SNIFFING OUT INHALANT ABUSE

This form of substance abuse is widespread, but continues to fall below the
radar screen of most parents and many physicians.

Experts always say inhalant abuse seems to stand in the shadow of
other drug problems. It's not that the abuse -- often called sniffing
or huffing -- doesn't happen. It's that there is less awareness both
about how common it is among young people and about the related dangers.

That's why the AMA long has supported education among medical
professionals and the public regarding this form of substance abuse.
Late last month, the National Inhalant Prevention Coalition marked its
annual week-long effort to focus attention on this problem. The
group's warning message in terms of use, abuse and dangers is
certainly worth remembering.

First of all, statistics show that inhalant use and abuse is happening
- - a lot. In 2002, more than 22.8 million Americans, 2.6 million of
whom were between the ages of 12 and 17, reported that they had used
an inhalant at least once in their lives, according to the Substance
Abuse and Mental Health Services Administration Survey on Drug Use and
Health.

Still, according to a 2002 Parent Attitude Survey conducted by the
Partnership for a Drug-Free America, the problem is not on the radar
screen. Of those responding, 18% of teens reported having tried
inhalants but only 1% of their parents believed that their child might
have done so. Also, parents who said they had discussed drugs with
their children were less likely to discuss inhalants than marijuana,
heroin, crack or cocaine.

This knowledge gap is a real sign of trouble.

A key reason why is accessibility. Countless household items, from
glue and nail polish to gasoline and air fresheners, easily can become
deadly, addictive substances.

Kids, usually adolescents or preteens but some as young as age 7, get
a quick high by breathing these substances from an open container or
inhaling from a soaked rag held to the face. Even if parents are in
the dark, there's a good chance their children know the terminology:
glue sniffing, whippets, rush, poppers.

The instant euphoria users get from inhalant abuse lasts five to 15
minutes and then disappears, leaving little trace for parents or peers
to notice. Little trace, that is, unless the practice turns deadly.

The greatest risk lies in the fact that debilitating and potentially
lethal results can occur even with the first try. Still, the
Partnership for a Drug-Free America survey noted a "significant
erosion" in kids' understanding of the related hazards. In just two
years, agreement with the statement "sniffing or huffing things to get
high can kill you" dropped from 68% to 48% among sixth-graders and
from 73% to 63% among eighth-graders. (Chillingly, the NIPC recently
made available guidelines for coroners and medical examiners that
outlined signs to look for in diagnosing inhalant deaths.)

Moreover, there tends to be a pervasive idea that the practice is
harmless. Consider, for instance, that the latest Scooby-Doo movie
reportedly shows a character huffing nitrous oxide from a whipped
cream can for fun - a visual that clearly sends a dodgy message to a
vulnerable age group.

Compounding the problem is that inhalant use is addictive. And that's
when signs do become evident - the telltale "huffers" rash or drying,
redness, spots or sores around the mouth and nose; red or runny eyes
or nose; paint or stains on body or clothing; chemical breath odor; or
an unexplained collection of abusable products, just to name a few.

Over the long term, inhalant use causes heart, lung, kidney, liver and
peripheral nerve damage. And treatment is an extensive, difficult and
complex process, so much so that many facilities do not attempt these
interventions. Nonetheless, according to SAMHSA, an estimated 180,000
people needed treatment in 2002. Additionally, because inhalants are
often the first drug young people use, it is considered by many to be
a gateway to other abuse.

Thus, there is a sense of urgency attached to addressing the issue of
inhalant use and abuse. Physicians can play an important role, in
terms of educating their patients and by being on the watch for signs
of inhalant abuse -- including what might be happening in their own
homes.

After all, statistics show it is happening, and taking inhalant abuse
out of the shadows is long overdue.