice. Implications for research: as a common substance abuse with serious health consequences, treatment of inhalant dependence and abuse should be a priority area of substance abuse research.

Copyright 2010, John Wiley & Sons

Kulahci Y; Sever C; Noyan N; Uygur F; Ates A; Evinc R et al. Burn assault with paint thinner ignition: An unexpected burn injury caused by street children addicted to paint thinner. Journal of Burn Care & Research 32(3): 399- 404, 2011. (15 refs.)

The frequency of assault by burning among all burn patients varies from country to country. Assault by burning, although uncommon, is a serious form of trauma and a significant source of morbidity and mortality. The aim of this retrospective study was to identify the epidemiologic features, current etiological factors, and the mortality of nine patients admitted to our burn unit between January 1999 and January 2009 after unexpected burn assault by paint thinner ignition caused by street children addicted to paint thinner. The circumstances of this injury and preventive measures are discussed.

Copyright 2011, Lippincott, Williams & Wilkins

Kurniali PC; Henry L; Kurl R; Meharg JV. Inhalant abuse of computer cleaner manifested as angioedema. American Journal of Emergency Medicine 30(1): 265.e3, 2012. (12 refs.)

Inhalant abuse is the intentional inhalation of chemical vapors or volatile substance to achieve a euphoric effect. Although no statistical data are reported yet, inhalant abuse is potentially life-threatening and has resulted in a wide range of toxic effects such as central nervous system depression, seizures, aspiration, cardiac arrhythmia, asphyxiation, hypoxia, metabolic acidosis, and sudden death among others. We are reporting a 25-year-old white man who was brought to the emergency department after inhaling aerosolized computer-cleaning spray composed of difluoroethane. He was found to have marked upper and lower lip facial swelling consistent with angioedema. The patient also had a prolonged QT interval, mild inspiratory stridor, but no urticaria. In this case, we believe the difluoroethane-related angioedema represents either idiopathic or bradykinin-induced angioedema.

Copyright 2012, WB Saunders

Li L; Zhang X; Levine B; Li GH; Zielke HR; Fowler DR. Trends and pattern of drug abuse deaths in Maryland teenagers. Journal of Forensic Sciences 56(4): 1029-1033, 2011. (29 refs.)

The Office of the Chief Medical Examiner of Maryland recorded a total of 149 drug abuse deaths of teenagers aged 13-19 years between 1991 and 2006. Of these deaths, 96 (64.4%) were caused by the use of narcotic drugs only, 29 (19.5%) by both narcotics and cocaine, four (2.7%) by both narcotics and methylenedioxymethamphetamine, six (4.0%) by cocaine only, and 14 (9.4%) by volatile substances (e.g., butane, Freon, nitrous oxide, and propane). The annual death rate from drug abuse for teenagers increased from 1.4 deaths per 100,000 population in 1991 to 2.7 deaths per 100,000 population in 2006 (chi-square test for time trend, p < 0.01). The increase in teenager drug abuse deaths occurred in 1999 and since has remained at a higher rate. Further analysis revealed that the increase in drug abuse deaths was attributable to a large degree to narcotic drugs, particularly heroin / morphine and methadone, and was confined to teenagers residing in the suburban and rural areas.

Copyright 2011, Wiley-Blackwell

Lim MSC; Hellard ME; Hocking JS; Spelman TD; Aitken CK. Surveillance of drug use among young people attending a music festival in Australia, 2005-2008. Drug and Alcohol Review 29(2): 150-156, 2010. (14 refs.)

Introduction and Aims. In order to monitor trends in illicit drug use among youth, surveillance of drug use behaviours among a variety of populations in different settings is required. We monitored drug use among music festival attendees. Design and Methods. Cross-sectional studies of young people's reported drug use were performed at a music festival in Melbourne from 2005 to 2008. Self-administered questionnaires collected information on drug use, demographics and other risk behaviour. Results. From 2005 to 2008, over 5000 questionnaires were completed by people aged 16-29; 2273 men and 3011 women. Overall, use of any illicit drug in the past month was reported by 44%. After adjusting for demographic and behavioural characteristics, the prevalence of recent illicit drug use decreased significantly from 46% in 2005 to 43% in 2008 (OR 0.92, 95% CI 0.87-0.97). After adjusting for age and sex the downwards trend was repeated for amphetamines and cannabis, but a significant increase in prevalence was observed in hallucinogen, ecstasy and inhalant use. Drug use was more common among men, older participants and those engaging in high-risk sexual behaviour. Discussion and Conclusions. Illicit drug use was much more common in this sample than in the National Drug Strategy Household survey, but the direction of trends in drug use were similar; drug use prevalences were much lower than in the Ecstasy and Related Drugs Reporting System, the Illicit Drug Reporting System or National Needle and Syringe Program Survey. Music festival attendees are a potentially useful group for monitoring trends in illicit drug use.

Copyright 2010, Wiley-Blackwell

Lopez-Quintero C; Neumark Y. The epidemiology of volatile substance misuse among school children in Bogotaa, Colombia. Substance Use & Misuse 46(Supplement 1): 50-56, 2011. (34 refs.)

Volatile substance misuse (VSM) is increasing among Colombian youth. Rates and correlates of VSM, exposure-opportunity (EO) to VSM, and positive VSM intentions were examined in 2006 among 2,279 students (mean age 14.8 years) in 23 schools in Bogotaa, Colombia. Sixteen percent experienced an EO, 3%% reported past-year VSM, and 7-10%% reported positive VSM intentions. Multilevel-logistic models revealed that VSM among friends was associated with past-year VSM (adjusted odds ratio (AOR) = 5.56, 95%% confidence interval (CI) = 2.3-13.6) and VSM intention (AOR = 2.48, 95%%CI = 1.6-3.9). Other correlates include male gender, a low perceived risk, and poor academic achievement. At-risk groups were identified, and targeted prevention strategies were suggested. The study's limitations are also noted.

Copyright 2011, Informa Healthcare

Loza O; Strathdee SA; Lozada R; Staines H; Ojeda VD; Martinez GA et al. Correlates of early versus later initiation into sex work in two Mexico-US border cities. Journal of Adolescent Health 46(1): 37-44, 2010. (40 refs.)

Purpose: To examine correlates of early initiation into sex work in two Mexico-U.S. border cities. Methods: Female sex workers (FSWs) >= 18 years without known HIV infection living in Tijuana and Ciudad Juarez who had recent unprotected sex with clients underwent baseline interviews. Correlates of initiation into sex work before age 18 were identified with logistic regression. Results: Of 920 FSWs interviewed in Tijuana (N = 474) and Ciudad Juarez (N = 446), 9.8% (N = 90) were early initiators (<18 years) into sex work. Median age of entry into sex work was 26 years (range: 6-58). After adjusting for age, compared to older initiators, early initiators were more likely to use inhalants (21.1% vs. 9.6%, p = .002), initiate sex work to pay for alcohol (36.7% vs. 18.4%, p < .001), report abuse as a child (42.2% vs. 18.7%, p < .0001), and they were less likely to be migrants (47.8% vs. 62.3%, p = .02). Factors independently associated with early initiation included inhalant use (adjOR = 2.39), initiating sex work to pay for alcohol (adjOR = 1.88) and history of child abuse (adjOR = 2.92). Factors associated with later initiation included less education (adjOR = 0.43 per 5-year increase), migration (adjOR = 0.47), and initiating sex work for better pay (adjOR = 0.44) or to support children (adjOR = 0.03). Conclusions: Different pathways for entering sex work are apparent among younger versus older females in the Mexico-U.S. border region. Among girls, interventions are needed to prevent inhalant use and child abuse and to offer coping skills; among older initiators, income-generating strategies, childcare, and services for migrants may help to delay or prevent entry into sex work.

Copyright 2010, Society for Adolescent Medicine

Mackowick KM; Heishman SJ; Wehring HJ; Liu F; McMahon RP; Kelly DL. Illicit drug use in heavy smokers with and without schizophrenia. Schizophrenia Research 139(1-3): 194-200, 2012. (75 refs.)

Objective: The prevalence of cigarette smoking among people with schizophrenia is greater than that of the general population. Because smoking and use of other drugs co-vary, we examined illicit drug use in current smokers not trying to quit or reduce their tobacco use. We recruited outpatient participants who had a DSM-IV diagnosis of schizophrenia or schizoaffective disorder (schizophrenia, n=70) and a control group who had no Axis I psychiatric disorders (control, n=97). During a 2-3-hour session, participants completed demographic and research questionnaires, including the Drug Use Survey (DUS). Results: Participants with schizophrenia were older than controls (p<0.001) and smoked more cigarettes per day (p=0.01), but did not differ in degree of nicotine dependence. Ever using a drug was similar between the groups, except that significantly more participants with schizophrenia reported ever using hallucinogens (p<0.001) and inhalants (p=0.001). For alcohol, cocaine, and marijuana, fewer participants with schizophrenia were current users, but more participants with schizophrenia were past users (ps<0.0001). Heavy smokers from the general population continued to use illicit drugs throughout their lives, while schizophrenia participants had the highest period of illicit drug use in their 20s. Conclusions: These data suggest that illicit drug use tends to be high in heavy cigarette smokers, regardless of a schizophrenia diagnosis. However, while illicit drug use is high across the lifespan of heavy smokers in the general population, heavy smokers with schizophrenia use illicit drugs mostly in the first decade of their illness.

Copyright 2012, Elsevier Science

MacLean SJ; d'Abbs PHN. Five challenges for volatile substance misuse policy and intervention in Australia. (editorial). Drug and Alcohol Review 30(2): 223-227, 2011. (33 refs.)

Marsiglia FF; Kulis S; Hoffman S; Calderon-Tena CO; Becerra D; Alvarez D. Migration intentions and illicit substance use among youth in central Mexico. Substance Use & Misuse 46(13): 1619-1627, 2011. (54 refs.)

This study explored intentions to emigrate and substance use among youth (ages 14-24) from a central Mexico state with high emigration rates. Questionnaires were completed in 2007 by 702 students attending a probability sample of alternative secondary schools serving remote or poor communities. Linear and logistic regression analyses indicated that stronger intentions to emigrate predicted greater access to drugs, drug offers, and use of illicit drugs (marijuana, cocaine, inhalants), but not alcohol or cigarettes. Results are related to the healthy migrant theory and its applicability to youth with limited educational opportunities. The study's limitations are noted.

Copyright 2011, Informa Healthcare

Marsiglia FF; Yabiku ST; Kulis S; Nieri T; Parsai M; Becerra D. The influence of linguistic acculturation and gender on the initiation of substance use among Mexican heritage preadolescents in the borderlands. Journal of Early Adolescence 31(2): 271-299, 2011. (93 refs.)

This article examined the impact of linguistic acculturation and gender on the substance use initiation of a sample of 1,473 Mexican heritage preadolescents attending 30 public schools in Phoenix, Arizona. It was hypothesized that linguistic acculturation operates differently as a risk or protective factor for young children than for older youth. The study used discrete-time event history methods to model the rate at which nonusing children initiate substance use. Alcohol, cigarettes, marijuana, and inhalants were studied separately while inhalant use was examined more closely. Results suggested that while linguistic acculturation is a risk factor for Mexican heritage preadolescents, this association depended on the type of substance. For inhalants, higher linguistic acculturation with friends was inversely associated with drug initiation both for boys and girls. Implications for preventive science and future intervention research are discussed.

Copyright 2011, Sage Publications

Martino SC; McCaffrey DF; Klein DJ; Ellickson PL. Recanting of life-time inhalant use: How big a problem and what to make of it. Addiction 104(8): 1373-1381, 2009. (37 refs.)

Aims: To establish the prevalence of recanting of life-time inhalant use, identify correlates of recanting to gain insight to its causes and develop a method for distinguishing recanters who truly are versus are not life-time users of inhalants. Design and setting: Longitudinal survey data from students in 62 South Dakota middle schools who were participating in a field trial to evaluate a school-based drug prevention program. Measurements: At grades 7-8, participants reported on their life-time inhalant use, other drug use and drug-related beliefs, attitudes and behaviors. Findings: Forty-nine per cent of students who reported life-time inhalant use at grade 7 recanted their reports a year later. Comparison of students who recanted inhalant use with those who did or did not report inhalant use consistently on drug-related beliefs, attitudes and behaviors at grades 7 and 8 suggested that, whereas some inhalant use recanting reflects denial of past behavior, some reflects erroneous initial reporting. Based on a latent mixture model fitted to the multivariate distribution of grade 7 and grade 8 responses of recanters and consistent reporters, we calculated the probability that each recanter was, in fact, a life-time inhalant user. An estimated 67% of the recanters in our sample appear to be life-time inhalant users who admitted use in grade 7 and then denied that use at grade 8; 33% appear to be students who reported use incorrectly at grade 7 and then corrected that error at grade 8. Conclusions: Inhalant use recanting is a significant problem that, if not handled carefully, is likely to have a considerable impact on our understanding of the etiology of inhalant use and efforts to prevent it.

Copyright 2009, Society for the Study of Addiction to Alcohol and Other Drugs

Morgan CJA; Muetzelfeldt L; Muetzelfeldt M; Nutt DJ; Curran HV. Harms associated with psychoactive substances: Findings of the UK National Drug Survey. Journal of Psychopharmacology 24(2): 147-153, 2010. (6 refs.)

Nutt and colleagues' 'rational' scale to assess the harms of commonly used drugs was based on ratings by a panel of experts. This survey aimed to assess drug users' views of the harms of drugs using the same scale. As users' drug choices are not solely based on harms, we additionally assessed perceived benefits. The survey was hosted at http: UK residents reported their experience of 20 commonly used substances; those with direct experience of a substance rated its physical, dependence-related and social harms as well as benefits. A total of 1501 users completed the survey. There was no correlation between the classification of the 20 drugs under the Misuse of Drugs Act and ranking of harms by users. Despite being unclassified substances, alcohol, solvents and tobacco were rated within the top ten most harmful drugs. There was a remarkably high correlation (r = 0.896) overall between rankings by users' and by experts. Ecstasy, cannabis and LSD were ranked highest by users on both acute and chronic benefits. These findings imply that users are relatively well informed about the harms associated with the drugs they use. They also suggest that the current UK legal classification system is not acting to inform users of the harms of psychoactive substances.

Copyright 2010, Sage Publications

Morris MD; Case P; Robertson AM; Lozada R; Vera A; Clapp JD et al. Prevalence and correlates of 'agua celeste' use among female sex workers who inject drugs in Ciudad Juarez, Mexico. Drug and Alcohol Dependence 117(2-3): 219-225, 2011. (35 refs.)

Background: Agua celeste, or "heavenly water", is the street name for a sky-blue colored solvent reportedly inhaled or ingested to produce an intoxicating effect. Study aims were to (1) describe prevalence of agua celestse (AC) use, and (2) identify correlates of lifetime and recent use of AC use among female sex workers who also inject drugs (FSW-IDUs) in northern Mexico. Methods: Between 2008 and 2010, baseline data from FSW-IDUs >= 18 years old living in Tijuana or Ciudad Juarez participating in a longitudinal behavioral intervention were analyzed using logistic regression. Results: Among 623 FSW-IDUs (307 from Tijuana and 316 from Ciudad Juarez (CJ)), 166 (26%) reported ever using AC, all of whom lived in CJ. Among the CJ sample, lifetime prevalence of AC use was 53%, median age of first use was 16 years (IQR: 14-23), and 10% reported it as their first abused substance. Ever using AC was independently associated with ever being physically abused and younger age, and was marginally associated with initiating injection drug use and regular sex work at age eighteen or younger. Among those ever using AC, 70/166(42.2%) reported using it within the last 6 months, which was independently associated with using drugs with clients before or during sex, being on the street more than 8 h per day, and younger age. Discussion: We observed considerable geographic variation in the use of AC in northern Mexico. Future studies exploring factors influencing use, its precise formulation(s), and its potential health effects are needed to guide prevention and treatment.

Copyright 2011, Elsevier Science

Muhuri PK; Gfroerer JC. Mortality associated with illegal drug use among adults in the United States. American Journal of Drug and Alcohol Abuse 37(3): 155-164, 2011. (58 refs.)

Objectives: To examine all-cause and cause-specific mortality over a 15-year follow-up period in relation to at-baseline reported lifetime use of illegal drugs from five classes (marijuana, cocaine, heroin, hallucinogens, and inhalants) among adults in the United States (US) household population. Methods: The study involved 20,983 sample adults who responded to the 1991 National Health Interview Survey Drug and Alcohol Use supplemental questionnaire and also met the eligibility criteria for mortality follow-up. Cox proportional hazards models were estimated to examine the relationships. Results: Adults who at baseline reported lifetime heroin use were at significantly higher risk of all-cause death over the follow-up period (hazard rate ratio or HR = 2.02; 95% confidence interval or CI 1.26-3.23), compared with those who did not report using drugs from any of the five classes, even after adjusting for age, sex, race, education, marital status, cigarette smoking status, and alcohol use status. Those who at baseline reported lifetime cocaine (no heroin) use had a significantly higher rate of death associated with human immunodeficiency virus diseases over the follow-up period than nonusers of drugs from any of the five classes. Several limitations of the analysis are discussed. Conclusions: Further research is needed to understand and track the elevated mortality associated with illegal drug use and the correlates of drug-poisoning deaths.

Copyright 2011, Informa Healthcare

Mullens AB; Young RM; Dunne MP; Norton G. The Amyl Nitrite Expectancy Questionnaire for Men who have Sex with Men (AEQ-MSM): A measure of substance-related beliefs. Substance Use & Misuse 46(3): 1642-1650, 2011. (55 refs.)

A measure of perceived reinforcement associated with amyl nitrite was developed and evaluated among gay and bisexual men. This is the first known expectancy measure to date for this drug class. The Amyl Nitrite Expectancy Questionnaire for Men who have Sex with Men (AEQ-MSM) was completed online by 102 gay and bisexual men, between 2006 and 2008 in Queensland, Australia. The AEQ-MSM demonstrated good psychometric properties and was associated with consumption patterns. Factor analysis revealed three distinct reinforcement domains: "Enhanced sexual desire and pleasure," "Disorientation," and "Sexual negotiation." Limitations include sampling via self-selection, recruitment through health centers and self-report data. Implications for sexual activity and risk-taking, including reducing associated harm (e.g., HIV transmission), and future directions are discussed.

Copyright 2011, Informa Healthcare

Neumark Y; Bar-Hamburger R. Volatile substance misuse among youth in Israel: Results of a national school survey. Substance Use & Misuse 46(Supplement 1): 21-26, 2011. (33 refs.)

Volatile substance misuse (VSM) among Israeli youth has been identified as widespread and growing. Using data from the 2009 National School Survey of 12-18 year olds (N = 7,166), this study describes VSM prevalence among Jews and Arabs, examining relationships between past-month VSM and sociodemographic, behavioral, psychological, and interpersonal characteristics. Past-month VSM, reported by 7.5%% of respondents, was significantly associated with other risky behaviors including past-month illicit drug use (Adjusted odds ratios (AOR) = 5.41, 95%% CI: 3.5-8.1), Internet gambling (AOR = 2.12, 95%% CI: 1.5-3.1), smoking, binge drinking, and truancy. National drug policy must address VSM and develop strategies to reduce demand and supply. Potential study limitations are noted.

Copyright 2011, Informa Healthcare

Njord L; Merrill RM; Njord R; Lindsay R; Pachano JDR. Drug use among street children and non-street children in the Philippines. Asia-Pacific Journal of Public Health 22(2): 203-211, 2010. (40 refs.)

This study characterizes the prevalence of drug use among Filipino street children compared with Filipino non street children. A cross-sectional survey was administered to 311 street children and 528 non street children aged 13 to 17 years. Participants were enrolled through 4 nonprofit organizations and 3 high schools located in Manila, Philippines. After adjustment for age and sex, street children with little or no contact with their families were 2.0 (95% confidence interval [CI] = 1.7-2.3) times more likely to smoke tobacco, 1.3 (95% Cl = 1.2-1.5) times more likely to use alcohol, 36.7 (95% CI = 16.4-82.0) times more likely to use inhalants, and 5.5 (95% Cl = 3.6-8.2) times more likely to use illegal drugs than their non street counterparts. Street children who maintained contact with their families, compared with non street children, were 8.7 (95% CI = 3.9-19.4) times more likely to use inhalants and 2.8 (95% Cl = 1.7-4.6) times more likely to use illegal drugs. There was no significant difference in tobacco or alcohol use between street children who maintained contact with their families and non street children. All street children were significantly more likely to have been given or sold a drug in the past 30 days and to have received drug education compared with non street children. Filipino street children are at greater risk of abusing drugs than are non street children, with street children who do not maintain family contact being at greatest risk.

Copyright 2010, Sage Publications

Office of Applied Studies, Substance Abuse and Mental Health Administration. The NSDUH Report: Trends in Adolescent Inhalant Use: 2002 to 2007. (March 16, 2009). Rockville MD: Substance Abuse and Mental Health Administration, 2009. (3 refs.)

This issue of "The NSDUH Report" examines trends in the use, dependence or abuse, and initiation of inhalants among adolescents (those ages 12 to 17). The National Survey on Drug Use and Health (NSDUH) defines inhalants as "liquids, sprays, and gases that people sniff or inhale to get high or to make them feel good." NSDUH collects data not only about the use of any inhalant, but also about the use of specific types of inhalants. Respondents who used inhalants were asked when they first used them, and responses to this question were used to identify persons who had initiated use in the 12 months before the survey. Adolescents have easy access to some dangerous substances´┐Żordinary household products such as glue, shoe polish, and aerosol sprays. These products are safe when used as intended, but they can be dangerous and even deadly when sniffed or "huffed" to get high. The percentage of adolescents (i.e., youths aged 12 to 17) who used inhalants in the past year was lower in 2007 (3.9%) than in 2003, 2004, and 2005 (4.5, 4.6, and 4.5%, respectively). Among adolescents who used inhalants for the first time in the past year (i.e., past year initiates), the rate of use of nitrous oxide or "whippits" declined between 2002 and 2007 among both genders (males: 40.2 to 20.2%; females: 22.3 to 12.2%). In 2007, 17.2% of adolescents who initiated illicit drug use during the past year indicated that inhalants were the first drug that they used; this rate remained relatively stable between 2002 and 2007.

Public Domain

Ogel K; Coskun S. Cognitive behavioral therapy-based brief intervention for volatile substance misusers during adolescence: A follow-up study. Substance Use & Misuse 46(Supplement 1): 128-133, 2011. (29 refs.)

Of 62 males admitted for treatment in Turkey in 2008 with a diagnosis of volatile substance misuse (VSM) dependency, half were randomly allocated to receive a cognitive behavioral therapy (CBT)-based brief intervention and an education program and half participated only in the education program. One year after treatment, 38.2%% of the experimental group and 58.1%% of the control group had continued VSM during the last three months. This statistically significant difference indicates that CBT-based brief intervention is associated with reducing VSM in adolescents. Factors associated with abstinence after treatment are identified and study limitations are noted.

Copyright 2011, Informa Healthcare

Paul I; Reichard RR. Subacute combined degeneration mimicking traumatic spinal cord injury. American Journal of Forensic Medicine and Pathology 30(1): 47-48, 2009. (10 refs.)

Subacute combined degeneration (SCD) of the spinal cord is the most common neurologic manifestation of vitamin B12 (cobalamin) deficiency and is usually secondary to autoimmune gastritis, but may also be seen in malnutrition syndromes Such as chronic alcoholism, strict vegetarianism, gastrectomy, and also in nitrous oxide abuse. Although traumatic spinal cord injury is routinely encountered in the medical examiner's office, medical causes of spinal cord abnormalities such as SCD should be considered in the appropriate clinical setting. We report a case of alcohol-associated SCD mimicking traumatic spinal cord injury.

Copyright 2009, Lippincott, Williams & Wilkins

Peltzer K; Ramlagan S. Illicit drug use in South Africa: Findings from a 2008 national population-based survey. South African Journal of Psychiatry 16(1): 8-15, 2010. (26 refs.)

Objective. The aim of this secondary analysis of the South African National HIV Prevalence, Incidence, Behaviour and Communication (SABSSM) 2008 survey is to provide current data on illicit drug use that could assist in the development and implementation of effective substance abuse policies and intervention programmes aimed at these populations in South Africa. Method. A multistage random population sample of 15 828 people age >= 15 (56.3% women) was included in the survey. Illicit drug use was assessed by 2 sections of the Alcohol, Smoking and Substance use Involvement Screening Test (ASSIST). Frequency analyses for different age groups, geolocality, educational level, income, and population group were calculated, as were odds ratios for these variables regarding combined illicit drug use. Results. Current cannabis use was reported by 3.3% of the population sample-6.1% of the men and 1.2% of the women and the use of combined all-other illicit drugs (cocaine, amphetamines, inhalants, sedatives, hallucinogens, opiates) was reported by 1.8% of the participants. Coloured men (14.3%) were most likely, and Indian or Asian women (0.6%) least likely, to be cannabis users. Illicit drug use (combined) among men was associated with the 20 - 34-year age group and the coloured and white population groups, and among women in the younger age groups, the coloured and white population groups, and low and higher income. Conclusion. An increase of cannabis and other illicit drug prevalence rates was observed from 2005 (2.1%) to 2008 (3.3%) in the population sample. Multilevel interventions are required to target illicit drug users, in addition to creating awareness in the general population of the problems associated with illicit drug use. There is a need to address illicit drug use in national and provincial policy planning and intervention efforts and, in terms of treatment, a need to ensure that treatment practitioners are adequately trained to address illicit drug use. Future prospective studies are necessary to assess the impact of illicit drug use.

Copyright 2010, South Africa Medical Association

Perron BE; Bohnert ASB; Monsell SE; Vaughn MG; Epperson M; Howard MO. Patterns and correlates of drug-related ED visits: Results from a national survey. American Journal of Emergency Medicine 29(7): 704-710, 2011. (28 refs.)

Purpose: Drug treatment can be effective in community-based settings, but drug users tend to underuse these treatment options and instead seek services in emergency departments (EDs) and other acute care settings. The goals of this study were to describe prevalence and correlates of drug-related ED visits. Basic Procedures: This study used data from the National Epidemiologic Survey on Alcohol and Related Conditions, which is a nationally representative survey of 43,093 US residents. Main Findings: The overall prevalence of drug-related ED visits among lifetime drug users was 1.8%; for those with a lifetime drug use disorder, 3.7%. Persons with heroin dependence and inhalant dependence had the highest rates of ED visits, and marijuana dependence was associated with the lowest rates. Multivariate analyses revealed that being socially connected (ie, marital status) was a protective factor against ED visits, whereas psychopathology (ie, personality or mood disorders) was a risk factor. Conclusions: Significant variability exists for risk of ED use for different types of drugs. These findings can help inform where links between EDs with local treatment programs can be formed to provide preventive care and injury-prevention interventions to reduce the risk of subsequent ED visits.

Copyright 2011, Elsevier Science

Perron BE; Howard MO. Adolescent inhalant use, abuse and dependence. Addiction 104(7): 1185-1192, 2009. (21 refs.)

To compare adolescent inhalant users without DSM-IV inhalant use disorders (IUDs) to youth with IUDs (i.e. abuse or dependence) across demographic, psychosocial and clinical measures. Cross-sectional survey with structured psychiatric interviews. Facilities (n = 32) comprising the Missouri Division of Youth Services (MDYS) residential treatment system for juvenile offenders. Current MDYS residents (n = 723); 97.7% of residents participated. Most youth were male (87%) and in mid-adolescence (mean = 15.5 years, standard deviation = 1.2, range = 11-20); more than one-third (38.6%, n = 279) reported life-time inhalant use. Antisocial behavior, temperament, trauma-exposure, suicidality, psychiatric symptoms and substance-related problems. Among life-time inhalant users, 46.9% met criteria for a life-time DSM-IV IUD (inhalant abuse = 18.6%, inhalant dependence = 28.3%). Bivariate analyses showed that, in comparison to non-users, inhalant users with and without an IUD were more likely to be Caucasian, live in rural or small towns, have higher levels of anxiety and depressive symptoms, evidence more impulsive and fearless temperaments and report more past-year antisocial behavior and life-time suicidality, traumatic experiences and global substance use problems. A monotonic relationship between inhalant use, abuse and dependence and adverse outcomes was observed, with comparatively high rates of dysfunction observed among inhalant-dependent youth. Multivariate regression analyses showed that inhalant users with and without an IUD had greater levels of suicidal ideation and substance use problems than non-users. Youth with IUDs have personal histories characterized by high levels of trauma, suicidality, psychiatric distress, antisocial behavior and substance-related problems. A monotonic relationship between inhalant use, abuse and dependence and serious adverse outcomes was observed.

Copyright 2009, Society for the Study of Addiction to Alcohol and Other Drugs

Perron BE; Howard MO; Vaughn MG; Jarman CN. Inhalant withdrawal as a clinically significant feature of inhalant dependence disorder. Medical Hypotheses 73(6): 935-937, 2009. (28 refs.)

Inhalant use is the intentional inhalation of vapors from commercial products or specific chemical agents for the purpose of achieving intoxication. Inhalants are among the most common and pernicious forms of substance use and the least studied of the major drugs. Diagnosis of inhalant dependence, according to the DSM-IV [Weintraub E, Gandhi D, Robinson C. Medical complications due to mothball abuse. South Medicine J 2000;93:427-9] excludes inhalant withdrawal symptoms, as expert opinion has suggested that an inhalant withdrawal syndrome is neither common nor clinically significant. This article draws from multiple sources of data to suggest that withdrawal symptoms can be part of inhalant dependence and are clinically significant. This hypothesis needs rigorous evaluation to ensure the diagnostic validity of inhalant use disorders.

Copyright 2009, Churchill Livingstone

Perron BE; Howard MO; Maitra S; Vaughn MG. Prevalence, timing, and predictors of transitions from inhalant use to Inhalant Use Disorders. Drug and Alcohol Dependence 100(3): 277-284, 2009. (46 refs.)

Background: Few studies of the natural history of DSM-IV inhalant substance use disorders (I-SUDs) have been conducted. This investigation examined the prevalence, timing, and predictors of transitions from inhalant use to formal I-SUDs among inhalant users within a nationally representative sample. Methods: Participants were 664 U.S. residents participating in the 2000-2001 National Epidemiologic Survey on Alcohol and Related Conditions who reported lifetime inhalant use. Respondents completed structured interviews assessing DSM-IV psychiatric/substance use disorders. Bivariate and Cox regression analyses were conducted to identify risk factors for transitions from inhalant use to I-SUDs. Results: Nearly one in five (19.4%) persons initiating inhalant use developed an I-SUD. Most I-SUD transitions were to inhalant abuse rather than inhalant dependence. Risk for development of I-SUDs was greatest in the first year following initiation of inhalant use and low thereafter. Multivariate proportional hazards models indicated that presence of a mood/anxiety disorder (HR = 7.7. CI = 3.1-18.9) or alcohol use disorder (HR = 11.9, CI = 5.46-26.00) antedating initiation of inhalant use predicted significantly elevated risk for I-SUDs, whereas being married conferred a lower risk for onset of I-SUDs. Conclusions: I-SUDs were relatively common among inhalant users, generally occurred in the year following initiation of inhalant use, and were associated with early-onset mood/anxiety and alcohol use disorders. Given the young average age at onset of inhalant use and the rapidity with which most I-SUDs developed, interventions directed to adolescents who have initiated inhalant use might be effective in reducing the proportion of inhalant users who develop I-SUDs.

Copyright 2009, Elsevier Science

Perron BE; Vaughn MG; Howard MO; Bohnert A; Guerrero E. Item response theory analysis of DSM-IV criteria for Inhalant-use Disorders in adolescents. Journal of Studies on Alcohol and Drugs 71(4): 607-614, 2010. (39 refs.)

Objective: Inhalants are a serious public health concern and a dangerous form of substance use. An important unresolved issue in the inhalant literature concerns the validity of inhalant-use diagnoses and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, distinction between inhalant abuse and inhalant dependence. To address these limitations and provide the foundation for helping build stronger diagnostic and assessment tools related to inhalant problems, this study examined the dimensionality of the criteria set and the abuse dependence distinction using item response theory (IRT) analysis. Method: This study used data from a survey of the population of Missouri Division of Youth Services' residents of the residential treatment system. The current study focused on adolescents and young adults who reported a lifetime history of inhalant use (N = 279). Results: The results from the IRT analysis showed no consistent hierarchical ordering of abuse and dependence criteria, providing strong evidence against the abuse dependence distinction. The abuse criterion of legal problems associated with use represented the item with the highest level of inhalant severity. The dependence criterion that was related to giving up important social, occupational, or recreational activities provided the most accurate discrimination between individuals at different levels of severity. Conclusions: Inhalant-use disorders are best represented using a dimensional versus a categorical approach. IRT analysis provides guidance for selecting criteria that can be useful for brief assessments of inhalant-use problems.

Copyright 2010, Alcohol Research Documentation Center

Petroianu A; dos Reis DCF; Cunha BDS; de Souza DM. Prevalence of alcohol, tobacco and psychotropic drug consumption by medical students of the "Universidade Federal de Minas gerais". Revista da Associacao Medica Brasileira 56(5): 568-571, 2010. (34 refs.)

OBJECTIVE. The purpose of this study was to assess the prevalence of alcohol, tobacco and psychotropic drug consumption by students of the Medical School of the Federal University of Minas Gerais, Brazil, and to verify aspects related to those addictions. METHODS. This study was carried out with students of all years of the medical course invited to participate anonymously, by answering a self-applied questionnaire which was previously evaluated and adapted to Brazilian reality. It was based upon the World Health Organization's Guidelines for Student Substance Use Survey and included 25 questions about drug addiction. Student's t test and chi-square test were applied to assess differences between the mean and proportions of data. RESULTS. Alcohol and tobacco were the more frequently used by the students, 85.2% and 16.3% respectively. Among psychotropic drugs, marijuana was reported by 16.5% of students, LSD by 6.9%, sedatives by 12%, amphetamines by 7.5% and inhalant substances by 16.8%. Cocaine, crack, opiates, anti-cholinergics and anabolics consumption were rarely mentioned. CONCLUSION. Alcohol was the drug most used and was related to other drug addictions. Drugs were most frequently used by single, male students, who live alone and do not support themselves.

Copyright 2010, Association Medica Brasileira

Phatak DR; Walterscheid J. Huffing air conditioner fluid: A cool way to die? American Journal of Forensic Medicine and Pathology 33(1): 64-67, 2012. (8 refs.)

"Huffing," the form of substance abuse involving inhalants, is growing in popularity because of the ease and availability of chemical inhalants in many household products. The purpose in huffing is to achieve euphoria when the chemicals in question interact with the central nervous system in combination with oxygen displacement. The abuser is lulled into a false sense of safety despite the well-documented potential for lethal cardiac arrhythmia and the effects of chronic inhalant abuse, including multisystem organ failure, and brain damage. Huffing air conditioner fluid is a growing problem given the accessibility to outdoor units and their fluid components, such as difluorochloromethane (chlorodifluoromethane, Freon), and we have classified multiple cases of accidental death due to the toxicity of difluorochloromethane. Given the ubiquity of these devices and the vast lack of gating or security devices, they make an inviting target for inhalant abusers. Acute huffing fatalities have distinct findings that are present at the scene, given the position of the decedent and proximity to the air conditioner unit. The purpose of the autopsy in these cases is to exclude other potential causes of death and to procure specimens for toxicological analysis.

Copyright 2012, Lippincott, Williams & Wilkins

Praharaj SK; Kongasseri S. Naphthalene addiction. Substance Abuse 33(2): 189-190, 2012. (6 refs.)

Inhalant abuse such as kerosene, petrol, gasoline, and typewriter correction fluid has been reported from India. Naphthalene or mothballs, a commonly used substance in households and freely available in the market is an uncommon form of inhalant abuse which may lead to severe medical complications. We report an adolescent with addiction to naphthalene balls who developed severe anemia.

Copyright 2012, Taylor & Francis

Praveen D; Maulik PK; Raghavendra B; Khan M; Guggilla RK; Bhatia P. Determinants of inhalant (whitener) use among street children in a south Indian City. Substance Use & Misuse 47(10): 1143-1150, 2012. (40 refs.)

A cross-sectional study was conducted in the year 2008 among 174 children in observation homes in Hyderabad, India, to estimate the distribution of inhalant (whitener) use among this population. Data were collected using an instrument developed for this purpose. About 61% of the children were boys and their mean age was 12.2 years (range 5-18 years). Whitener use was found in 35% of the children along with concurrent use of other substances. Peer pressure was the commonest cause reported for initiating substance use. The high prevalence is an important concern for the Indian policymakers given the large number of street children in Indian cities.

Copyright 2012, Informa Healthcare

Ramtekkar UP; Striley CW; Cottler LB. Contextual profiles of young adult ecstasy users: A multisite study. Addictive Behaviors 36(3): 190-196, 2011. (47 refs.)

These analyses assess contextual profiles of 612 young adult ecstasy users, 18-30 years of age, from St. Louis (USA), Miami (USA) and Sydney (Australia). Bivariate analyses revealed different contextual factors influencing ecstasy use. Friends were the most common sources of ecstasy at all sites and most used with friends. St. Louis and Miami use mostly occurred in residences, whereas in Sydney use was mostly at clubs, bars or restaurants. Ecstasy consumption at public places and in cars, trains or ferries was significantly higher in Miami (89% and 77%) than in St. Louis (67% and 65%) and Sydney (67% and 61%). At all sites, simultaneous use of LSD/mushroom and nitrous oxide with ecstasy was common; concurrent amphetamines predominated in Sydney and heroin/opiates in St. Louis Contextual factors influencing ecstasy use among young adults vary by geographic region. Their inclusion may help tailor effective prevention programs to reduce or ameliorate ecstasy use.

Copyright 2011, Elsevier Science

Ringwalt CL; Clark HK; Hanley S; Shamblen SR; Flewelling RL. Project ALERT: A cluster randomized trial. Archives of Pediatrics & Adolescent Medicine 163(7): 625-632, 2009. (26 refs.)

Objective: To evaluate the effects of Project ALERT on adolescents' lifetime and 30-day use of cigarettes, alcohol, marijuana, and inhalants. Design: Cluster randomized trial. Setting: Schools from 11 states were enrolled in 2 successive cohorts from 2004 to 2008. Participants: All public schools in the United States that included grades 6 through 8 and enrolled at least 100 students in sixth grade were recruited. Of the 40 schools that began the study, 34 (17 per condition) completed it. Data were analyzed from 5883 unique participants. Intervention: Project ALERT, a manualized classroom-based substance use prevention curriculum for the middle grades, was taught to sixth and seventh graders. Main Outcome Measures: Students were surveyed before the onset of the intervention, as sixth graders, and after the completion of the 2-year intervention, as seventh graders. Outcome measures included lifetime and 30-day use of cigarettes, alcohol, marijuana, and inhalants. Results: At baseline, students in the intervention condition were slightly to moderately more likely to report use for each of the 8 measures examined than were students in the control condition. For all measures except lifetime use of cigarettes, these differences were less pronounced at follow-up and therefore were in the direction of favorable program effects. These changes were statistically significant, however, for only 1 outcome measure, past 30-day use of alcohol (reduction in the adjusted odds ratio from 2.07 at baseline to 1.32 at follow-up; P = .006). Conclusion: Project ALERT was not effective when delivered to the sixth grade population we targeted.

Copyright 2009, American Medical Association

Ringwalt CL; Clark HK; Hanley S; Shamblen SR; Flewelling RL. The effects of Project ALERT one year past curriculum completion. Prevention Science 11(2): 172-184, 2010. (42 refs.)

School-based drug prevention curricula constitute the nation's most prevalent strategy to prevent adolescent drug use. We evaluated the effects of one such curriculum, Project ALERT, on adolescent substance use. In particular, we sought to determine if a single effect on 30-day alcohol use, noted shortly following the completion of the 2-year program, could be detected 1 year later. We also looked for delayed effects on other outcomes of interest, namely lifetime alcohol use, and 30-day and lifetime use of cigarettes, marijuana, and inhalants. We employed a randomized controlled trial that used school as the unit of assignment. Thirty-four schools with grades 6-8 from 11 states completed the study. Seventy-one Project ALERT instructors taught 11 core lessons to sixth graders and 3 booster lessons to seventh graders. Students were assessed prior to the onset of the intervention, as sixth graders, after the completion of the 2-year curriculum, as seventh graders, and again 1 year later as eighth graders. This paper examines data from the pretest and final posttest. Using hierarchical nonlinear modeling, we found that our earlier effect on 30-day alcohol use did not persist. Further, we continued to find no effects for lifetime alcohol use and both the lifetime and 30-day use of cigarettes, marijuana, and inhalants. Our findings do not support the long-term effectiveness of Project ALERT, when delivered to sixth graders.

Copyright 2010, Springer

Samson R; Kado H; Chapman D. Huffing-induced cardiomyopathy: A case report. Cardiovascular Toxicology 12(1): 90, 2012. (13 refs.)

The intentional inhalation of fumes from gasoline or solvents for recreational purposes is commonly known as Huffing, Sniffing or Dusting (Anderson and Loomis in Am Fam Physician 68(5):869-874, 2003). Inhalant abuse is known to be "Cardio-toxic", causing sudden death and chronic myocardial damage (Meadows and Verghese in South Med J 89(5):455-462, 1996; Anderson and Loomis in Am Fam Physician 68(5):869-874, 2003). We report a 20-year-old white man who presented with altered mental status following ingestion of multiple alprazolam and oxycodone tablets. He was found to have diffused ST-T changes on his EKG. Cardiac enzymes were found to be elevated-CK: 599 U/L, CK-MB: 16.8 ng/mL and Troponin: 0.78 ng/mL. A transthoracic echocardiogram (TTE) revealed global left ventricular (LV) dysfunction with an ejection fraction (EF) of 10-15%. During hospitalization, the cardiac enzymes started trending downward and this was followed by spontaneous resolution of the LV dysfunction. The patient also admitted to inhaling "Dust-Off" spray 2-3 days prior to admission. Inhalant abuse can cause cardiomyopathy and should be considered a probable cause in patients presenting with cardiac dysfunction of unknown etiology, particularly in teenagers and young adults.

Copyright 2012, Humana Press

Scott KD; Scott AA. An examination of information-processing skills among inhalant-using adolescents. Child Care Health and Development 38(3): 412-419, 2012. (26 refs.)

Background. This study investigates the association between inhalant use and information processing (IP) in adjudicated polysubstance users. Polysubstance users who used inhalants (n= 158) were compared with polysubstance users who did not use inhalants (n= 303). Hispanic Americans comprised 72% of the participants; European Americans, African Americans and Asian Americans comprised 28% of the participants. Method Standardized intelligence and achievement tests were used to assess information-processing constructs of working memory and processing speed. Psychosocial and substance abuse standardized surveys were used to assess drug use severity and psychosocial problems associated with substance use. Results. Polysubstance users who used inhalants (PSI users) were younger, used more drugs more frequently and had more psychiatric admissions than non-inhalant polysubstance users (PSO users). Statistical analysis also shows that PSI users performed worse on measures of IP selected tests in comparison with the PSO users. Conclusion. Inhalant users begin abusing substances at a younger age and suffer from more verbal and non-verbal processing, behavioural, language and memory problems than non-inhalant users.

Copyright 2012, Wiley-Blackwell

Semple S; Strathdee S; Zians J; Patterson T. Sexual risk behavior associated with co-administration of methamphetamine and other drugs in a sample of HIV-positive men who have sex with men. American Journal on Addictions 18(1): 65-72, 2009. (43 refs.)

This study examined the association between sexual risk behavior and co-administration of methamphetamine with other drugs in a sample of 341 HIV-positive MSM. Those who reported methamphetamine co-administration in the past two months (65%) reported significantly more unprotected anal and oral sex and a greater number of casual, anonymous, and paid sex partners in this timeframe compared to men who used methamphetamine alone. Two primary patterns of co-administration were identified: 1) drug combinations motivated by sexual performance and enhancement (eg, methamphetamine, poppers, sildenafil); and 2) party drug combinations (eg, methamphetamine, GHB, ketamine). Implications for further research and possible applications to risk-reduction interventions are discussed.

Copyright 2009, Taylor & Francis

Sharma S; Lal R. Volatile substance misuse among street children in India: A preliminary report. Substance Use & Misuse 46(Supplement 1): 46-49, 2011. (18 refs.)

Although substance misuse among children in India has been documented for over a decade, volatile substance misuse (VSM) is a comparatively recent phenomenon there. This paper reviews available Indian studies about VSM among street children and documents the extent of misuse, experienced benefits and harms, and risk factors. Reported perceived benefits include enhanced physical strength, decreased shyness, sleep induction, feeling good, and numbing physical and psychological pain. Identified risk factors include domestic violence, a dictatorial father, presence of stepparents, migrant status, and substance use in the family. Limitations of the current paper and the need for further research are discussed.

Copyright 2011, Informa Healthcare

Siegel JT; Alvaro EM; Patel N; Crano WD. " would probably want to do it. Cause that's what made them popular": Exploring perceptions of inhalant utility among young adolescent nonusers and occasional users. Substance Use and Misuse 44(5): 597-615, 2009. (68 refs.)

With an eye toward future primary prevention efforts, this study explores perceptions of inhalant utility among young adolescents in the United States. The study makes use of data gathered via nine focus groups conducted in Tucson, Arizona in 2004 (N = 47, mean age = 13.2 years). Three main themes emerged concerning the perceived utility of inhalant use: (1) Inhalant use as a means of mental escape, (2) Inhalant use as a social tool, and (3) Inhalant use as a parental relations tool. Additionally, participants discussed an interaction hypothesis regarding inhalant use and popularity. Implications for future research are suggested and limitations described.

Copyright 2009, Taylor & Francis

Sikes A; Walley C; McBride R; Fusco A; Cole RF; Lauka J. Inhalant and prescription medication abuse among adolescents: An inexpensive, accessible, and misperceived trend. Journal of Child & Adolescent Substance Abuse 20(3): 237-252, 2011. (52 refs.)

Inhalant and prescription medication abuse, particularly among adolescents, are serious problems in our society. Several risk factors associated with inhalant and medication abuse among adolescents have been identified. As a result, adolescents may suffer multiple consequences in a range of developmental areas. The purpose of this article is to examine in-depth the prevalence, risk factors, and consequences associated with inhalant and prescription medication abuse among adolescents. Recommendations in the prevention and intervention of inhalant and prescription medication abuse are provided.

Copyright 2011, Taylor & Francis

Smith GW; Farrell M; Bunting BP; Houston JE; Shevlin M. Patterns of polydrug use in Great Britain: Findings from a national household population survey. Drug and Alcohol Dependence 113(2-3): 222-228, 2011. (55 refs.)

Background: Polydrug use potentially increases the likelihood of harm. As little is known about polydrug use patterns in the general population, it is difficult to determine patterns associated with highest likelihood. Methods: Latent class analysis was performed on nine illicit substance groups indicating past year use of cannabis, cocaine, amphetamines, ecstasy, LSD, mushrooms, amyl nitrate, tranquillisers and heroin or crack. Analyses were based on data from a large multi-stage probability sample of the population of Great Britain (n=8538) collected in 2000. Multinomial logistic regression was performed highlighting associations between classes, and demographic and mental health variables. Results: A three class solution best described patterns of polydrug use; wide range, moderate range, and no polydrug use. For males and young people, there was a significantly increased chance of being in the wide and moderate range polydrug use groups compared to the no polydrug use class. Hazardous drinking was more likely in the wide and moderate polydrug classes with odds ratios of 9.99 and 2.38 (respectively) compared to the no polydrug use class. Current smokers were more likely to be wide and moderate range polydrug users compared to the no polydrug use class with odds ratios of 4.53 and 5.85 respectively. A range of mental health variables were also related to class membership. Conclusions: Polydrug use in Great Britain can be expressed as three distinct classes. Hazardous alcohol use and tobacco use were strongly associated with illicit polydrug use, polydrug use appeared to be significantly associated with mental health, particularly lifetime suicide attempts.

Copyright 2011, Elsevier Science

Spiller H; Lorenz DJ. Trends in volatile substance abuse. Journal of Addictive Diseases 28(2): 164-170, 2009. (13 refs.)

The purpose of this article is to evaluate whether social, geographic, and demographic factors have a relationship to trends in volatile substance abuse. Two datasets were obtained. Dataset 1 was all patients reported to U.S. poison centers with inhalation abuse of a non-pharmaceutical substance between 2000 and 2005. Dataset 2 was annual data from the U.S. Department of of Labor and U.S. Census Bureau for each of the 50 states for the years 2000 through 2005 for unemployment rate, population density, poverty rate, high school graduation rate and percentage of population with bachelor degree. The two datasets were compared for geographic (by state) and temporal (by year) relationships using U.S. government demographic categories. The U.S. poison centers state that 12,428 patients with volatile substance abuse have been reported over the 6 year period of 2000-2005, with a mean of 2,071 patients annually. A strong negative trend was found between volatile substance abuse and population density, with volatile substance abuse increasing as population density decreased. This trend remained consistent over the 6 years of evaluation. A negative trend was found with percentage of population with a bachelor's degree and volatile substance abuse. No trend was found when comparing volatile substance abuse and poverty rate, unemployment rate, or high school graduation rate. Volatile substance abuse appears to increase as population density decreases, following a previously suggested relationship with a rural setting. Volatile substance abuse appears to increase as percentage of population with a bachelor's degree decreases.

Copyright 2009, Haworth Press

Stefanidou M; Lefkidou I; Lefkidis C; Spiliopoulou C; Maravelias C. Death of a HIV-infected homosexual from nitrite inhalants (poppers). (editorial). West Indian Medical Journal 59(4, Special Issue): 450-452, 2010. (24 refs.)

Takagi M; Lubman DI; Cotton S; Fornito A; Baliz Y; Tucker A et al. Executive control among adolescent inhalant and cannabis users. Drug and Alcohol Review 30(6): 629-637, 2011. (34 refs.)

Introduction and Aims. Inhalants are frequently among the first drugs abused by adolescents; however, little is known about how chronic inhalant abuse affects cognition (e.g. executive functioning). Several studies have examined cognitive deficits among inhalant users; however, no study has thoroughly addressed the confounding issues frequently associated with inhalant users (e.g. polysubstance use). The aim of the current study was to examine possible deficits in cognitive control among young, regular inhalant users and explore the relationship between inhalant use and executive functioning. Design and Methods. Three groups (n = 19) of young people (aged 14-24) were recruited: an inhalant-using group, a drug-using control group and a community control group. The inhalant and drug-using controls were matched on demographic, clinical and substance use measures. All three groups were matched on age, sex and education. Cognitive control was assessed using Stroop and Go/No-Go tasks. Results. There were no significant differences in performance between the groups on any measure. However, three measures (incongruent reaction times and congruent errors for the Stroop and omission errors for the Go/No-Go) were significantly correlated with inhalant use measures, suggesting inhalant use was associated with poorer performance. Discussion and Conclusions. The lack of significant differences between the groups is surprising; however, it raises important questions regarding cognitive deficits among chronic inhalant users. Further longitudinal studies using well-matched control participants are required to delineate the nature and timing of cognitive and neurobiological pathology among adolescent inhalant users.

Copyright 2011, Wiley-Blackwell

Takagi M; Lubman DI; Yucel M. Solvent-induced leukoencephalopathy: A disorder of adolescence? Substance Use & Misuse 46(Supplement 1): 95-98, 2011. (30 refs.)

Volatile substance misuse is common during early adolescence; however, limited work has been conducted investigating the neurobiological effects of such use on the developing brain. While both animal and human studies report cognitive and neurobiological harm associated with volatile substance misuse during adolescence (particularly involving white matter structures), the complex psychosocial characteristics of volatile substance misusers confound the specificity of reported volatile substance-related pathology in human subjects. In addition, few studies have examined whether cognitive and neurobiological recovery occurs with abstinence, although there is some literature indicating that neurological and cognitive improvement is possible, but relates to the frequency and duration of previous use. Longitudinal studies utilizing well-matched control samples are required to fully delineate the short- and long-term impact of volatile substance misuse on adolescent brain development.

Copyright 2011, Informa Healthcare

Takagi MJ; Yucel M; Lubman DI. The dark side of sniffing: Paint colour affects intoxication experiences among adolescent inhalant users. Drug and Alcohol Review 29(4): 452-455, 2010. (11 refs.)

Introduction and Aims. Inhalant abuse among adolescents is a significant health concern in many countries; however, limited research has explored whether the intoxication experience differs between commonly used inhalants. The aim of the present study was to examine how exposure to different types of paints (chrome vs. non-chrome) were experienced by adolescent users. Design and Methods. Sixteen adolescent (aged 15-19 years) regular inhalant users completed a semistructured questionnaire enquiring about their inhalant use. Participants were divided into two groups based on paint colour preference [chrome paints (n = 10) and non-chrome paints (n = 6)] and were compared using appropriate statistical tests. Results. Relative to non-chrome users, the chrome-using group were more likely to report deliberately inhaling to experience altered perceptions (such as visual and auditory hallucinations). In addition, a significantly greater proportion of chrome users reported that the perceptual alterations they experienced after sniffing paint differed between paint colours, with chrome colours being associated with more vivid hallucinations. Discussion and Conclusion. While both chrome and non-chrome users reported a comparable level of pleasure from paint sniffing, chrome paint users were more likely to be motivated by the potential to hallucinate. Our findings suggest that the type of inhalant used is an important consideration that may have relevance to clinical treatment.

Copyright 2010, Wiley-Blackwell

Takagi M; Yucel M; Cotton SM; Baliz Y; Tucker A; Elkins K et al. Verbal memory, learning, and executive functioning among adolescent inhalant and cannabis users. Journal of Studies on Alcohol and Drugs 72(1): 96-105, 2011. (32 refs.)

Objective: Inhalant use is a common form of drug misuse among young adolescents. However, very little is known about how chronic inhalant misuse affects cognition. Several studies have examined cognitive deficits among inhalant users, but no study has thoroughly addressed the confounding issues frequently associated with inhalant users (e.g., polysubstance use). The aim of the current study was to examine possible deficits in memory, learning, and executive components of memory (interference susceptibility) among young, regular inhalant users relative to a statistically equivalent drug-using control group (primarily cannabis users) and a community control group. Method: Three groups of 21 young people (aged 13-24 years) were recruited: an inhalant-using group, a drug-using control group, and a community control group. The inhalant and drug-using controls were matched at the group level on demographic, clinical, and substance use measures. All three groups were statistically equivalent on age, sex, and education. The Rey Auditory Verbal Learning Test was used to assess memory, learning, and interference susceptibility. Results: Community controls performed significantly better than both drug-using groups, while inhalant users were more susceptible to proactive interference relative to drug-using controls. Conclusions: Difficulty in successful proactive interference resolution demonstrated by the inhalant group may relate to inhalant-specific deficits in executive functioning. These findings raise important questions regarding the hypothesized toxicity of inhalants and of substance-specific cognitive deficits among regular adolescent substance users. Future studies should consider using more specific, experimental probes of cognitive functioning to identify potentially subtle changes among substance-using adolescents.

Copyright 2011, Alcohol Research Documentation

Temple JR; Freeman DH. Dating violence and substance use among ethnically diverse adolescents. Journal of Interpersonal Violence 26(4): 701-718, 2011. (61 refs.)

Teen dating violence is a serious public health concern with numerous and long-lasting consequences. Although alcohol and drug use have been associated with dating violence, little is known about the role of specific substances, especially the use of club drugs and the nonmedical use of prescription drugs. Thus, the authors examined the association between dating violence victimization and the use of a variety of licit and illicit substances among 1,565 ethnically diverse and economically disadvantaged high school students in southeast Texas. Past year dating violence victimization was reported by 14.1% of boys and 11.3% of girls. Compared to their nonabused counterparts, youth who experienced dating violence were more likely to smoke cigarettes, drink alcohol, binge drink alcohol, sniff glue to get high, use marijuana, use ecstasy, use Vicodin, and use Xanax. However, with the exception of alcohol and cigarettes, all substances were reduced to nonsignificance in multivariate analyses. No differences were found in the rate of dating violence between African American, White, and Hispanic adolescents.

Copyright 2011, Sage Publications

Tharp-Taylor S; Haviland A; D'Amico EJ. Victimization from mental and physical bullying and substance use in early adolescence. Addictive Behaviors 34(6-7): 561-567, 2009. (35 refs.)

Logistic regression analyses were used to assess the association between victimization from mental and physical bullying and use of alcohol, cigarettes, marijuana, and inhalants among middle school students. Self-report data were analyzed from 926 ethnically diverse sixth through eighth grade students (43% White, 26% Latino, 7% Asian American/Pacific Islander, 3% African American, 14% mixed ethnic origin, and 5% "other") ages 11-14 years from southern California. Substance use was collected at two time points (fall 2004 and spring 2005) during an academic year. Models were run for each substance separately. Results supported an association between victimization from bullying and substance use. Youths who experienced each type of bullying (mental or physical) separately or in combination were more likely to report use of each substance in spring 2005. This finding held after controlling for gender, grade level, ethnicity and substance use in fall 2004.

Copyright 2009, Elsevier Science

Toprak S; Cetin I; Guven T; Can G; Demircan C. Self-harm, suicidal ideation and suicide attempts among college students. Psychiatry Research 187(1-2): 140- 144, 2011. (45 refs.)

Self-harm, suicidal ideation, and suicide attempts are well represented behaviours in the general population of both developed and developing countries. These behaviours are indicative of underlying risk factors that show a strong interdependent correlation. In this study we attempted to define correlates for and prevalence of self-harm, suicidal ideation, and suicide attempts among Turkish college students. This 2006 study included 636 students from two Turkish state universities. Our results showed that the lifetime prevalence of self-harm was 15.4%, the prevalence of suicidal ideation was 11.4%, and the prevalence of suicide attempts was 7.1%. We uncovered correlates for self-harm, including low income, unsatisfying familial relationships, smoking, and alcohol, inhalant, and tranquilizer abuse. Tranquilizer abuse shared a dual role as a correlate for suicide ideation and as a means to attempt suicide. Additionally, we found that drug abusers and adolescents who practise self-harm presented the highest suicide risk.

Copyright 2011, Elsevier Science

Velasquez JR. The use of ammonia inhalants among athletes. Strength and Conditioning Journal 33(2): 33-35, 2011. (7 refs.)

Ammonia inhalants (AI) are commonly used by athletes as possible ergogenic aids during training or competition. Virtually, no research exists that has examined ai effectiveness, safety, or prevalence among athletes. Anecdotally, ai use is widespread, with some adverse reactions having been reported. The present article serves as an introduction to the use of AIs and examines the anecdotal use of AIs among the athletic population, as well as their effectiveness, practices, and safety. Strength and conditioning professionals, coaches, and sports medicine personnel should be familiar with their use and contraindications because adverse reactions have been reported.

Copyright 2011, Lippincott, Williams & Wilkins

Villatoro JA; Cruz SL; Ortiz A; Medina-Mora ME. Volatile substance misuse in Mexico: Correlates and trends. Substance Use & Misuse 46(Supplement 1): 40-45, 2011. (16 refs.)

This paper analyzes volatile substance misuse in Mexico since the 1980s. Data were collected from national household and school surveys, epidemiological surveillance systems, and studies among special populations. Volatile substance misuse begins at 12-14 years. Prevalence is approximately 1% in the general population, 7% among high school students, and higher for street children. Toluene is the main solvent used, but preferences vary within population groups. Volatile substance misuse has increased among youngsters that live in families and attend school. Marijuana and volatile substances are now the drugs of choice among Mexican female high school students. The study's limitations are noted.

Copyright 2011, Informa Healthcare

Walls NE; Bell S. Correlates of engaging in survival sex among homeless youth and young adults. Journal of Sex Research 48(5): 423-436, 2011. (81 refs.)

Using a sample of 1,625 homeless youth and young adults aged 10 to 25 from 28 different states in the United States, this study examines the correlates of having engaged in survival sex. Findings suggest that differences exist based on demographic variables (gender, age, race, and sexual orientation), lifetime drug use (inhalants, Valium (TM), crack cocaine, alcohol, Coricidin (TM), and morphine), recent drug use (alcohol, ecstasy, heroin, and methamphetamine), mental health variables (suicide attempts, familial history of substance use, and having been in substance abuse treatment), and health variables (sharing needles and having been tested for HIV). In addition to replicating previous findings, this study's findings suggest that African American youth; gay, lesbian, or bisexual youth; and youth who had been tested for HIV were significantly more likely to have engaged in survival sex than White, heterosexual youth, and youth who had not been tested for HIV, respectively. Implications for interventions with youth and suggestions for future research are discussed.

Copyright 2011, Taylor & Francis

Zacny JP; Jun JM. Lack of sex differences to the subjective effects of nitrous oxide in healthy volunteers. Drug and Alcohol Dependence 112(3): 251-254, 2010. (30 refs.)

Background: Although numerous studies have assessed subjective effects of nitrous oxide few studies have analyzed for sex differences. Since sex differences have been reported in subjective effects of several drugs such as opioids nicotine and alcohol we sought to determine if sex modulates the subjective effects of the inhalant nitrous oxide in healthy volunteers Methods: Thirty-eight females and seventy-two males from nine studies that were conducted in our laboratory were included in this retrospective analysis. All experimental studies utilized randomized placebo-controlled repeated measures designs in which subjects Inhaled 30% nitrous oxide in oxygen and 100% oxygen (placebo) Dependent measures in this analysis were subjective effects measured at baseline and 15 min into the inhalation period. Results: Nitrous oxide produced a number of subjective effects including those that could be considered abuse liability-related ( elated having pleasant thoughts drug liking) but sex did not modulate these effects. Conclusions: Females and males showed similar subjective responses to 30% nitrous oxide. Future prospective studies might assess other concentrations other measures (choice analgesic response) and other inhaled general anesthetics to more comprehensively characterize the role of sex in response to inhalants.artmouth e-journal

Copyright 2010, Elsevier Science