The New Straits Times, April 23, 2000
By Prof Dzulkifli Abdul Razak
LAST November, I received an e-mail regarding an article entitled `Generation Gap' by one Dave Barry (The Washington Post, Nov 7, 1999). The writer quoted a news item from the Straits Times of Singapore:
`TAIPEH: Some young Malaysians are sniffing cow dung to get high, according to a lawmaker. "They look for fresh cow dung and, on locating it, put a large tin can over it, pierce a hole at the top and sniff through it," Perak State Assemblyman Mat Isa Ismail said on Saturday.
He said that this was becoming a trend.'
While cow dung sniffing may not be such a big fad (not yet!) as claimed, it has a pertinent message: sniffing gas or fumes may be a problem we have long under-estimated.
After all, this is what inhalant abuse is all about. By definition, it refers to the intentional breathing of gas or fumes for the purpose of reaching a high. It does not matter what the source is - it could well be methane gas released from fresh cow dung.
Examples of other sources are abundant, including common items such as typewriter correction fluids, felt-tip markers, spray paints, air-fresheners, cooking gas and sprays. Even air-conditioning refrigerants are not spared. Freon, the substance in home air-conditioning units, has been inhaled causing death in the US.
The death of three young Malaysians recently, allegedly due to glue-sniffing, has again struck a blow to our strategy against drug abuse. Even as we concentrate on amphetamine-type stimulants (ATS) and narcotics, a glue-sniffing story hit the front-page (NST, April 11). Judging from the headline `Little info on inhalant abuse' we seem to be in the dark as to the popularity and dangers of inhalants among the young, a phenomenon described as "the silent epidemic".
Since inhalants are not illegal and are readily found everywhere, it is not surprising that they are easily abused - even by schoolchildren.
"Inhalants pack an immediate high - just the sort of instant gratification kids go for," said one expert. The high can bring feelings of euphoria, lightheadedness and exhilaration, as well as hallucinations.
According to the Malaysian Crime Prevention Foundation, as many as 459 schools in the country are said to be in high-risk areas and noted, among others, for "drug trafficking and addiction" (NST, April 14).
This raises the question as to how vulnerable our schoolchildren are to "the silent epidemic" and we what can do to prevent it.
The American Academy of Pediatrics found that children's first inhalant use typically begins between 6-8 years, peaking at about age 14.
Because inhalants are not drugs per se, many remain oblivious to their use and dangers. Their symptoms, too, are not easily recognisable. The effects are generally short-lived, thus more difficult to spot than ganja or alcohol abuse.
There is no need for `pushers' or hiding places. There is no special apparatus required, nor needle marks nor track scars to give abusers away.
Like tobacco and alcohol, inhalants are toxic with severe ramifications to the nervous system. They can certainly kill, as the recent tragedy illustrates. In fact, due to their risks, inhalants are dubbed `Russian roulette in a can' because users can die at any time. There is always the possibility of "sudden sniffing death" for for first-time or regular users.
In the US, reportedly more than a million people used inhalants to get high just last year. The US National Institute on Drug Abuse reported that one in five teens has used inhalants either by sniffing, snorting, bagging (inhaling from plastic bags) and huffing (inhaling from soaked cloth).
Significantly, the glue-sniffing tragedy has opened up the Pandora's Box. While we were told that ATS such as Ecstacy and syabu are fast becoming a new threat in the illicit drug market, nothing much is being said of the licit market. As we continue to pour resources to control the former, seemingly we have neglected the licit sources which has the potential of being `silently' abused.
In fact it can be more worrying, because the list of such licit substances is virtually endless. Each one of them could be legally bought from just about any outlet nationwide, unsuspectingly and without any fuss at all.
Just any product containing chemicals such as acetone, butane, fluorocarbon, methylene chloride and methanol, propane tetrachloroethylene, toluene, trichloroethane and trichloroethylene are all potentially open to abuse. Some can be found in adhesives such as glues and rubber cements; others in aerosols like hair sprays, paint sprays, deodrant sprays, fabric protectors or air freshners, or in cleaning agents such as degreasers and spot removers.
It may well be in solvents such as paint removers and thinners, polish removers, correction fluids, lighter and fuel gas as well as gasoline. Even fire extingusher containing bromochlorodifluoromethane is not spared. So is food like whipped creams involving the whipped cream propellant.
Thus overnight, inhalants have joined the rank of tobacco and alcohol to make up the three toxic substances potentially abused mostly by teenagers and schoolchildren.
But this phenomenon is not strictly confined to youths in schools only. A more recent study in the US identified similar exposures implicating teenagers in workplaces. The study reported that the most common substances involved are cleaning agents, solvents, paints, in addition to caustics and bleach, some with known abuse potentials.
These substances are often used in the entry-level jobs frequently filled by adolescents and school-leavers. Since many of these jobs are in small businesses or homes, they are often not closely regulated by government agencies. The study is carried out by Harvard Medical School, Children's Hospital and the Massachusetts Poison Control System in Boston.
Now that the Pandora's Box is wide open, we must seize the opportunity to strategise more effectively at least for the three licit substances - inhalants, tobacco and alcohol. Even when not involving death, each can cause a myriad of related diseases and severe long-term health risks. All are addictive, as serious as that of dadah abuse. In the new strategy they should be dealt with as dadah. Inhalants do cause physical and psychological addiction and abusers suffer from withdrawal symptoms.
Thus we cannot go on talking and advocating a dadah-free environment without equally emphasing tobacco-free, alcohol- and inhalant abuse-free environment as well. The dichotomy of dadah and so-called non-dadah is creating unnecessary barrier and false perception in the planning and deployment of resources to combat the mounting substance abuse problem confronting the younger generations.
It is abundantly clear now that there is no limit to any form of substance abuse, including those seemingly harmless products. We must act fast to respond to these changing dimensions, like mandating clear warning labels and also product advertising, direct or indirect, apart from effective education and enforcement. Otherwise soon enough we may have to deal with the problems `fresh cow dung' too.
