CICAD: Inter-American Observatory on Drugs (OID)

Inhalant abuse in South America

 

Inhalant abuse looms as a major threat for South American youth Illustation: public health and invesstment on the line

By Marya Hynes Dowell and Pedro Mateu-Gelabert*

This article is adapted from a more complete analysis that is being prepared for publications in a peer-reviewed periodical.

Although public opinion and the mainstream media view inhalants as a street-kid drug and governments do not give inhalant use a prominent place in public health and drug policy in most South American countries, a careful reading of the latest surveys of secondary school students shows, in some countries, inhalant use is far more prevalent than the consumption of cocaine, coca paste and amphetamines, posing a serious problem for public health.

This conclusion arises from a secondary analysis of the results in the Jóvenes y Drogas - un Desafio para la Política Pública, a joint effort between CICAD and the United Nations Drug Control Programme (UNODC) through their regional office in Peru working with nine South American national drug commissions, published in 2006. The report analyzed survey data on drug use of secondary school students from nine South American countries in 2005: Argentina, Bolivia, Brazil, Colombia, Chile, Ecuador, Paraguay, Peru and Uruguay.

Close at hand

Inhalants are breathable chemical vapors that produce psychoactive (mind-altering) effects. There are a variety of products legally available in the home, in the workplace and in the open market that contain inhalable substances (NIDA, Infofacts, Inhalants). The definition of inhalants is often problematic because the term includes a variety of chemical substances that produce a range of psychoactive and pharmacological effects, which are treated in most drug use surveys as if they were a single substance.

Inhalants enter the bloodstream quickly through the lungs and are rapidly carried to the brain. Although the different chemical substances found in inhalants produce various pharmacological effects, most elicit a rapid period of excitation, followed by drowsiness, lightheadedness, disinhibition and agitation (NIDA, Inhalant Abuse). In large amounts, solvents and gases produce anesthesia, loss of sensation and unconsciousness (NIDA Monograph series 148, Epidemiology of Inhalant Abuse: an International Perspective (1995) and Inhalant Abuse Among Children and Adolescents (2005)).

Long-term use is associated with a variety of neuro-psychological disorders including loss of muscular coordination and widespread brain damage (Makalinao), and evidence supports disruption to other sensory motor functions governed by the nervous system (Galinda et al, Oetting et al). Toluene, for instance, also produces damage to the heart, lungs, liver and kidneys (Medina Mora).

Among the most commonly abused substances are those that contain toluene, a solvent found in paint thinner and glue. Other substances are gases, propellants and aerosols.

A stealthy threat

CICAD’s comparative analysis shows that across age groups and gender lines, inhalants are the second most common drug used among secondary school students, and in more than one country, they are the first drug used. This holds true for both lifetime prevalence of drug use, and for more frequent use as well. Inhalant use follows only marijuana as the most commonly used drug, exceeding prevalence rates for both cocaine and pasta base in nearly every country and only tapers off slightly once we reach the oldest age group.

Table 1: Lifetime Prevalence of Illicit Drug Use by Country
Among Secondary School Students
Country Marihuana Coca paste1 Cocaine Ecstasy Inhalants
Argentina 10.52 2.81 3.96 1.33 4.74
Bolivia 4.62 1.70 1.88 1.39 3.44
Brazil 6.36 n/d 1.942 n/d 16.55
Colombia 8.20 1.42 1.92 3.49 4.00
Chile 16.65 3.07 4.08 3.39 5.47
Ecuador 6.80 1.61 2.31 2.04 5.29
Paraguay 3.69 0.70 0.90 0.42 2.67
Peru 4.46 1.23 1.71 0.97 4.57
Uruguay 11.40 1.11 2.30 0.65 2.91
-->

Although in most countries, overall drug use is generally lower among females than males, inhalant use presents a disturbing gender trend. Among females, in Brazil, Ecuador, Paraguay and Peru, inhalants were the most commonly used illicit drug, when examining lifetime prevalence across all drugs.

Table 1: Lifetime Prevalence of Inhalant Use
Among Secondary School Students by Gender
Country Males Females
Argentina 5.98 3.71
Bolivia 4.37 2.51
Brazil 17.77 15.48
Colombia 5.24 2.96
Chile 5.40 5.54
Ecuador 7.14 3.66
Paraguay 2.60 2.75
Peru 4.99 4.16
Uruguay 3.65 2.30

 

Use by age also shows worrisome patterns. In the 14 year and younger age group, inhalants were the second most common drug used in most countries, regardless of frequency of use. This age group is of particularly concern because children that already manifest regular drug use at this age are prime candidates for long-term addiction.

Table 2: Past Year Use of Inhalants 
Secondary School Students, According to Age
Country 12-14 years 15-16 years 17- years
Argentina 2.28 3.08 2.62
Bolivia 0.60 1.56 1.90
Brazil 11.36 18.12 18.73
Colombia 2.01 3.93 5.90
Chile 2.17 2.97 2.45
Ecuador 2.21 2.50 2.03
Paraguay 1.44 1.58 1.59
Perú 1.65 1.81 2.17
Uruguay 0.78 2.45 1.57

A gateway to drug abuse

The pattern of use by age group differs from the United States and Canada, where inhalant use peaks at the eighth grade (roughly comparable to the 14-year old group) and then tapers off as youth begin to use other drugs. In the countries in this study, inhalant use peaked between 15 and 16 year of age (roughly comparable to tenth grade in the US), but use continued well into the 17 and older age group across countries.

Table 4: Prevalence of Illicit Drug Use in previous month,
among students 14 years and young, by country
Country Marijuana Coca paste1 Cocaine Ecstacy Inhalants
Argentina 2.25 1.10 1.53 n/d 1.41
Bolivia 0.46 0.28 0.41 0.31 0.29
Brazil 0.90 n/d  0.432  n/d  7.83 
Colombia 0.96 0.49 0.29 0.45 0.67
Chile 1.73 0.64 0.63 0.53 0.89
Ecuador 0.54 0.29 0.37 0.41 0.75
Paraguay 0.69 0.17 0.29 0.29 0.66
Perú 0.59 0.35 0.47 0.40 0.65
Uruguay 1.25 0.10 0.27 n/d 0.27

 

Table 5: Prevalence of illicit drugs in previous month ,
among students,  17 and older, by country
Country Marijuana Coca paste1 Cocaine Ecstasy Inhalants
Argentina 6.266 1.00 1.43 n/d 1.26
Bolivia 2.05 0.54 0.86 0.26 0.88
Brazil 7.93 n/d 3.022 n/d 13.33
Colombia 4.95 0.96 1.06 1.46 1.55
Chile 11.10 1.44 1.80 0.78 1.01
Ecuador 3.35 0.85 0.92 0.53 0.66
Paraguay 2.27 0.30 0.60 0.21 0.45
Peru 2.255 0.51 0.53 0.28 0.95
Uruguay 11.49 0.23 0.79 n/d 0.42
-->

Research on inhalant use among street children has established that many street children begin sniffing glue or toluene to ward off hunger. However, we do not have a clear explanation why children in the school system, who presumably are comparatively well off, begin using inhalants.

Photo: Students seated at typewritersThe potential impact on national education systems is high and should have serious implications for national drug policy. The widespread use of inhalants within the schools could have detrimental effects for public school systems across countries. Inhalants’ neurotoxicity affects children’s ability to perform in school (Lara et al), in addition to posing long-term consequences for the state’s public health system when children develop heart, kidney and liver dysfunctions as a result of use.

The special case of Brazil

Brazil’s inhalant use far exceeds its neighboring countries, making it particularly interesting for further study. Upwards of 15% of school-age children have used inhalants sometime in their life and as high as 10% reported regular inhalant use. There may be historical roots to this practice. As far back as the 1930s, lança perfumes (inhalable mixtures of perfume, ether and other substances) were used at carnaval or as a general party drug. Unfortunately, the available data of this study does not provide us with enough detail on the substances inhaled to ascertain which substances are used.

Conclusion

There exists a significant knowledge gap in drug use research and a pressing need to shed light on this public health issue. First, inhalants are typically treated in drug surveys as if they represent a single substance. But in reality, many substances are used and possess different neurological and toxicological effects. National policy makers need to know which substances are consumed to designate effective programs.

This analysis demonstrates that inhalant use is not limited to marginalized street children; rather it is a substance abuse problem that encompasses all gender and age groups, with dramatic implications for national education systems.

Participating national drug commissions

The OID expresses its appreciation to the national commissions that contributed  to this project.

Notes

1 For the purpose of clarity, the category of coca paste also included cocaine base and other cocaine-related substances, except for cocaine hydrochloride.

2 In the case of Brazil, figures refers to cocaine, coca paste and cocaine base.

-->

Authors

 Marya Hynes Dowell has worked at CICAD since 1996 and join the Observatory at it creation in early 2000. She has been the coordinator of the Costs Project since its inception.

Pedro Mateu-Gelabert holds a PhD in sociology and works at the National Development and Research Institutes Inc. (NDRI) in New York City.

 


updated on 8/14/2012 3:53:49 PM