A case of multiple trauma and lighter gas inhalation

The rate of volatile substance abuse is increasing among young people around the world. A 10-year-old boy was brought to the emergency room by the 112-emergency ambulance service due to fall from the roof of a four-storey building. His general medical condition was moderate-poor; his GCS (Glasgow Coma Scale) was nine, blood pressure: 118/90 mmHg, heart rate: 98/min, O2 saturation was: 100%. Skin abrasions were present on his jaw and the occipital region of the scalp. The patient was accepted as a multiple trauma patient. When the patient's confusion did not resolve, the patient's father informed us that the child may have inhaled lighter gas. The patient was hospitalized at the pediatric ward and was discharged on the 14th day of admission as his symptoms completely improved. Clinicians should be alert with regard to acute and/or chronic end-organ damages in the cases of gas inhalation without any antidote.

Effects of volatile substance abuse on the respiratory system in adolescents

Aim: Inhalant abuse is a prevalent and often overlooked form of substance abuse in adolescents. Chronic inhalant abuse can damage respiratory, cardiac, renal, hepatic, and neurolog- ic systems. This study aims to determine the physiologic effects of inhaling solvents on the respiratory functions. Methods: The general health status of the subjects was assessed by history taking, physical examination and a questionnaire which was designed to show the severity of respiratory symp- toms. Spirometry, ventilation/perfusion scintigraphy, and high resolution computed tomography (HRCT) were performed to assess pulmonary functions and anatomy. Results: Thirty-one male volatile substance abusers and 19 control subjects were included in the study. The mean age of onset of inhalant use was 14.6 ± 2.2 (9-18) years and dura- tion of drug use was 3.7 ± 1.7 years. The most common respi- ratory symptoms in volatile substance abusers were nasal congestion (45.2%), sputum (38.7%), exercise intolerance (32.3%) and cough (22.6%). Results of spirometric studies showed 12 (41.4%) subjects with low FVC values < 80% of predicted, indicative of restrictive ventilatory pattern in the study group. Although the difference was not statistically sig- nificant, restrictive ventilatory pattern was higher in the study group. There was no statistically significant correlation between restrictive ventilatory pattern and the age of onset/duration/frequency of inhalant abuse, respiratory symptoms and scintigraphic abnormalities. Subjects who had restrictive pattern in their pulmonary function tests were more likely to have abnormal findings at HRCT (p < 0.01). Conclusion: This study has shown a positive correlation between volatile substance abuse and the development of restrictive ventilatory pattern, but more comprehensive stud- ies are needed for more precise conclusions.

Silent deaths: a commentary on new mortality data relating to volatile substance abuse in Great Britain

Purpose The purpose of this paper is to provide a commentary on new information from the Office for National Statistics (ONS) on deaths caused by volatile substance abuse (VSA) in Great Britain which occurred between 2001 and 2016. Design/methodology/approach Comparing the new study with previous mortality data, the authors consider the strengths and some limitations of the analysis provided by ONS. Findings By utilising a broader range of codes and collating additional information from death certificates, the new report provides a more comprehensive measure of VSA mortality than was previously available, showing increasing prevalence of deaths. The age profile of people dying is older than in previous studies. Most deaths were associated with inhalation of gases and almost three-quarters of deaths involved volatile substances alone. Practical implications Understanding VSA mortality is essential for service planning. It is important that we identify why so many people whose deaths are associated with VSA are not accessing treatment, with particular concern about treatment access for those who only use volatiles. Training to support drug and alcohol and other health service staff to respond to VSA is essential. In future reports, data to identify socioeconomic correlations of VSA deaths would enable targeted responses. Additionally, information on whether deaths occur in long term rather than episodic or one-off users could enable risk reduction education. Originality/value This paper shows how data on VSA deaths may inform for policy and service planning.

Applying the lessons of VSA to new psychoactive substances

Purpose – The purpose of this paper is to explore whether there are ways in which the preventive strategies used to tackle volatile substance abuse (VSA) can be usefully applied to today’s new psychoactive substances (NPS). Design/methodology/approach – In 2010-2013, with funding from the Big Lottery, Re-Solv, in partnership with St George’s, University of London, and educari, commissioned a re-analysis of both the mortality data relating to VSA and of the legislative and preventative measures taken that may have played a part in the steady downward trend in VSA mortality since. This paper is informed by Re-Solv’s research findings and the papers resulting from it, namely, Ives (2013) and Butland et al. (2013). Findings – Efforts to reduce the harm from NPS could benefit from a re-examination of preventive approaches to VSA, which have resulted in a downward trend in mortality over the past two decades. Social implications – There is evidence from past prevention practice which could be relevant and applied to present day concerns about drugs and substances not previously available or used. Originality/value – This is the first paper to explore how learning from VSA might be applied to NPS and the “legal highs” of today.