Inhalant dependence: data from a tertiary care center in South India

Observations from a peculiar case of volatile substance dependence-A case report

Volatile substance dependence is a relatively rare form of substance use disorders. It is predominantly noted in the adolescent age group. Higher prevalence is also seen in individuals from the lower socio-economic strata. These agents induce a rapid mood change by altering the levels of central neurotransmitters. Here we present a unique case of volatile substance dependence in a middle aged female with iron deficiency anemia. We managed this with the SSRIs and parenteral iron preparations which led to recovery. This emphasizes the fact that any treatment regimen must address all the factors, co-morbidities and patient characteristics for complete recovery.

Acute Psychosis Following 1,1-Difluoroethane Inhalation

Inhalants are often abused due to their ability to acutely induce feelings of euphoria. Difluoroethane is a toxic lipophilic hydrocarbon that crosses the blood-brain barrier and inhibits the central nervous system. Studies have shown the cardiac, renal, and respiratory effects it has when abused; however, our literature review yielded no previous report of acute psychosis after difluoroethane inhalation. In order to prevent poor outcomes by missed diagnosis, we present a case of difluoroethane-induced acute psychosis.

Adolescent inhalant use and psychosis risk - a prospective longitudinal study

BACKGROUND

Cross-sectional studies have suggested inhalant use is associated with psychosis. This association was examined in a longitudinal study accounting for other substance use and potential confounders.

METHODS

We used a prospective sample (N = 6542) from the Northern Finland Birth Cohort 1986. Self-report questionnaires on substance use and psychotic experiences were completed when the cohort members were 15-16 years old. Inhalant use was categorized into four groups (never, once, 2-4 times, 5 times or more). Subsequent psychosis diagnoses (ICD-10) until age 30 years were obtained from national registers. Cox regression analysis was used to examine the association between adolescent inhalant use and risk of psychosis.

RESULTS

During the observation period 124 individuals were diagnosed with incident psychosis. Overall, there were 225 (3.4%) subjects with any inhalant use, 18 (8.0%) of whom were diagnosed with psychosis during the follow up. Of non-inhalant users (n = 6317) 106 (1.7%) were diagnosed with psychosis. Compared to non-users, those using inhalants had increased risk of incident psychosis with most frequent inhalant use associated with the greatest risk (unadjusted HR = 9.46; 3.86-23.20). After adjusting for baseline psychotic experiences, other substance use, comorbid mental disorder and parental substance abuse, the increased risk of psychosis persisted (HR = 3.06; 1.05-8.95). Furthermore, a dose-response effect between inhalant use and risk of psychosis was identified (OR = 2.34; 1.83-2.99).

CONCLUSIONS

Inhalant use in adolescence was independently associated with incident psychosis. The adverse health outcomes associated with adolescent inhalant use provide compelling reasons for implementation of policies to reduce the use of volatile substances in adolescents.

Treatment Seeking Behavior of Inhalant Using Street Children: Are We Prepared to Meet Their Treatment Needs

CONTEXT

There is a lack of evidence for help and treatment seeking behavior of street children using inhalants.

AIMS

The present study was planned to provide a comprehensive understanding on the patterns, correlates of inhalant use and treatment seeking behavior of street children from Delhi, India.

MATERIAL AND METHODS

Participants were a purposive sample of 100 inhalant using street children below 18 years identified with the assistance of five community service organizations/nongovernmental organization working with street children in the city of Delhi. Information on a semi-structured questionnaire with items pertaining to the demographic and drug use parameters was collected by trained research staff in a one-to-one in field setting.

STATISTICAL ANALYSIS

All data were entered into SPSS 12.0, data quality checks performed and examined.

RESULTS

The sample had an average age of 12.8 ± 2.4 years (range 4-17 years), 96.5% reported regular past month and 87.0% past 24 h use of inhalants. The mean age of onset of inhalant use was 9.3 ± 2.8 years The substances most commonly reported were toluene from eraser fluid (by 83.0%), glues (34.0%) and petroleum products (3.0%); mean frequency of use was 9.8 times in a day. Of the sample, 18% used inhalants when they were alone, and the rest reported using with drug using network friends; 76% reported tolerance and mild withdrawal symptoms such as restlessness, anxiety, craving, irritability and lethargy. A variety of problems and perceived benefits due to inhalant use were reported; 46% inhalant users had never abstained from its use, and 77% reported never having sought any medical help.

CONCLUSIONS

Study findings provide a better contemporary understanding of inhalant abuse among Delhi street children. This information can assist in the formulation of a needs-based intervention for the inhalant using street children.

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.

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.