Tuesday, 23 July 2013


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.

  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.


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.


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.


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.


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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