Academic journal article East Asian Archives of Psychiatry

Inhalant Abuse: A Study from a Tertiary Care De-Addiction Clinic

Academic journal article East Asian Archives of Psychiatry

Inhalant Abuse: A Study from a Tertiary Care De-Addiction Clinic

Article excerpt

Introduction

Inhalants refer to a group of psychoactive substances that get transformed to vapours and produce mind-altering effects. Inhalant use has been considered one of the most dangerous forms of substance abuse, even leading to death and serious accidents. (1,2) Commonly used inhalants include: petrol, paint thinners, paint removers, glues, typewriter correction fluids, adhesives, and varnishes. The prevalence of inhalant abuse has been reported to vary from 9 to 20%. (3,4)

The general absence of knowledge (5) is reflected in the minimal description of inhalant use disorders in the DSM-IV. (6) The attributes and patterns of this condition studied so far are limited by their sample sizes and the extent of coverage. (7-10) A recent Cochrane review failed to find any appropriate study on the treatment of inhalant abuse/ dependence. (11)

The current study therefore set out to explore the correlates of inhalant abuse of the subjects from a drug de-addiction clinic.

Methods

The study was conducted at a tertiary-level multi-specialty hospital. The study subjects were recruited from the drug dependence treatment clinic run in the institute's Department of Psychiatry and De-addiction. The patients presenting to the treatment clinic were assessed in detail and diagnosed using the DSM-IV/ICD-10 nosological systems. Subsequently an individualised treatment plan was formulated for each patient. The predominant substances of abuse observed in the clinic included: tobacco, alcohol, cannabis, and opioids. However, among children and adolescents, inhalants constituted a major group of substances of abuse.

The current study was a chart review of the cases with inhalant abuse/dependence presenting to the clinic over the 2-year period, from January 2008 to December 2009. All the treatment records of the de-addiction clinic were reviewed, and information gathered regarding patients with inhalant abuse/dependence. The definition of inhalant abuse and dependence was that used in the DSM-IV--a maladaptive pattern of inhalant use leading to clinically significant impairment or distress, as manifested by impairment in physical, occupational, legal and social domains, occurring within a 12-month period. Inhalant dependence was defined as a maladaptive pattern of inhalant use leading to clinically significant impairment or distress, as manifested by [greater than or equal to] 3 of the 7 features occurred at any time in the same 12-month period.

Information on socio-demographic parameters, which included age, gender, marital status, education level, occupation, income, family type, religion, place of residence, and the support system, was collected. For the purpose of the current study, adolescence was defined as the period between the age of 10 and 19 years, according to the World Health Organization guidelines. The nuclear family was defined as the family structure where the unmarried children stayed with their parents. The joint family was defined as the family where 2 or more married couples stayed together. Conditions of anonymity and confidentiality were strictly adhered to during the course of the study.

Information was also gathered on the substance use profile of the patients. This included the type of substances, duration of use, reason for initiation, amount used, type of inhalant used, family history of substance abuse/ dependence, history of psychiatric illness, and the level of impairment attributed to inhalant use. Previous quitting attempts and reasons for seeking treatment were also looked into.

Data Analyses

Data analysis was carried out using the Statistical Package for the Social Sciences, Windows version 17.0. Descriptive analysis of the study variables was carried out. Inter-group analyses were also conducted for subjects with and without psychiatric co-morbidity, and those with and without previous abstinence attempts. For this purpose, independent sample t tests and the Mann-Whitney U test were respectively used for parametric and non-parametric analyses. …

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