Volatile Substance Abuse Still a Problem Understand what Volatile Substance Abuse VSA is Understand the broad dangers associated with VSA Know VSA mortality rates and trends Know prevalence rates as far as is possible ID: 529826
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Slide1
Toolkit 1 Volatile Substance Abuse: Still a Problem?Slide2
Understand what Volatile Substance Abuse (VSA) isUnderstand the broad dangers associated with VSAKnow VSA mortality rates and trends Know prevalence rates as far as is possible
Know what products are used in VSAUnderstand supply side legislation
Toolkit
completion
aims
AimsSlide3
The products abused* change over timeThe glue sniffing of the past has become the butane gas and aerosol buzzing* of recent years
VSA has not gone away
What is VSA?
*see slide notesSlide4
VSA definition
The deliberate inhalation of volatile chemicals, gases and solvents found in consumer and industrial products through the mouth and/or nose, for the sole purpose of achieving a ‘high’.What is VSA?Slide5
What are volatile substances?Common terms for VSA include ‘buzzing,’ ‘huffing,’ ‘sniffing,’ ‘bagging’.Volatile Substances* comprise a large group of gases and compounds.Butane in cigarette lighter refills is the most commonly used volatile substance in recent years. It is colourless and
odourless.Butane and propane are used as the propellant in aerosols.What is VSA?
*see slide notesSlide6
The effects of volatile substancesInhalation produces rapid, short acting intoxication. Recovery from the psychoactive* phase is rapid - within 15 - 30 minutes; from the intense phase just a few minutes.
What is VSA?
*see slide notesSlide7
Appeal of volatile substancesAccessible*InexpensiveLegal, innocuous*The effect: extreme, hallucinations often reported
Readily available despite legislationEasy to concealControl: rapid intoxication and rapid resolution of intoxication: can use and return to a ‘sober’ state quicklyWhat is VSA?
*see slide notesSlide8
Some reasons why people use*“I buy mine from supermarkets online. I felt too conspicuous in shops, but no one ever questioned why I was buying 15 deodorants at a time”“There’s no dunt like a gas
dunt.”“I bet I could find something in this room.”“Buzzin’ takes me to another place….away from all the crap in my life.”“It’s been my road to hell.”“My brothers were doing it so I tried it.”“My ma drinks..….this is my drink.” “Yeah, I know I can die doing it. So what? I don’t care.”“I saw my cousin sniffing hairspray. I only did it once. Am I addicted now?”
What is VSA?
*see slide notesSlide9
“VSA is too dangerous – don't do it” ACMD
(Advisory Council for the Misuse of Drugs)*VSA Dangers
*see slide notesSlide10
VSA Dangers
Why is VSA of concern?
VSA can and does kill - even on the
first use.
Sudden Sniffing Death is unique to
VSA
(see next slide).
Almost 2,400
recorded
deaths in the
UK.
Absolute Harm Reduction is not an option – there are no ‘safe’
methods of use.
Very hidden
activity.
Associated with young people – youngest
deaths aged
7 (1997, 2003
).
But not exclusively – oldest death
85 (2008).
Legislative control
of the products used in VSA is extremely difficult, if not
impossible.*
VSA is not
illegal.*
Can cause an aggressive
effect.
*see slide notesSlide11
Sudden Sniffing Death*
Gases, aerosols, and solvents can make the heart oversensitive to the effect of adrenaline. A burst of activity leads to more adrenaline, leading to an even greater risk of death. This oversensitivity can remain for several hours following recovery from the psychoactive phase.
A heart that stops beating as a result of VSA can be very difficult to resuscitate. Defibrillation needs to be administered within 10 minutes.
VSA Dangers
*see slide notesSlide12
Mortality Medical research teams at St George’s, University of London, have provided the Trends in UK Deaths Associated with Abuse of Volatile Substances Report since 1971.
Mortality details on the following 3 slides all taken from the most recent report.*VSA Mortality
*see slide notesSlide13
Since 1971, VSA has claimed over
2,390 lives in the UK, with 327 deaths in Scotland. Up to 2000, almost 2/3 of deaths were of young people under the age of 19 with the most common age of death being 15.
The mean age of death in the UK from 2000-2009 is 30.
The youngest
deaths reported were of
7-year-olds
(2003, 1997).
VSA kills more young people aged 15 and under than all illegal substances.
Deaths by primary substance abused in 2009 in the UK
VSA Mortality
MortalitySlide14
Mortality
Standardised Mortality Ratios (SMRs)*, 2000-2009. All ages.
172
179
91
89
83
74
73
111
129
129
70
112
Government Region
SMR
2009 deaths
North East
129
3
North West
73
5
Yorkshire/Humber
112
3
East Midlands
129
2
West Midlands
111
2
East
89
4
London
70
3
South East
83
3
South West
74
0
England (all)
90
25
Wales
91
1
Scotland
172
17
Northern Ireland
179
3
VSA Mortality
*see slide notesSlide15
Males are at higher risk of death
VSA MortalityGender distribution of VSA death
2009
2000-2009
Male
35 (73.9%)
420 (78.5%)
Female
12 (26.1%)
115 (21.5%)
However
, the proportion of adult females (18-years or older) dying from VSA has increased over time, from 1% between 1983-87 (6 deaths) to 17% between 2003-07 (45 deaths).Slide16
VSA
prevalence:difficult to determine
VSA Prevalence
The British Crime Survey*
measured substance use amongst 16-59 year olds in England & Wales. Figures from the survey for 2010/11:
Experimental users rarely engage with substance misuse services
Chronic users often report
that self
stigma prevents them from disclosure and/or service engagement
Ever Used
Cocaine
9.6%
VSA
2.3%
Heroin
0.8%
*see slide notesSlide17
Reported Use of Individual Substances, Ever: 13 and 15 years old
Extract: from Table 4.6 SALSUS (Scottish Adolescent Lifestyle And Substance Abuse Survey) 2010*
Solvents, glues and gases
2008
2010
13 year-olds
2%
2%
15 year-olds
4%
3%
Poppers*
2008
2010
13 year-olds
1%
1%
15 year-olds
5%
3%
VSA Prevalence
*see slide notesSlide18
Individual Substances Offered, Ever: 13 and 15 years old
Extract: from Table 4.16 SALSUS (Scottish Adolescent Lifestyle And Substance Abuse Survey) 2010*
Solvents, glues and gases
2008
2010
13 year-olds
5%
5%
15 year-olds
9%
7%
Poppers
2008
2010
13 year-olds
2%
1%
15 year-olds
12%
6%
VSA Prevalence
*see slide notesSlide19
ESPAD 2011Lifetime VSA of 15-16 year old students in 36 European Countries. The average across these Countries is 9%. Highest Prevalence
Lowest PrevalenceCroatia 28% United Kingdom 10%Latvia 23% Ireland 9%Slovenia 20% Cyprus 8%Monaco 15% Lithuania 7%Greece 14% Ukraine 3%Malta 14% Italy 3%Sweden 11% Moldova 2%2011 ESPAD: The European School Survey Project on Alcohol and Other Drugs*
VSA Prevalence
*see slide notesSlide20
Who tries VSA? VSA cuts across all demographics – there is no stereotypical VS user.Higher risk is associated with history of trauma - just as with any type of substance misuse.
High rates of 12-16 year-olds reporting ever having used VSs were identified in the following*Those excluded from school (48%), Those who truant from school (41%)Those with impoverished living conditions/street homeless (43%)Those with a record of delinquency/criminal behaviour (26% serious offenders, non offenders 2%) VSA Prevalence
*see slide notesSlide21
What products are used?Hundreds of products found in supermarkets, newsagents, chemists, the home, DIY outlets, schools, offices, industrial sites…etc.
VSA Products
*see slide notes
Suggested classroom activities*
ACTIVITY SLIDESlide22
Products abused today*Volatile solvents:
PetrolIndustrial gluesNail polish removerPaint stripperSome correctional fluidAerosols:Hair sprayDeodorantsSpray paintPain relief sprayAir freshenerGasesFuel gas
Butane lighter gas
Nitrous oxide (whipped cream canisters)(whippets)
Nitrites: known as poppersVideo head
cleaners
Room
odourisers
VSA Products
*see slide notesSlide23
HeliumHelium is an inert gas (not a volatile substance) and causes death by asphyxiation, displacing bloodstream oxygen. Using a mask or bag, unconsciousness occurs within seconds, potentially permanent brain damage in 2 minutes, then death. The St George’s VSA Report has included an early warning on deaths associated with Helium since 2001.
There were 111 Helium deaths* in the period 2001–2009. 26 deaths in 2008, 46 deaths in 2009, 33 deaths in 2010.93% of deaths were suicides caused by asphyxia, 6% recorded as open verdict and 1% as misadventure.VSA Products
*see slide notesSlide24
The SACKI Logo*
Introduced in 1997, the use of the SACKI logo is voluntary. It does not appear on every product that may be abused.
This may lead young experimental users to identify a product without the logo as ‘safer’ than products bearing the logo.
VSA Products
*see slide notesSlide25
VSA supply - legal matters UK1. The Cigarette Lighter Refill (Safety) Regulations 1999 Butane gas
cigarette lighter refills may not be supplied or sold to under 18-year-olds. This regulation, part of the Consumer Protection Act, was added due to the large number of deaths associated with gas lighter refills. 2. Intoxicating Substances (Supply) Act 1985 (does not include Scotland: see next slide)This act prohibits the sale or supply to persons under the age of 18 of substances which may cause intoxication if inhaled, if the supplier knows or has reasonable cause to believe that the substance is likely to be inhaled for the purposes of intoxication.
VSA & The Law
The penalties for breaking either law is a maximum fine of £5,000 or up to six months imprisonment, or both.Slide26
Legal matters – Scotlandnot just age restriction*
Scottish Common Law Selling/supplying any product to anyone of any age knowing that the product will be abused for VSA has been held to constitute criminal conduct. Fines of up to £12,000 and prison sentences of 2 years have been imposed. VSA is sufficient singular cause for referral of a young person to the Children's Panel due to the danger presented during each and every episode of VSA.
VSA & The Law
*see slide notesSlide27
Contact detailsScotland: Marina Clayton Development Manager Scotland07505 000024 scotland@re-solv.org
Re-Solv UK Head Office01785 817885 information@re-solv.orgSlide28
Questions?
?
?
?
Published August 2013. Review date August
2015.