Substance
Abuse at Home
"Neither do children have support
systems to keep away from substance abuse, nor is there a proper mechanism for
their de-addiction and treatment”: Child rights activist
Addiction can be a terrible thing, tearing
families apart and destroying lives. The variety of substances that are abused
on a daily basis could surprise many. While drugs – both illegal and
prescription – are often abused, as well as alcohol, there are a number of
other substances that have made their mark. For one Indian boy, that substance
is whitener ink.
There are a lot of everyday items that you use at
home which could introduce a child to the addicting world of substance abuse.
Some of these items are things that as a parent would not even imagine would be
addicting to a child! But children being children need to be taught about the
nature of addiction so that they do not accidentally become prey to these
harmful substances.
Here is a list of items that one need to keep
away from a child or educate him about:
Sniffing Glue:
This is probably the biggest name in the list of substances abused.
Sniffing glue for extended periods of time can have effects such as brain
damage and temporary or in some cases even permanent memory loss. Sniffing glue
can also cause rashes around the mouth and nose. at home. Sniffing quick repair
glue has become a huge problem for parents across the world. It contains an
organic solvent that is highly addictive. This is inhaled by squirting some
quick fix glue into a paper bag and then inhaled. It has an immediate effect on
the inhaler, and makes him disoriented and inebriated.
White Ink:
This is a fairly new addiction among young teenagers
in India today. Sniffing shoe whitener, or eraser white ink has caught on among
many kids in India today. This substance is poured on a handkerchief or into a
bag and then inhaled. Doing this for some time makes the sniffer dizzy, high
and disconnected. The chemical toluene is what affects the sniffer as it has a
hallucinatory effect on the sniffer.
What makes white ink or WINK attractive to teenagers is how cheap white ink is
and the effect it has on them. So make sure you keep an eye on the
shoe-whitener or white ink you stock at home. Toluene is also found in paint
thinner and nail polish remover.
Gas:
Even sniffing the butane gas that we use in India for the stove,
is a substance that children use for chemical abuse. The smell of butane has an
instant effect on the inhaler, as it can make him dizzy, emotionally unstable,
hallucinate and even pass out in some cases. The biggest con is that it can
make him forget his current location, which could lead to even fatal accidents.
Excessive huffing of butane could lead to long term brain damage and even
recurrent paranoia.
Whitener (correction fluid) inhalation
caused the death:
Whitener is abused as an inhalant in India.
Whitener exerts its effects through trichloroethane, a volatile solvent.
Inhalants include
other substances such as petrol and toluene. These substances are cheap,
accessible and readily available to children and adolescents.
Epidemiology
Solvent abuse
is prevalent among street children and working kids. Teenagers
start using solvents to gain entry into a gang, and occasionally as experimentation.
Its use in a college student is unusual. But this may be a developing pattern
indicating spread of the habit into middle class homes. Most adolescents are
one-time or short-term users. Those who abuse inhalants persistently usually
have conduct disorders.
Most of
the street children were inhaling whiteners daily. 300% more harmful than
alcohol . Inhaling whiteners is 300 per cent more harmful than regular
alcohol. It directly affects the nervous system and hampers functioning of
lungs, brain, kidneys. A whitener is sold with a diluter that is an organic
solvent (hydrocarbon) like toluene, trichloroethylene, methyl benzene, which
are alcoholic. The organic solvents when deeply inhaled give a sudden kick.
Methods of inhalant abuse
1.
Sniffing - direct inhalation from a container or
piece of clothing sprayed with the substance.
2.
Huffing - holding a soaked cloth over the nose
or mouth to increase the concentration of vapours.
3.
Bagging - breathing from a paper or plastic bag
containing the volatile substance to further increase the concentration .
Mechanism of action
Young people
abuse volatile solvents by
deliberately inhaling available vapours 15–20 times over 10-15 minutes. This
results in concentrations of up to 10000ppm as against the industrial standard
of 50-100ppm.
Inhaled organic solvents like toluene cross from the blood into the
brain within minutes. In the brain cells solvents act on specific
receptors (NMDA and GABA) to produce effects similar to those of alcohol.
Toluene, a common solvent in thinner and paint, increases opiate receptors
in the Nucleus Accumbens - a key brain area associated with the reward system
and the experience of pleasure. Toluene enhances dopamine release in the
Nucleus Accumbens.
Effects on the body
- At low
concentration (500-4000ppm)
transient euphoria and disinhibition make abusers prone to risk taking and
accidents.
- At higher
concentrations (6000-15000ppm)
dizziness, sleepiness, slurred speech, blurred vision and headaches
appear. Users appear confused, unbalanced, or begin responding to
hallucinations.
- Higher
doses
result in seizures, coma and cardiopulmonary arrest.
Death by inhalant
- Sudden
sniffing death
is the most common cause. Even first-time experimental users are at
risk of sudden sniffing death as a result of heart rhythm abnormalities
especially if the user is startled or agitated.
- Suffocation
and burns
from exploding solvents
- Accidental
injury
as a result of impulsive risk taking and impaired motor skills while
intoxicated.
- Suicide accounts
for up to 40% of inhalant-related deaths
- First-time
users
are also likely to die, perhaps because they are inexperienced at this
dangerous pastime.
Recognition
Inhalant abuse should be suspected in
teenagers showing
intermittent intoxication, and signs of recent inhalant abuse including paint
or oil stains on clothing or skin, spots or sores around the mouth, red eyes,
runny nose, chemical odour on the breath, and a dazed
appearance (Anderson, 2003).
Mass screening in schools could be undertaken as part of the annual health
check. The mental health component for middle and high schoolers should include
the CRAFFT.
The CRAFFT is a validated short screening instrument for substance abuse in
teenagers.
Laboratory diagnosis is not reliable as these volatile substances
- Do not
persist in
the body beyond a few hours
- They are
undetectable in urine samples because of their volatility
- Hippuric
acid,
a long lasting toluene metabolite is also produced by foods and raises the
question of false positives. Also, it is usually not available for testing
in emergency.
Outcome
For most adolescents inhalant use should be
regarded as a passing phase or fad. A few persistent users have antisocial
personality disorder and abuse other substances. Chronic users develop damage
to all organ systems - heart, lungs, brain, kidneys, and liver.
Treatment
There is no specific medication to treat
intoxication or for abstinence.
If you suspect a child is intoxicated with an inhalant stay calm and do
not alarm him or her. Startling or frightening the child precipitates
hallucinations and can also lead to ‘sudden sniffing death’ due to the
effect on heart rhythm. Initiate cardio-pulmonary resuscitation (CPR)
until help arrives if there is no heart beat or breathing.
When the child or adolescent recovers the incident should be discussed
non-confrontationally. Remember, even a single inhalation can kill the
child. Also abuse of other substances is frequent with regular whitener
abusers. After talking it over commit to seeking psychiatric help.
Social, environmental and recreational opportunities need to be addressed.
While nearly 60 to 70 per cent of
all street children in India are victims of substance abuse, there is no proper
de-addiction programme or facility available to them. What has made things
worse for these children is that the commonest substance of abuse, the
whiteners used for erasing ink on paper, are easily available across the
country. And no, it is not the stationery shops alone that sell them now; even
the pan shops do so.
Child rights activist said of the
nearly 50,000 street children with no support and the lakhs of others who have
some care available, a vast majority are into substance abuse. They mostly
sniff the whitener which is easily available. Some also consume tablets and
powders of various types.
The biggest problem is that
neither do these children have support systems to keep away from substance
abuse, nor is there a proper mechanism for their de-addiction and treatment.
The problem has been compounded by
the easy availability of whiteners. The Police does not act against its sale as
it is not a banned substance. Also they do not clamp down on those who sell
whiteners to children despite knowing fully well that the substance would only
be used for addiction.
However, for the juveniles in
conflict with law, the High Court had recently ordered the setting up of a
de-addiction centre at Kingsway Camp. But the Government has not provided any
such facility for ordinary street children who earn their living.
Such children, he said, are
normally sent to the psychiatric wards of government hospitals. These, however,
are no good as they have strong withdrawal symptoms and need proper treatment
which is not possible without admission.
All-India Institute of Medical
Sciences has started a facility for such children in Ghaziabad but there
children are required to be accompanied by attendants and due to this many of
the single children are unable to avail of the services.
Children in the age group of
eight to 12 years are increasingly getting addicted to otherwise ordinary
substances much to the concern of their parents and authorities at de-addiction
centres in the country.
Peer pressure, heartbreak,
unhappy family life and lack of a cordial relationship with parents are some of
the reasons why children get addicted to substances like whiteners or
adhesives. apart from whitener addiction, we also get cases of addiction to
petrol and adhesives. We have found children inhaling the fumes of petrol or
adhesives and then being unable to get rid of the habit.
Whiteners, adhesives and
pain-killing ointments are what these children are turning to, either because
of peer pressure or some family discord among other reasons.
The situation becomes worse when the parents
started realising that their teenage son had picked up hazardous habits and
developed several medical complications.
Teenagers themself confessed the parents on
some kind of weird drugs. They said he is addicted to inhaling the vapour from
the glues that we use to fix puncture in tyres. He promised to give up them and
again start going to school. But he was never able to come out of it.
The illiterate parents had no
idea how to deal with the situation. Not knowing what to do.
“Many parents feel that they
would be able to free their child of addiction on their own but this is not
possible in every case. While it is possible in case of mild addiction (in the
initial stage), the child would need expert guidance if his/her addiction
reaches the moderate or severe stage.
Inhaling or drinking whiteners
seriously impacts a child’s health, Drinking whitener can lead to failure of
the liver system, while inhaling it can cause a breakdown of the nervous system.
Children can also show symptoms of schizophrenia; they can start mistrusting or
abusing everyone around them.
A number of students in the city are addicted
to substances such as whitener, ink remover, thinner and vulcanising solution.
At lunch break every day, student doesn't
open his tiffin box. Instead, he rushes to the fields behind his school
somewere and vigorously sniffs his handkerchief to get high on the whitener he
has poured into it.
Teacher
told Parents that student was sleeping
in the classroom and frequently sniffed his handkerchief. Just a couple of
sniffs of the toxic toluene in the whitener gives student an instant high. He
and his friends pour the whiteners into kerchiefs and even socks and inhale for
a kick.
While
toluene, an organic solvent, plays on the central nervous system and gives a
euphoric feeling, it is also a slow poison that can cause seizures, memory
loss, dilated heart condition, brain damage and even death.
A few
years ago, the addiction was confined to children from the poorer and lower
middle classes. But psychiatrists say they are now seeing whitener abuse in
matriculation schools and engineering colleges.
"Ganja
(marijuana) is costlier and not easily available. Addiction to marijuana can be
easily detected, but it is more difficult to identify a whitener .
Whiteners
and diluters are available in all stationery stores for just `27 for 15ml.
Shops close to school campuses stock whiteners. There's no control over the
sale of whiteners as it is not a drug under the purview of the Narcotics Drugs
and Psychotropic Substances Act.
Curing
people of the addiction is a struggle that takes months or even years. With
constant counselling, anti-depressants and anti-craving drugs, some are cured.
Speedy recovery lies in early detection, say experts. If the child is
withdrawn, seems depressed, sleepy and is irregular to school, parents should
watch out, they say. Red eyes and drop in academic performance are other signs
and it would be best to seek professional help, they add.
Sometimes,
the addiction starts at home, say counsellors, as toluene is present in several
substances used in households, such as paint, shoe polish and thinners.
Some
children inhale paint while others do petrol fumes. Often they resort to theft
to support their habit.
"Unless
the government bans sale of whiteners to minors, children will continue to fall
prey to this white poison," says a 45-year-old mother, whose 15-year-old
son is in the process of shaking off his addiction to whiteners.
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