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Consumer views

Realising we have a problem with sniffing glue or other solvents is a very difficult first step to recovery. We often sniff to create a sense of wellbeing that we can't achieve in ordinary life. Slowly, our ability to resolve life's difficulties disappears. It's much easier to sniff our problems away than to do the hard work of sorting them out. For some of us, sniffing becomes the main focus in our lives and we find we need more and more of it to get the same feeling of wellbeing. In order to maintain our habit we become dishonest and this can lead to self-hatred. Our relationships with friends, family or whanau, teachers and employers fall apart. At this point we may start to feel desperate. This is often the point at which we start to reach out for help. This is when our recovery begins.

Support and information

People with major solvent-use problems need a lot of support to maintain their recovery. Some get their best support from others who have been through the same kind of experience. Other people find a professional who is supportive, or friends and family or whanau may offer good support. People who sniff solvents can make more informed choices if we educate ourselves about our condition and the types of treatment and support that are available. It's also useful to know about your rights.

Support, compassion and understanding are critical. It is great if you have family or whanau or friends to support you when the going gets hard. You might like to spend more time with people who don't use at all or don't use heavily. You might talk to someone, such as a supportive adult, about your not so good feelings.

Using services

Some people who have solvent-use problems sooner or later go to see their GP or a counsellor or are referred to specialist services. If you fear you might harm or kill yourself it is vital that you seek help immediately. Sometimes it is hard for people who sniff solvents to seek help, either because we want to hide their sniffing, or because we feel well and don't agree we have a problem. Acknowledging we have a problem and need help can be very scary.

Reducing the risks

If you've made up your mind to try solvents and nothing is going to change this, here are a few things to remember so that you can be as safe as possible.

• Make sure you are with friends or people who can look after you if something goes wrong.
• Don't sniff on your own or wander off alone. The effects of solvents will hit you so quickly you might not be able to handle them and could feel out of control.
• Never spray aerosols directly down your throat. They are extremely cold and can freeze your throat and cause your breathing to stop. This is very serious and you could die.
• Many solvents are flammable, so never use lighters or matches around solvents.
• Putting plastic bags over your head can cause you to suffocate.
• Don't drive after you have used solvents, as your responses will be affected.
• If you have a mental health problem or a family history of mental health problems it may be more risky for you to use drugs of any kind, including solvents.
• If you are using solvents because you want to block out feelings of pain, sadness, depression or anger it may be better to talk to a friend or supportive adult about what's going on for you.

Family and whanau views

Solvent abuse can tear families and whanau apart. Families and whanau may find their relative secretive, withdrawn, moody and irritable. They often feel powerless to know what to do. Their feelings for their relative can swing from concern for their difficulties, to hostility towards their relative for disrupting their lives. Families and whanau often live through all this without support from their community or from health services.

Support and information

Families and whanau often feel drained and stressed and need support to look after themselves as well as their relative who sniffs. Their other family or whanau relationships can get neglected when the needs and disruptive behaviour of the person who sniffs take over. There are several ways families and whanau can get support. They can get in touch with other families and whanau who have had similar experiences. Some drug and alcohol services provide good support options for families and whanau. Families and whanau need information on the person's condition, their options for treatment and their rights.

Experiences with services

Ideally families and whanau who are involved in caring for someone who sniffs solvents need to be able to communicate freely with professionals about their relative. They may also need some professional help to mend any damage that has occurred in the family or whanau because of their relative's sniffing.

Emergency management

If someone is high on solvents and needs help:

• try to keep calm
• stay with them as long as the situation is safe
• remove the solvents from them
• don't light a smoke or give them a cigarette
• try to sit them upright
• if they are unconscious put them in the recovery position, if you know it
• reassure the person that they are going to be okay
• call an ambulance and don't be afraid to tell the emergency workers what has been taken.

Getting help and support

It is important to remember the great majority of young people found using solvents do not need intensive treatment, they need good information, support and understanding.

If you are concerned about your own or another person's solvent/inhalant use it may be useful to talk to someone who is trained to help. There are a number of alcohol and drug services to help people (and their Family or whanau/partner when this is the choice of the person seeking help) to deal with their solvent abuse or other drug problems. These services are free of charge and clients are entitled to confidentiality.

Help may also be available from a general practitioner, youth worker or other counsellor skilled in drug/alcohol treatments.

Psychosocial treatments

Counselling or psychological help

You might need to consider other problems or difficulties in your life which cause you worry or stress. Some people misuse solvents because they have had painful or difficult experiences. Sometimes people who have grown up with violence, verbal or other types of abuse, use drugs as a way of coping with unpleasant memories or emotional pain. Using drugs can seem to help ease the memories and the pain, but usually this is not a good long-term answer. After the drug wears off the problem is still there. It may be helpful to get counselling to talk about and help resolve other problems or difficulties.

Drug and alcohol services referred to above or at the end of this article will direct you to an appropriate counsellor or therapist.

All types of therapy/counselling should be provided in a manner which is respectful and with which you feel comfortable and free to ask questions. It should be consistent with and incorporate your cultural beliefs and practices.

Groups, organisations and websites

ADA - Alcohol Drug Association, New Zealand
Confidential information, advice and referral service for people with questions about their own or someone else's drinking or drug use.
Freephone 0800 787 797, 10am - 10pm daily
www.adanz.org.nz

ALAC (Alcohol Advisory Council)
Information, resources and very comprehensive links to other sites
Freephone 0508 258 258
www.alcohol.org.nz

Alcoholics Anonymous (AA)
A self-help organisation for alcoholics. This is a nation-wide number where you will be directed to an AA contact in your area.
Freephone 0800 229 675

Al-Anon
For friends, family, whanau and supporters of someone with an alcohol problem
Freephone 0508 425 2666
Phone 09 309 4792

Alcohol and Public Health Research Unit
Surveys, statistics, and research on current issues
www.aphru.ac.nz

Care NZ (formerly NSAD)
Offices in Wellington, Auckland and Hamilton. Support and treatment for those at risk or dependent on alcohol and drugs, in the community and the workplace.
6th Floor, Polo House
267 Wakefield Street
WELLINGTON
Ph 04 385 1517
Fax 04 385 1516
Web www.carenz.co.nz

FADE
Training, information and resources
www.fade.org.nz

The New Zealand Drug Foundation
Information for organisations and individuals
www.nzdf.org.nz/

Alcohol and Drug Centres
Most areas have a drug and alcohol centre which will have some pamphlets and information sheets. Contact the Citizen's Advice Bureau or your GP for details.

Ministry of Youth Affairs
Information and material available. Can put people in touch with local resources.
Ph 04 471 2158 (Sandra Meredith)

Websites

Urge/Whakamanawa
www.urge.org.nz

Re-Solv
www.re-solv.org/index2.htm

National Inhalant Prevention Coalition
www.inhalants.org/

Books

Buzzed: the Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy by Cynthia Kuhn, Scott Swartzwelder, Wilkie Wilson, Jeremy J. Foster (Contributor), Leigh Heather Wilson (Contributor). W.W. Norton & Company, 1998.

Inhalant Drug Dangers by Judy Monroe. Enslow Publishers Inc., 2002.

Inhalants by Myra Weatherly. Enslow Publishers Inc., 2001.

Solvents and inhalants

Solvents are substances produced from organic chemicals. They have a large number of household, commercial and industrial uses as, for example, fuels, cleaning fluids, toiletries, glues, fillers, paint and thinners.

A common characteristic of all these substances is their volatile nature - that is, they evaporate rapidly when exposed to air and give off chemical fumes. Some solvents are gaseous by nature, some fume at room temperature and some vaporise if heated.

People use solvents to get high or out of it. Because solvents are sniffed or inhaled they are also called inhalants. People have inhaled substances over thousands of years, so this is not a new behaviour.

Since the 1950s the number of products that contain volatile solvents has increased dramatically. Households contain a large number of solvents, including such things as petrol, glues, spray paint, thinners, propellant gases used in aerosols, hair spray, air fresheners, cigarette lighter fuels, nail polish remover, correction fluid and thinners, marker pens and aftershave.

How solvents and inhalants work

When inhaled, solvents enter the bloodstream directly from the lungs. The chemicals in solvents are fat soluble and rapidly reach the brain and other body organs, so the effects are felt very quickly.

Solvents have a central nervous system depressant effect - that is, they slow down the brain functions. Even in small doses, solvents produce temporary distortions to how people sense and see things.

Some solvents are broken down and excreted through the kidneys, while many are breathed out through the lungs. Because of this, the solvent smell may remain on the person's breath for several hours after they have inhaled.

Solvent and inhalant users

Children and teenagers are the usual users of solvents. It is not illegal to use solvents in New Zealand.

In 1990 a large survey of drug use in New Zealand found that only 0.9 percent of those surveyed had ever tried solvents. Two percent of those aged 15 to 17 reported having tried solvents, with no use in the past 12 months for women over 17 and men over 19 years of age. This survey did not include young people under 15 years of age, but did confirm that solvent use is usually confined to children and teenagers.

This study and other research and anecdotal evidence indicates that very few people try solvents and, of those who do, only a very small percentage develop serious problems from using them.

How solvents and inhalants are used

Usually solvents are inhaled directly from their container or a bag of some kind. Alternatively a rag or handkerchief soaked in solvents is held over the nose or mouth. It is not uncommon for people using solvents to increase the effects by concentrating the fumes in an enclosed space - a cupboard, room, or area under the house. A really dangerous method of using solvents is to cover the head and shoulders with a plastic bag. If the solvent is heated a more concentrated vapour can be produced.

Aerosols can be sprayed directly into the mouth and are highly dangerous when used like this.

Types of solvent and inhalant use

Experimental use

Experimental use is usually by children or young people who try solvents because others are doing it. They are curious and solvents are available and cheap. Sniffing doesn't go beyond a few episodes and they are usually not harmed by experimentation. There can be exceptions to this, as some solvents can be dangerous the first time they are used.

The biggest risk facing experimental users of solvents is their inexperience and lack of good information about both the products they are sniffing and the least harmful ways of sniffing.

Only a very small proportion of those who try sniffing continue. Most young people stop after a short period of time. If you find children or friends sniffing, it is highly likely this is experimental use, so it is important to keep a perspective on the behaviour and wait for the young person to recover before discussing the situation.

Social use

Social use includes young people who, after experimentation, continue to use solvents occasionally in a recreational or social way with friends.

People who sniff socially tend to know more about solvents than experimental users so are less likely to be damaged by their use. Social use tends to stop by mid adolescence when other drugs such as alcohol and tobacco may be used.

Problematic use

Solvent use can be considered problematic when people start to see their solvent use as more important than other activities or if problems from solvent use arise. Indicators of problematic use include hassles with friends or family, health effects, financial pressure and beginning to use solvents as a way to manage difficult feelings, stresses or situations.

Chronic use

Only a very small number of those who ever use solvents will become chronic users. With chronic use, more regular and increasing amounts need to be taken to get the same effect. They may use alone or with others.

Those who use chronically often have difficulties at home, such as instability, disruption, family poverty and/or drinking problems, behaviour problems, low achievement at school, depression and anxiety. They often use solvents as a way of managing their problems. Chronic solvent use can be viewed as a symptom of underlying problems.

The decision about what is chronic use depends on the amount and type of solvents used, how often, the reasons why they are used and the degree of damage to the person that can be seen.

Effects of solvent and inhalant misuse

The effects of solvent misuse vary from person to person and situation to situation, so it is hard to predict what one individual's reaction will be.

Any drug effect depends on a combination of the drugs taken; the way they are taken; the strength of the drug; how experienced the person using them is; their general and mental health; the person's mood when they take the drug; their individual responses and the setting in which use occurs.

Short-term effects

The person using solvents will often experience an initial feeling of wellbeing and relaxation. They may feel excited, exhilarated, dizzy, be disinhibited (behaving in ways that are not usual for them), have blurred vision, experience flashes of light, ringing in the ears or become agitated.

Acute intoxication with solvents is similar to being drunk on alcohol, but comes on more quickly and lasts a much shorter time. The physical effects of solvent use may last up to 45 minutes, however the high usually lasts only seconds or minutes. Experienced users may prolong the effects by concentrating the drug inside a plastic bag.

If more solvents are used people can become much dizzier, restless, confused and lose control of their body and feelings. This loss of control can be dangerous as people can injure themselves. At times solvents encourage aggressive or dangerous behaviour.

Other likely effects of continued use of solvents are sleepiness, vomiting, chest pains, nose bleeds, bad headaches, breathing problems (especially if the person has asthma), muscle weakness, hallucinations and unconsciousness.

Most solvent users recover quickly from these effects which usually disappear within a few minutes to half an hour if sniffing is stopped. The after effects of solvent misuse may be a hangover-like feeling for up to 24 hours, including headaches, tiredness, looking pale, poor concentration and nausea.

The harm most often associated with volatile substances is how and where they are used. Accidents or death can be the result of people sniffing in stressful or unsafe places, such as on a busy road, near a railway line or on a roof. Sudden death due to cardiac arrest has been known to occur on rare occasions, particularly if the person using solvents engages in sudden strenuous activity or gets a significant shock. It is also likely to occur with certain solvents that have additives to increase their effectiveness as a solvent.

Long-term effects

With continued use, tolerance to the effects of solvents develops, that is, the body adapts to the solvent use and people need more and more to get the desired effect.

Psychological dependence develops in a small number of people, as they come to rely on solvents more to manage their life. This sort of dependency means that solvents can become central to a person's thoughts and actions. They may spend large amounts of time thinking about solvents, about how they are going to get them and when they are next going to use them.

Physical dependence (where the person develops withdrawal symptoms such as sweating, shaking or confusion) on solvents is rare, but can occur.

As well as the effects described in the section above, constant use of solvents can cause nose bleeds, bloodshot eyes, bad breath and thirst. Continued use can cause weight loss, trembling and depression. These effects are likely to clear up once sniffing stops.

Regular use over a long period of time can be serious because the side effects can become more permanent. Memory loss, brain damage and personality changes can occur, as well as nerve damage, weakness and fatigue.

Heavy solvent use over a long period of time (five or more years) has resulted in a number of reports of brain and nervous system damage. Long term use of aerosols and cleaning fluids has been known to cause lasting kidney and liver damage and to cause hallucinations. Repeated sniffing of leaded petrol can cause lead poisoning which can cause various types of cancers.

Some solvent products, particularly aerosol gases and cleaning fluids, can make the heart sensitive and cause heart failure, especially if people physically exert themselves when using. Because many inhalants contain more than one volatile solvent it can be difficult to identify the specific chemicals that do damage. On rare occasions people do die from sniffing solvents, sometimes from cardiac arrest.

The only products that are known to cause death in even first-time users are aerosols and fire extinguishers - the fluorocarbons in these products can cause heart or respiratory failure.

Other possible effects of solvents

Because of the large variety of solvents there can be a wide range of problems blamed on solvent use.

There is no evidence that sniffing will progress to the use of other drugs. However, solvent use does indicate the young person is willing to try substances.

There is mixed evidence that the chronic or long-term use of solvents causes withdrawal symptoms when stopped.

The permanent effects resulting from specific solvents are somewhat unknown. There are some indications that solvents can damage the liver, kidneys, eyes, heart and bone marrow. However the true prevalence and nature of brain damage, even among chronic users, is not fully clear, especially when other drug use and injuries are put into the equation.

Little is known about the effects of solvents on pregnancy and the growth of the developing baby. One study found that babies whose mothers used toluene (found in some paints and glues) when pregnant had developmental delays, behaviour problems and some head and limb abnormalities.

There has been little research on the mental health effects of solvent use. However it is likely that solvent use will worsen existing mental health problems and may produce problems where none have previously been evident.

Signs of solvent and inhalant abuse

Some of the possible signs of solvent use include:

• rashes around the nose and mouth, eye redness or swelling, irritation of the chest and throat with coughing or gagging
• nausea, vomiting and weight loss
• headaches
• skipping school and disappearance from home
• hangover-type symptoms, e.g slurred speech or uncoordinated behaviours; a change in sleeping patterns; staying up late and not wanting to get out of bed
• moody, irritable or withdrawn behaviour.

Some of these signs like staying up late, withdrawing from the family or whanau, and acting up - are part of being an adolescent. It is important not to over-interpret these things as a definite sign of drug taking. More direct evidence that children or adolescents are sniffing might include:

• the disappearance of aerosols, glues, perfumes and petrol from around the home
• empty solvent containers or plastic bags
• the remains of solvents on bedclothes or the lingering smell of solvents
• a definite smell of solvents detectable on the breath
• glue stains on clothes.

Parents and family or whanau members will react differently when they find out that their child has been sniffing. If possible, it is worth considering the best way to react and not instantly punish the child. Most young people will become defensive about their sniffing and setting up conflict and confrontation is not useful.

Many young people change their drug use when they come to better understand the possible harm to themselves or others. Most sniffers are young and don't know a lot about the effects of sniffing, so providing information about solvents is useful.

Young people discovered sniffing also need to know that they have the security around them to make changes. Talk to your child about what is going on, your concerns, assure them of your love and that you want to help.

The Health and Disability Commissioner Act 1994

This Act governs all actions taken by the Health and Disability Commissioner, the office and advocacy services. It is the legal document which gives the authority to ensure the rights are delivered. The purpose of the Act is

"To promote and protect the rights of health consumers and disability services consumers, and, to that end, to facilitate the fair, simple, speedy, and efficient resolution of complaints relating to infringements of those rights" (Section 6).

The Act’s objective is achieved through

• the implementation of a Code of Rights (see below)
• a complaints process to ensure enforcement of those rights, and
• ongoing education of providers and consumers.

Code of Health and Disability Services Consumers' Rights

There are ten rights set out in the code and these rights apply to all health and disability support services in New Zealand, both public and private services. The code gives rights to all people who use health and disability services and describes the obligations of all providers of health and disability services. The Health and Disability Commissioner contracts advocates in each region to ensure the code is upheld.

To make a complaint to the advocate in your region, contact the office of the Health and Disability Commissioner.

The Health and Disability Commissioner
Freephone 0800 11 22 33
E-mail hdc@hdc.org.nz
Web www.hdc.org.nz

AUCKLAND
Level 10, Tower Centre
45 Queen Street
PO Box 1791
Auckland
Ph 09 373 1060
Fax 09 373 1061

WELLINGTON
Level 13, Vogel Building
Aitken Street
PO Box 12 299
Wellington
Ph 04 494 7900
Fax 04 494 7901

The Privacy Act 1993

The Privacy Act sets out general rules about the protection of our personal information. Extra rules have been developed to protect health information. These rules are set out in the Health Information Privacy Code, which is contained within the Privacy Act.

The Health Information Privacy Code sets out 12 rules that agencies must follow when dealing with health information. These rules cover the collection, storage, use and disclosure of health information, and give you the right to access and correct your health information.

The code applies to you whether you are receiving health services voluntarily or under the Mental Health Act.

Under the code, health services can develop their own policies for dealing with health information. You are advised to ask for a copy of their policies. Health services must appoint a Privacy Officer, so find out who that person is in the service you are dealing with. You may request information from or make a complaint to the service’s Privacy Officer.

The Privacy Commissioner.
Freephone 0800 803 909

Office of the Privacy Commissioner
PO Box 466
AUCKLAND
Ph 09 302 8655
Email privacy@iprolink.co.nz (Auckland)
            privacy@actrix.gen.nz (Wellington)
Web www.privacy.org.nz

Further information

On the Record: A Practical Guide to Health Information Privacy, Office of the Privacy Commissioner, 2nd edition, July 2000.

Protecting Your Health Information: A Guide to Privacy Issues for Users of Mental Health Services. Mental Health Commission, 1999.

The Mental Health (Compulsory Assessment and Treatment) Act 1992

For a person to be compulsorily assessed and treated it must first be determined that they have a mental disorder. The definition of ‘mental disorder’ is described in the Act.

The Act sets out clear procedures that must be followed when a person is compulsorily assessed and treated. People under the Act lose their right to choose and consent to assessment and treatment. All other rights as described in the Health and Disability Commission’s Code of Rights remain.

To ensure a person’s rights are upheld and correct procedures are followed the Minister of Health appoints District Inspectors for each area. They are lawyers and you may request information from or make a complaint to them. You can find out who the District Inspector for your area is by contacting the Ministry of Health or your local community law centre. (Contact details are at the front of this section)

In general, the Act gives young people (16-19 years) the same rights as adults. For people under 16 there are additional protections.

The Ministry of Health publishes helpful user information guidelines on the Mental Health Act. Contact details for the Ministry are at the front of this section.

Further information

The Mental Health Act: Information for Families and Whanau, Schizophrenia Fellowship.

The Schizophrenia Fellowship (SF)
Freephone 0800 500 363

National Office
PO Box 593
Christchurch
Ph 03 366 1909
Fax 03 379 2322
Web www.sfnat.org.nz
Email office@sfnat.org.nz

Look in your telephone directory for the local Schizophrenia Fellowship.

The Children, Young Persons and Their Families Act 1989

This Act applies in two situations.

• When it is decided that children and young people are defined as needing care or protection and,
• where children or young people offend against the law.

This Act defines a child as someone under the age of 14, and a young person as someone who is 14 or over but under 17 years of age. If concerns have been raised about a child or young person’s care or protection in the first instance, an informal meeting is usually called with the family and a social worker.

Formal options available through this Act are:

• family group conference
• application to the Family Court
• removal of the child or young person.

Care and protection issues may mean the involvement of The Child Youth and Family Service (CYFS). Look in your telephone directory under Government Agencies for contact details for your local CYFS.

For more information, it may be helpful to contact:

The Office of the Commissioner for Children
PO Box 5610
WELLINGTON
Ph 04 471 1410
Fax 04 471 1418
Email children@occ.org.nz
Web www.occ.org.nz

Youthlaw Tino Rangatiratanga Taitamariki
Provides free, confidential legal information and advocacy for young people under 25, anywhere in Aotearoa New Zealand.
PO Box 7657
Wellesley Street
AUCKLAND
Ph 09 309 6967
Fax 09 307 5243
Email youthlaw@ihug.co.nz
Web www.youthlaw.co.nz

The Criminal Justice Act 1985

This Act sets out rules that apply to people who have been charged with, or found guilty of committing some kind of criminal act.
One part of the Act applies to situations where a person is experiencing a mental illness AND has been charged with or found guilty of committing some kind of criminal act. A person in this situation can become a ‘special patient’ under the Mental Health (Compulsory Assessment and Treatment) Act 1992.

The Protection of Personal Property Rights Act 1988

This Act describes what can happen legally when a person is unable to make all or some of their own decisions about their personal and property matters. This is called a lack of capacity. The Family Court decides if a person lacks capacity.

In some cases, the Family Court may appoint a welfare guardian for someone who is unable to make these decisions. A welfare guardian has the power to make a wide range of decisions, such as where a person lives and how they should be cared for. A welfare guardian can act and consent to treatment on that person’s behalf.

Family Court contact details are listed at the front of this section.