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Volatile Substance Abuse

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www.knowthescore.info
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VOLATILE SUBSTANCE ABUSE (VSA)

Introduction

Many people think Volatile Substance Abuse (VSA) is a problem of the past, with 1980's images of teenage glue sniffers inhaling old crisp packets in derelict alleyways. They are wrong. VSA is still very much a problem of today, with a much wider variety of everyday products available for abuse. However, the effects of abusing these products are as dangerous as they ever were - messing about with them can mean instant death.

An average of eight ¹ people die each year in Scotland from VSA. Many of those who die are under 18. The risk of first-time death from heart failure, as a result of experimenting, is very real.

Solvent Abuse Can Kill Instantly

What is VSA?

VSA occurs when volatile substances, normally intended for household use, are inhaled through the mouth and nose for the sole purpose of getting a 'buzz'. The most commonly abused substances are:

• butane gas, used as a propellant for aerosols or as a fuel gas for products such as lighters;

• solvents, which are used in many products to keep the ingredients in a liquid state within a canister or bottle.

What products can be abused?

Over 30 products that can be abused could be found in the home, all readily available, with legitimate uses.

Some of these products are listed below:

• cigarette lighter refills;

• disposable lighters containing butane;

• aerosols - deodorants, hairspray, paint spray, furniture products;
  pain-relieving spray, air freshener, fly spray, carpet cleaner, etc.;

• solvent-based adhesives;

• petrol;

• some typewriter correction fluids;

• nail varnish and nail varnish remover;

• dry-cleaning fluids;

• paint thinners and paint removers;

• UHT cream - whipped cream cans;

• dyes (for shoes);

• cleaning agents - degreasing materials, sticking plaster remover, etc.;

• Halon fire extinguishers (no longer sold but still in use in some public buildings).

Why do people abuse these products?

The psychological reasons for inhaling volatile substances can be many and complex. Most young people who experiment with volatile substances do so out of curiosity. Physically, the effects of VSA are similar to getting drunk. The main difference is that young people who have used volatile substances can become affected very quickly and experience disturbing hallucinations. Intoxication wears off rapidly, perhaps within 30 minutes. Such effects can vary from person to person.

Young people may experiment a few times with friends or with someone who has used volatile substances before. A small proportion moves on to more frequent abuse, usually with a group of other users. Often these young people stop after a while and move on to other interests. However, a few, often those with personal, family or social difficulties, may be more vulnerable and develop problematic use.

Problematic use starts to affect the life of the individual and becomes a higher priority than other things in life. The problem user is someone whose life has become very chaotic and centres entirely around VSA and the 'next hit'.

What are the risks?

There is NO safe way of abusing solvents. The biggest danger from abusing these products is INSTANT DEATH. Death can happen at the first attempt or following many attempts.

Death can occur due to the following:

Heart failure

This is when the heart becomes over sensitive to adrenaline and beats ineffectively. If the 'sniffing' is followed by exertion or excitement, the heart can't cope and stops. Some aerosol sprays freeze the organs, which can result in the lungs and airways producing fluids - this carries serious additional risks.

Choking

There is also a risk of choking on vomit, caused when the body is trying to get rid of unwanted substances. However, if someone is unconscious after inhaling a solvent, the person's airways are likely to become blocked, which could suffocate him or her to death.

Accidents - fatal or serious

Accidents can occur when someone is 'high' or hallucinating. A user may imagine that he or she can jump from great heights, or stop a speeding train. Someone inhaling alone could drown if falling into water. Many deaths result from suffocation because the solvents are inhaled from plastic bags. There is also the risk of burns, as many of these products are highly flammable and can explode.

People who inhale solvents and volatile substances over a long period may also risk the following:

• damage to the nervous system, involuntary twitching and numbness;

• breathing difficulties - damage to the lungs;

• liver damage;

• kidney damage;

• bone marrow damage;

• damage to the eye (optic atrophy);

• damage to the inner ear (cochlea damage);

• damage to reproductive organs;

• damage to the brain.

How do I know if someone may be abusing solvents?

Some signs of 'sniffing' can be difficult to distinguish from normal adolescent behaviour. The effects wear off quickly, within 30 minutes or so, and it is rare to encounter young people who are 'drunk' from the effects. Symptoms such as nausea, headaches and dilated pupils can be misleading as they may have many causes unrelated to use of volatile substances. If they are persistent, these symptoms in themselves warrant being checked by a doctor. However, evidence from the products themselves may indicate that someone has a 'sniffing' problem.

Some signs and symptoms of VSA use are:

• a chemical smell on clothing, hair or breath;

• empty or damaged butane gas, aerosol or glue containers (look for teeth marks on nozzles, towels with white marks on, bags containing glue, etc.);

• disappearance of aerosols, glues, etc. from around the home;

• 'drunken' behaviour, such as lack of co-ordination and coherence;

• changes in sleep patterns;

• changes in appetite;

• changes in behaviour, e.g. tiredness, irritability, aggressiveness, mood swings;

• changes in school performance;

• changes in health, e.g. headaches, tummy aches, conjunctivitis, coughs.

What can I do if I suspect someone is abusing solvents?

If you suspect someone is 'high' on solvents:

• keep calm - assess the situation, including the risks to yourself;

• stay with the person - as long as the situation is safe for both of you;

• ensure adequate air - by opening windows or loosening tight clothing, etc.;

• keep the person calm and still - there is a risk of sudden death if he or she is made too active or panics. Don't chase or excite him or her;

• remove the solvents from the person - don't use force;

• be supportive - when people are 'high' on solvents, it is not the best time to discuss their 'sniffing' problem. Being supportive at this stage will open channels of communication for later;

• stay with the person - until the effects have worn off.

If the person is unconscious:

• check for a response - by gentle shaking or loud talking;

• apply first aid if you know how - check his or her Airway, Breathing and Circulation;

• place the person on his or her side in the recovery position (see the diagrams below) - to ensure he or she cannot choke through vomiting whilst unconscious;

• get help - call an ambulance or, if possible, send someone and inform the emergency workers where you are, what has been taken, and that the unconscious person may require cardiac defibrillation;

• stay with the person (if you can) - keep him or her warm and still.

NB: Do not use the recovery position if the person has a major injury, e.g. to the back or neck

1. Kneel next to the person. Place the arm closest to you straight out from the body. Position the far arm with the back of the hand against the near cheek.	2. Grab and bend the person's far knee.
3. Protecting the head with one hand, gently roll the person toward you by pulling the far knee over and to the ground.	4. Tilt the head up slightly so that the airway is open. Make sure that the hand is under the cheek. Place a blanket or coat over the person (unless he or she has a heat illness or fever) and stay close until help arrives.

For general information (i.e. rather than emergencies):

You can call the 'Know the Score' information line (0800 587 587 9), where a trained operator will be happy to speak with you. Alternatively, you can log on to the 'Know the Score' website www.knowthescore.info, which gives you access to the websites of Scotland's leading drugs agencies. This includes Re-Solv, the Society for the Prevention of Solvent and Volatile Substance Abuse, who helped to produce this booklet.

How can parents help their children?

You may be able to prevent your children trying solvents at all, if you tell them about the dangers. Most children don't knowingly poison themselves. If they knew the dangers of VSA, they might not take the risk. If you discover that your child has been abusing solvents, what do you do?

• don't panic: talk to your children - be calm and reassure them that you care. If you are aggressive, you may not find out what you need to know. Find out why they tried sniffing. Put yourself in their shoes;

• a fuller discussion is important - the best time is within a few days of the sniffing episode, but not immediately after, or while he or she is intoxicated. The chemicals may have an effect on his or her behaviour over a couple of days, until they leave the bloodstream;

• be supportive - let your children know that they can talk with you about anything. Pledge your support, whatever the circumstances;

• tell them clearly about the dangers;

• listen - children who repeatedly abuse solvents may have other problems that they are trying to deal with. You could help to solve them;

• break the abuse cycle - find out if your child sniffs as part of a group. The parents of the other group members may be unaware that there is a problem;

• encourage your children - try to get them to enrol in activities which will make them appreciate their physical or mental well-being, e.g. sport or voluntary work;

• monitor the situation - especially at times when your child may be under stress;

• share your concerns - if you remain concerned, seek support from your GP, school doctor/teacher, or a trusted friend or relative;

• get advice - there are contact numbers in this booklet that you can approach for help.

The law and VSA?

Since October 1999, the law makes it an offence to supply gas lighter refills to young people under the age of 18 years. It is also illegal to sell butane gas lighter refills to anyone under 18. This regulation was made under Section 12 of the Consumer Protection Act 1987 and applies to the whole of the UK.

The penalties for selling butane gas lighter refills to anyone under 18 may be a sentence of up to six months' imprisonment, or a maximum fine of 5,000, or both.

Scottish Common Law provides for an offence of 'recklessly' supplying or selling substances to people of any age, knowing that they are to be used for the purpose of abuse. There is no age limit, and 'reckless' sales to over-18s have resulted in prosecution fines and prison sentences.

The Children (Scotland) Act 1995 updated arrangements first put in place by the Social Work (Scotland) Act 1968, and provides a framework for Scotland's system of care and justice for children. The system deals with children who are in need of care and protection, and/or who have committed a variety of offences. The focus of the legislation is to ensure that action is taken to address welfare issues for the child. The Solvent Abuse (Scotland) Act of 1983 was an amendment to the 1968 Act and made VSA in itself a specific ground for referral ² to the Children's Reporter. Where statutory intervention is considered necessary, the Children's Reporter will arrange a Children's Hearing to consider what action is required. It is important to note, however, that the reason for referral, i.e. solvent abuse, is not classed as an offence.

1 Trends in Death Associated with Abuse of Volatile Substances 1971-2001, St George's Hospital Medical School. June 2003.
² S52(2)(1) Children (Scotland) Act 1995.