Determinants of inhalant (whitener) use among street children in a South Indian city

A brief exposure to toluene vapor alters the intrinsic excitability of D2 medium spiny neurons in the rat ventral striatum

Although volatile organic solvents such as toluene are used for commercial and industrial uses, they are often voluntarily inhaled for their intoxicating and euphoric effects. Research into the effects of inhalants such as toluene on brain function have revealed actions on a variety of ligand-gated and voltage-activated ion channels involved in regulating neuronal excitability. Previous work from this laboratory has also shown that brief exposures to toluene vapor induce changes in the intrinsic excitability and synaptic transmission of neurons within the medial prefrontal cortex and ventral tegmental area that vary depending on projection target. In the present study, we recorded current-evoked spiking of medium spiny neurons (MSNs) in the nucleus accumbens (NAc) core and shell in adolescent rats exposed to an intoxicating concentration of toluene vapor. Compared to air controls, firing of NAc core MSNs in Sprague-Dawley rats was not altered 24 h after exposure to 10,500 ppm toluene vapor while spiking of NAc shell MSNs was enhanced at low current steps but reduced at higher current steps. When the rheobase current was used to putatively identify MSN subtypes, both "D1-like" and "D2-like" MSNs within the NAc shell but not core showed toluene-induced changes in firing. As toluene may itself have altered the rheobase resulting in misclassification of neuron subtype, we conducted additional studies using adolescent D2-Cre rats infused with a Cre-dependent mCherry reporter virus. Following toluene vapor exposure, spiking of NAc shell D2+ MSNs was enhanced at low current steps but inhibited at higher currents as compared to air controls while there were no differences in the firing of NAc shell D2- MSNs. The toluene-induced change in NAc D2+ shell MSN firing was accompanied by alterations in membrane resistance, rheobase, action potential rise time and height with no changes noted in D2- MSNs. Overall, these data add to a growing literature showing that brief exposures to intoxicating concentrations of toluene vapor causes selective alterations in the excitability of neurons within the addiction neurocircuitry that vary depending on sub-region, cell-type and projection target.

The global distribution and epidemiology of alcohol and drug use among street-involved children and youth: a meta-analysis

Background: Street-involved children and youth (SICY) who work and live on/of the streets are more likely to inject drugs and engage in psychoactive substance use.Objectives: The present study aimed to identify the prevalence, distribution, sociodemographic determinants, and risk-taking associated with alcohol and drug use among SICY.Methods: Studies published in English related to alcohol and drug use among SICY were searched for from December 1 1985 to July 1 2022, on PubMed, Scopus, Cochrane, and Web of Science.Results: After full-text paper evaluation, 73 studies were included in the meta-analysis. Results indicated that lifetime prevalence rates were 44% (alcohol), 44% (crack), 33% (inhalants), 44% (solvents), 16% (tranquilizer/sedatives), 22% (opioids), and 62% (polysubstance use). The current prevalence rates were 40% (alcohol), 21% (crack), 20% (inhalants), 11% (tranquilizer/sedatives), and 1% (opioids). Also, life-time and current prevalence of alcohol and crack use, current prevalence of tranquilizer/sedative use, and life-time prevalence of polysubstance use were higher among older age groups. Life-time prevalence of tranquilizer/sedative use was lower among older age groups.Conclusions: The high prevalence of using alcohol, crack, and inhalants is a major issue because they are used extensively among different age groups, including minors. Such findings are beneficial for policymakers, health authorities, and professionals in developing programs aimed at minimizing inhalant use and other types of substance use harms among this group. It is important to accurately monitor this risk-exposed population to understand the mechanisms that might help protect them from high-risk substance use.

The Need for Action: Addressing Inhalant Abuse and Whitener Addiction Among Adolescents

Inhalant abuse and whitener addiction are serious problems among adolescents that have significant consequences for physical and mental health, as well as for families, communities, and society as a whole. This review article discusses the causes and health consequences of inhalant abuse and whitener addiction among adolescents, as well as the challenges in addressing the problem. The paper also outlines strategies for addressing inhalant abuse and whitener addiction, including education and awareness campaigns; early intervention and treatment; collaboration between schools, healthcare providers, and community organizations; and support for families affected by inhalant abuse and addiction. The paper concludes with a call to action for policymakers, healthcare providers, and community members to prioritize and address inhalant abuse and whitener addiction among adolescents. By working together, we can help to prevent substance abuse and promote the health and well-being of our youth.

The Global Distribution and Epidemiology of Psychoactive Substance Use and Injection Drug Use Among Street-Involved Children and Youth: A Meta-Analysis

Background: Globally, street-involved children and youth (SICY) who work and live on/of the streets are at higher risk of increased psychoactive substances and injecting drug use. Objectives: The present study aimed to identify the prevalence, distribution, sociodemographic factors, and risk-taking behaviors associated with psychoactive substances and injecting drug use among SICY. Methods: Studies in English published from December 1 1985 to July 1 2022, were searched for on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on psychoactive substances and injecting drug use among SICY. The pooled-prevalence estimates were obtained using a robust fixed-effects model. Results: The most commonly reported life-time and current psychoactive substance was tobacco followed by cannabis, LSD/ecstasy, cocaine, methamphetamine, heroin and injection drug use. The results showed that life-time and current prevalence of methamphetamine and cannabis use, as well as life-time prevalence of cocaine, LSD/ecstasy, heroin, tobacco, and injecting drug use increased as age rose while current prevalence of cocaine and tobacco use decreased as age rose. SICY who were male, homeless, had parents who had died, had history of substance use among family members or best friends, had experienced violence, had casual sex partners, had a history of working in the sex trade, and had unprotected sex were all related to psychoactive substance use and injecting drug use. Conclusions: Research examining this population suffers from lack of studies, therefore, improving the knowledge for interventions aimed at reducing risk behaviors, particularly those related to the transmission of sexually transmitted infections such as HIV is of great importance.

The Effects of the Inhalant Toluene on Cognitive Function and Behavioral Flexibility: A Review of Recent Findings

Substance use disorder (SUD) is characterized, in part, by lack of control over drug seeking and taking. The prefrontal cortex (PFC) is highly involved in control of behavior and deficits in PFC structure and function have been demonstrated in clinical and preclinical studies of SUD. Of the various classes of drugs associated with the development of SUD, inhalants are among the least studied despite their widespread use among adolescents and children. In this work, we review what is currently known regarding the sites and mechanisms of action of inhalants with a focus on the volatile solvent toluene that is contained in a wide variety of legal and easily obtained products. We then describe how inhalants including toluene affect various behaviors with an emphasis on those associated with PFC function and how chronic use of inhalants alters brain structure and neuronal signaling. Findings from these studies highlight advances made in recent years that have expanded our understanding of the effects of inhalants on brain structure and reinforce the need for continued work in this field.

Sociodemographic and psychosocial correlates of substance abuse among street children: A cross-sectional survey in the streets of Kolkata, West Bengal

Context

India is now witnessing steady increase of substance abuse in younger age group. Street life is a major reason in addition to curiosity, unawareness of harm, migration, peer pressure.

Aims

To assess the prevalence, pattern and related factors of substance use and stress among the street living children.

Settings and Design

This street-based observational, cross sectional survey included 150 street children living in vicinity of railway stations, business activity centre and major religious places of Kolkata.

Methods and Material

A descriptive research was done in 150 street children, aged 6 to 18 years and stayed in the street for at least six months. Respondents and care givers were interviewed with pre designed proforma to obtain information on socio demographic attributes, pattern of substance abuse, psycho social issues, self rated health. Weight and height were recorded by calibrated standardized instrument.

Statistical analysis used

Collected data were analyzed with SPSS 22.0(licensed). Chi-square test or Fisher's exact test was done for normally distributed, skewed and categorical variables respectively. The significance level was set at 5%.

Results

Two-thirds of participants used substance. Illiteracy was significantly more in females. Perceived positive benefit was commonest reason while feeling happiness and diminished pain was the most common expectation behind substance abuse. Peer group had the biggest influence (92.0%) on their life. Substance abuse was significantly more in males, adolescents, employed, without family attachment, adult as influencer and in those who lived on street without family.

Conclusions

Higher prevalence of substance abuse among males, adolescents with adult influencer, employed and without family attachment highlighted the urgent need of intervention to see a better future.

Inhalant Abuse and Dextromethorphan

Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem. Also discussed is the misuse of a specific "over-the-counter" dissociative, dextromethorphan.

Gasoline abuse in a 10-year-old child with mental retardation: a case report

Inahalant abuse is of increasing interest in India. The age of onset is typically during adolescence. Gasoline inhalant use is rarely reported in adolescents with intellectual deficit. We report a case of petrol dependence in a 10-year-old child with mental retardation. Possible effect of petrol huffing on behavior and cognition is discussed.

Substance Abuse amongst the Street-children in Guwahati City, Assam

BACKGROUND

The nature of continuous exposure to the street and its associated life-styles make street children vulnerable to the use of psychoactive substances.

AIMS

The aim of the present study is to study some social factors of street children in Guwahati city and to ascertain the substance use behavior of the street children.

SUBJECTS AND METHODS

A population based cross-sectional study conducted during September 2008 to August 2009 among 215 street children between the ages of 5 and 18 years of Guwahati City Assam. The main outcome measures were substance use and its related risk factors prevalent among street children. The data collected were analyzed in Microsoft Office and percentages and Chi-square tests were used to analyze the variables.

RESULTS

Around 174/215 (80.9%) of study participants were substance abusers. It is noteworthy that as the age increases substance use was more common when compared to younger age group. The risk of substance abuse was 1.26 times relatively higher among those who had never been to school and 1.12 times more common in those from a joint family when compared to others. However the correlations were not found to be statistically significant. Substance abuse was 1.19 times more common in case of deaths of both parents and the association was found to be statistically significant (P = 0.02). Presence of step parents and substance use in the family was seen to be a risk factor for substance abuse and the association was highly significant (P < 0.001). The association of substance abuse with duration of street life was found to be highly significant. Majority of the substance users 152/174 (87.4%) were in the habit of sniffing glue and this was followed by smoking 147/174 (84.5%).

CONCLUSION

Substance abuse is an important concern affecting street children. Street and its associated life-styles make street children vulnerable to the use of psychoactive substances. Non- government organizations and Government should come forward to curb this problem and save millions of vulnerable lives.

Effects of transnational migration on drug use: an ethnographic study of Nepali female heroin users in Hong Kong

BACKGROUND

Past studies of female drug users in South Asia tend to focus on their plights, for instance, how they have been driven to drug use and encounter more problems than their male counterparts, such as HIV/AIDS and sexual abuse. Few studies focus on their active role--how they actively make use of resources in the external environment to construct their desired femininity through drug consumption. Furthermore, little is known about the situation of female South Asian drug users who are living overseas. This paper is a study of transnational migration, drug use and gender--how transnational migration influences the drug use of female transnational migrants.

METHODS

An 18-month ethnography has been carried out in a Nepali community in Hong Kong and 13 informants were interviewed. Data were coded and analyzed by using the grounded-theory approach. Themes related to the drug use of the female Nepali heroin users were identified.

RESULTS

The findings show that there are three important themes that significantly affect the drug use of female Nepali heroin users, which include (1) their relationships with intimate partners, (2) their means of support, and (3) their legal status in migration.

CONCLUSIONS

The findings are consistent with the concept of post-structuralism in gender and transnationalism theories. Female Nepali heroin users in Hong Kong are neither active agents nor passive victims; their active/passive role is largely dependent on their reconfigured opportunities and constraints in transnational migration. Thus, transnationalism should be taken as an important perspective to study the situation of female drug users in a globalized context.

Inhalant use among schoolchildren in northeast India: a preliminary study

Inhalant use by children leads to poor performance in school and has been observed to precede substance use later in life. There is paucity of data on inhalant use among school children in India, particularly in the Northeast region of the country. We determined the prevalence and documented inhalant use characteristics among schoolchildren in the Northeast region of India. This cross sectional study was conducted in six states in the Northeast region of India. Schoolchildren between eighth and eleventh standards from the capital areas of the states were included in the study. Data were collected using a questionnaire. Analysis was done using descriptive statistics and Chi-square test. Of the 4074 enrolled students, data from 3943 students who responded to the inhalant use question were analyzed. Mean age was 14.8 ± 1.2 years and 51.2% of participants were male. The proportion of students who had ever used inhalants (ever user) was 18.8% and adhesive/glue was the inhalant misused by most of the students. A higher proportion of males than females were ever users (P ≤ 0.001) and the most common place of use was at home (33.1%). Being in the presence of an older person using an inhalant or tobacco was found to be associated with use of inhalants among students. Nearly one-fifth of the students had used inhalants and nearly half used inhalants in the past month. Sensitization of the parents and school authorities to the problem, as well as preventive and curative services, should be considered.

A descriptive study of clinical, hematological, and biochemical parameters of inhalant users seeking treatment at a tertiary care center in India

BACKGROUND

Inhalant (or solvent) abuse is the purposeful inhalation of vapors or gases, intended to produce pleasurable psychoactive effects. There is a dearth of Indian studies on inhalant users.

AIM

The present study aimed to describe the socio-demographic, clinical, and psychosocial characteristics of inhalant users visiting a Tertiary Care Center in North India.

MATERIALS AND METHODS

The study was a retrospective chart review for 50 inhalant users who sought treatment for the first time from the center over a period of 2 years. All patients seeking treatment for inhalant use at the center were evaluated by a psychiatrist.

RESULTS

Mean age of the sample was 17.16±4.09 years and majority comprised of children and adolescents (72.2%). There were only three girls (6%). Majority comprised of school drop-outs (82%), from lower socio-economic status (80%). Mean age of initiation of first substance was 14.13±4.27 years and inhalants were first drugs for 38%. Duration of inhalant use ranged between 1 month and 7.5 years. Use was mostly uninterrupted, and 88% were dependent users. Correction fluid was the commonest product, used by huffing or sniffing. A large majority (86%) had used at least one other substance besides inhalants, and 8% reported involvement in high-risk sexual behaviors. Comorbid psychiatric disorder was seen in 8% of sample. Positive family history was observed in 30% of the sample. The mean hemoglobin of the sample was 11.88±0.60, with low hemoglobin in 25% of users. Neutrophils, lymphocytes, eosinophils, and monocytes were elevated beyond normal in 10.8%, 6.5%, 15.2%, and 7.5%, respectively. There was no evidence of leucopenia. Bilirubin and serum glutamic pyruvic transaminase was elevated in 6.6% and 13% of inhalant users, respectively.

CONCLUSION

The study adds to the limited date available on the treatment-seeking inhalant users from Indian settings. There is a need to examine the pattern of inhalant use in larger samples, across multiple sites in a prospective manner.