Cognitive and clinic profile of volatile substance users / Perfil cognitivo y clínico de usuarios de sustancias volátiles

Abstract Introduction Inhalant use disorder has increased in spite of its adverse medical consequences. Due to the inherent difficulties of working with this population, so far there has been no quantifiable clinical evidence of the cognitive characteristics of inhalants users in early withdrawal and the clinic effect of consumption time. Objective To evaluate the clinical and cognitive performance of inhalant users and the clinic effects of consumption time. Method A cross-sectional study in which 28 adult users of inhalants were included, divided in two groups according to their consumption time: less than or greater than seven years. They were all evaluated in terms of clinical and neuropsychological values. Results Consumers of inhalant showed presence of craving (M = 479.14, SD = 213.51), altered frontal behavior before (M = 119.18, SD = 29.53) and now (M = 130, SD = 33.03), sleeping problems (M = 8.93, SD = 3.4), and cognitive difficulties (inhibitory control, planning, decision-making, working memory, verbal fluency, and cognitive flexibility); all these tasks were statistically significant (p = < .05). Discussion and conclusion Executive functioning is impaired with inhalant use disorder; these alterations increase with withdrawal and craving and changes remain independent from the use time.

Resumen Introducción El trastorno por uso de inhalables ha aumentado a pesar de las consecuencias médicas adversas. Debido a las dificultades que entraña trabajar con estas poblaciones, hasta hace poco no había evidencia clínica cuantificable de las características cognitivas de los usuarios de inhalables en la abstinencia temprana y de los efectos clínicos del tiempo de consumo. Objetivo Se analizó el rendimiento clínico y cognitivo de usuarios de inhalables y los efectos clínicos del tiempo de consumo. Método Estudio transversal en el que se incluyeron 28 adultos usuarios de inhalables, divididos en dos grupos dependiendo del tiempo de consumo, menor o mayor a siete años. Todos fueron evaluados en términos de valores clínicos y neuropsicológicos. Resultados Los consumidores de inhalables mostraron presencia de craving (M = 479.14, SD = 213.51), comportamiento frontal alterado antes (M = 119.18, SD = 29.53) y actualmente (M = 130, SD = 33.03), problemas para dormir (M = 8.93, SD = 3.4) y dificultades cognitivas (control inhibitorio, planificación, toma de decisiones, memoria de trabajo, fluidez verbal y flexibilidad cognitiva); todas estas tareas fueron estadísticamente significativas (p = < .05). Discusión y conclusión El funcionamiento ejecutivo se ve afectado en el trastorno por uso de inhalables. Estas alteraciones aumentan en la abstinencia y en la apetencia, y los cambios se mantienen independientes del tiempo de uso.

Activo distribution and paraphernalia among "street children" / Distribución del activo y la parafernalia entre "niños de la calle"

Abstract Introduction The use of solvent inhalants has been documented in Mexico since the 1970s. Nevertheless, very little is known about the distribution and use dynamics among "street children". Few have ventured to study this issue because of the difficulties involved in working with marginalized, relatively inaccessible populations. Objective To analyze the distribution and consumption dynamics of activo, as it is known among street children in downtown Mexico City, and to document the paraphernalia and argot associated with these practices. Method This is a qualitative, descriptive, and interpretative study guided by the "Meeting Place" approach used by Hughes (1977), which has been adapted to Mexican population by Ortiz (1979). We also used ethnographic observation techniques and a social and immersion mapping of street spaces that allowed us to contact and relate to both informants and users. Results We identified activo distributors and storage areas; user groups were made up of men and women in a 7-3 ratio; physical and psycho-social characteristics of sellers and users, and some street argot and paraphernalia that allowed us to understand the dynamics of distribution and consumption. Discussion and conclusion The activo market is both captive and hidden; it is detrimental to the physical and mental health of street children, and is fostered by social exclusion and the lack of legislation.

Resumen Introducción El consumo de solventes inhalables se ha documentado en México desde la década de 1970; sin embargo, poco se sabe sobre la dinámica de distribución y consumo entre los "niños de la calle". Este tema se ha estudiado poco por las dificultades inherentes al trabajo con poblaciones marginales y de difícil acceso. Objetivo Analizar la dinámica de distribución y consumo del "activo" entre los "niños de la calle" de la zona centro de la Ciudad de México, así como documentar la parafernalia y el argot asociados a estas prácticas. Método Es un estudio de tipo cualitativo, de carácter descriptivo-interpretativo, guiado por el enfoque llamado "Lugares de Reunión" empleado por Hughes (1977) y adaptado a población mexicana por Ortiz (1979). También se emplearon técnicas etnográficas de observación, mapeo social e inmersión en los espacios de calle, que sirvieron para contactar y establecer un vínculo con los informantes y consumidores. Resultados Se identifican distribuidores y zonas de almacenamiento del activo; grupos de consumidores formados por hombres y mujeres en una proporción de 7 a 3; signos físicos y características psicosociales de vendedores y usuarios, así como el argot y parafernalia; lo que permite comprender la dinámica de distribución y consumo. Discusión y conclusión El mercado del activo es cautivo y oculto, deteriora la salud física y mental de los "niños de la calle" y es promovido además por la exclusión social y la falta de legislación.

Analysis of the Utilization of Respiratory Inhalants in 34 Hospitals from Nanjing Area during 2012-2014 / 中国药房

OBJECTIVE:To provide reference for rational use of respiratory inhalants. METHODS:The utilization of respiratory inhalants in 34 hospitals from Nanjing area during 2012-2014 was analyzed by SPSS13.0 software in respects of DDDs,consumption sum,DDC,health insurance and self-paying cost and so on. RESULTS:Respiratory inhalants involved 4 kinds of drugs, 5 kinds of dosage forms,12 kinds of general name and 38 kinds of trade name(specification)in 34 hospitals from Nanjing area during 2012-2014. The total DDDs and total consumption sum of respiratory inhalants increased from 10 827.46×103 and 71,006, 500 yuan in 2012 and 14 627.25×103 and 99,137,100 yuan in 2014,there was no statistical significance(P>0.05). 4 categories of respiratory inhalants in the list of DDDs were anticholinergic agents,compound preparations,glucocorticoid and β2 receptor agonists; DDDs of each type increased year by year,but only that of anticholinergic agents had statistical significance(P0.05). 5 kinds of inhalants in the list of DDDs were aerosol preparation,power aerosols,atomizing solution,nasal spray and clickhaler. DDDs of aerosol preparation and power aerosols increased year by year,with statistical significance(P<0.05). Top one in the list of consumption sum was power aerosols during 2012-2013 and atomizing solution in 2014;power aerosols took up the first place in the list of total consumption in 3 years. Among 12 kinds of general name inhalants,top 4 inhalants in the list of DDDs were ipratropium bromide,salmeterol and fluticasone, albuterol and budesonide,and the constituent ratio of their total DDDs in 3 years were 40.16% ,16.71% ,13.51% and 13.39%,respectively;the sum of constituent ratio of total DDDs in 3 years was more than 80%. Top 3 inhalants in the list of consumption sum were budesonide,salmeterol and fluticasone, budesonide and formoterol,and the sum of constituent ratio of their total consumption sum in 3 years were 39.59%,20.81% and 12.50% ,respectively;the sum of constituent ratio was more than 70% . DDC of salbutamol was the lowest. Among 38 kinds of trade name(specification)inhalants,the type and cost of health insurance accounted for 92.11% and 95.02% .Pulmicort atomization suspension and Symbicort Turbuhaler(160 μg)took up the first place in the list of health insurance cost and self-paying cost respectively,and they were B directory of health insurance. CONCLUSIONS:The utilization of respiratory inhalants was basically reasonable in 34 hospitals from Nanjing during 2012-2014.

El consumo de inhalables en las prácticas de socialidad de dos grupos de estudiantes de secundarias públicas / Inhalant use in the sociality practices of two groups of students at public middle schools

INTRODUCCIÓN: La extensión del consumo de inhalables hacia distintas poblaciones de México ocurre en el macrocontexto de la legalidad y la deficiente regulación sanitaria y policial de dichas sustancias, así como su gran disponibilidad y bajo costo, en combinación con los efectos placenteros de su inhalación, los cuales varían según el contexto y los usuarios. OBJETIVO: Aquí se describen las prácticas de coconstrucción de los contextos de consumo de inhalables. También, los efectos de éstos en dos grupos de estudiantes mexicanos de educación secundaria. MÉTODO: Se utilizó la metodología de la photo elicitation, analizando, en grupos de discusión, dos videograbaciones producidas por los mismos estudiantes, en las que consumen inhalables. RESULTADOS: Se realizó la categorización teórica de los datos con el software Atlas.ti. Se encontró que, a pesar de que los estudiantes inhalan tolueno, sólo una de las estudiantes experimentó mareo y dolor de cabeza, en tanto que otra compañera se sintió somnolienta. Sin embargo, el segundo video muestra que los estudiantes experimentaron la prendidez (euforia, desinhibición afectiva) y alucinaciones. El mareo, el dolor y la somnolencia parecen determinados mayormente por el consumo de tolueno y alcohol, pero los efectos disímiles, por la socialidad de los contextos de consumo del inhalable, la subjetivación de los estudiantes y su veteranía en el consumo. DISCUSIÓN Y CONCLUSIÓN: Se discute que los estudiantes prefieren el consumo de inhalables porque la "prendidez" fortalece su socialidad. Se concluye que conviene desalentar el consumo de inhalables incorporando la agencia y la subjetivación juvenil, sin desatender los factores macrosociales de la producción, comercialización y regulación de los inhalables.

INTRODUCTION: Inhalant use among various populations in Mexico occurs within the context of its legality, inadequate health regulation and supervision of its production and sales, high availability and low cost, combined with the pleasurable effects of inhaling, which vary according to the context and users. OBJECTIVE: This paper describes the social practices involved in the co-construction of inhalant use contexts of two groups of Mexican middle school students and their reported effects. METHOD: Photo elicitation methodology was used, with two videotapes produced by students on school sociality practices where inhalants we are used and then analyzed in discussion groups. RESULTS: The theoretical categorization of the data was performed using Atlas.ti software. It was found that although the students inhaled toluene, only one of the students experienced dizziness and headaches, while another classmate felt sleepy. The other video was different; students got high, experiencing euphoria, emotional disinhibition and hallucinations. Dizziness, pain and drowsiness seem largely determined by toluene and alcohol use, whereas the different effects appear to be caused by the sociality of the contexts of inhalant use, students' subjectivity and their length of consumption. DISCUSSION AND CONCLUSION: It is argued that students enjoy inhalant use because getting high reinforces their sociality. The article concludes that inhalant use should be discouraged by incorporating the agency and subjectivity of youth, without neglecting the macro-social factors involved in the production, marketing and regulation of inhalants.

Poppers, una droga emergente: Resultados del Sistema de Reporte de Información en Drogas

Introducción En la Ciudad de México, de acuerdo con los resultados del Sistema de Reporte de Información en Drogas SRID, los primeros reportes del uso de poppers datan de 1988 y paulatinamente ha ido incrementado su consumo. Objetivo Dado que una de las finalidades del SRID es identificar nuevas drogas y áreas que requieren investigación más detallada, se realizará un estudio descriptivo a fin de conocer las características asociadas a su consumo. Material y método Para evaluar el consumo de poppers se analizaron los datos recopilados por el Sistema de Reporte de Información en Drogas durante el periodo 2000-2012 I; así como las tendencias de uso durante 24 años. El instrumento utilizado es la Cédula "Informe Individual sobre Consumo de Drogas" que se aplica en Instituciones de Salud y de Justicia del Distrito Federal durante los meses de junio y noviembre de cada año. Resultados Entre los resultados más relevantes se destaca que el consumo de poppers se presenta en el grupo de adolescentes de 15 a 19 y en los adultos jóvenes de 20 a 24 años. Otro de los datos sobresalientes son las edades de inicio del consumo de esta sustancia, así como la frecuencia con la que se consume. Conclusiones A partir de los resultados encontrados, es necesario plantear líneas de investigación que permitan conocer el consumo de esta sustancia en población joven.

Introduction In Mexico City, according to the results of the Information Report System in Drug SRID, the first reports about the use of poppers date from 1988. The consumption of poppers has gradually increased throw on the years. Objective Given that one of the purposes of the SRID is to identify new drugs and areas that require further investigation, a descriptive study was performed to determine the characteristics associated with the consumption of poppers. Materials and methods To evaluate the use of poppers, data collected by the Information Reporting System on Drugs will be analyzed, during the period 20002012 I, as well as the trends in use for 24 years. The instrument used is the card "Individual Report on Consumption of Drugs", which is applied in health and justice institutions of the Federal District during the months of June and November of each year. Results The most relevant results among poppers consumption occurs in the group of adolescents from 15 to 19 and young adults aged 20-24 years. Another outstanding data are the ages of first use of this substance, and the frequency with which it is consumed. Conclusions From the results, it is necessary to propose research lines that reveal the use of poppers in young people.

The prevalence of inhalant use and associated factors among adolescents in Belo Horizonte, Brazil / Prevalência do uso de inalantes e fatores associados em adolescentes de Belo Horizonte, Brasil

The scope of this study was to establish the prevalence of inhalant use among adolescents and its association with marijuana use, alcohol consumption, socioeconomic status and gender. A cross-sectional study was performed with a representative sample of 891 adolescents from public and private schools in the city of Belo Horizonte, Brazil. Data were collected using two self-administered questionnaires: the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the Alcohol Use Disorders Identification Test (AUDIT C). The socioeconomic status was evaluated using the Social Vulnerability Index, mother's education level and type of school (public or private). The data were analyzed using the chi-square test (p < 0.05) and logistic regression analysis. The prevalence of inhalant use was 7.9%. No significant association was found between the use of inhalants and socioeconomic status after the logistic regression analysis. Inhalant use among adolescents was associated with marijuana use (OR: 4.61; 95% CI: 2.27 - 9.36) and with binge drinking (OR: 5.02; 95% CI: 2.57 - 9.81).

O objetivo deste estudo foi avaliar a prevalência do uso de inalantes em adolescentes e sua associação com o uso de maconha, consumo de álcool, condição socioeconômica e gênero. Um estudo transversal foi realizado em uma amostra representativa de 891 adolescentes de escolas públicas e privadas de Belo Horizonte, Brasil. Os dados foram coletados por meio de dois questionários autoaplicáveis: o Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) e o Alcohol Use Disorders Identification Test (AUDIT C). O Índice de Vulnerabilidade Social, o nível de escolaridade da mãe e o tipo de escola (pública ou privada) foram utilizados para determinar o nível socioeconômico. Os dados foram analisados utilizando o teste qui-quadrado (p < 0.05) e a análise de regressão logística. A prevalência do uso de inalantes foi de 7,9%. Não houve associação entre o uso de inalantes e o nível socioeconômico após a análise de regressão logística. O uso de inalantes por adolescentes esteve associado ao uso de maconha (OR: 4.61; 95% CI: 2.27 - 9.36) e ao consumo abusivo de álcool (OR: 5.02; 95% CI: 2.57 - 9.81).

Inhalant abuse- A rising public health problem.

These days inhalant abuse is common in both rural and urban settings. Laymen and professionals alike are negligent of this abuse. It is widely seen in children and can sometimes follow into adulthood too. Children try it out initially due to their anxiousness but later on get addicted to it. Parents are more worried about their children being exposed to drugs like cocaine and marijuana. But the fact is that children are more addicted to the inhalants that are commonly found in household things. Even a single episode of inhalant abuse can result in serious health problems. It can seriously impair the vital organs like heart, brain and kidneys. Repeated abuse is seen due to the elated feel that they experience after its use that resembles alcohol consumption. It produces initial excitation, drowsiness, disinhibiting, wooziness and agitation. In order to prolong the period of intoxication, they abuse repeatedly which in severe cases can even lead to death. Other causes of death can be due to suffocation, seizures, and coma or due to choking. Detoxification programs along with proper support and care from the family and friends will help the abusers to bring back the lost colour in their life. A systemic review of various electronic bibliographic by utilizing suitable search terms were used to obtain the data.

Patrón de consumo de solventes y daño neuropsicologico asociado a su uso / Consumption pattern and cognitive damage associated with solvent abuse

Se presentan los resultados de un estudio de comparación del Indice de Déficit (i.d.) de la Batería Neuropsicológica de Halstead-Reitan (BNH-R) y el Indice de Deterioro (ID) de la escala de inteligencia de Wechsler (WAIS), aplicados para la evaluación neuropsicológica de dos grupos de adolescentes: uno de usuarios y otro de no usuarios de solventes. Los sujetos provienen de una comunidad marginal y se les siguió durante un año, donde al principio y al final del mismo se evaluó tanto el patrón de consumo como el rendimiento cognitivo. Los resultados muestran que durante el año estudiado, los usuarios abandonaron su consumo en un 58 por ciento; 33 por ciento cambiaron a consumo eventual y 8.3 por ciento mantuvieron su patrón de consumo. En el grupo de no inhaladores el 58 por ciento se mantuvo en el no consumo y el 41 por ciento se inició en el consumo experimental. Se observa que el grupo de usuarios cambió su rendimiento cognitivo de un nivel de "daño moderado" a un nivel de "daño ligero" según el i.d. de la BNH-R, y el grupo de no usuarios se mantuvo en este segundo nivel. El ID del WAIS se invalidó en la primera aplicación, aunque en la segunda ubicó al grupo de usuarios en el nivel de "clínicamente significativo" y al grupo control en el de "sospechoso". Se concluye que el Indice del déficit de la bnh-r se muestra más consistente y congruente con los cambios en el patrón de consumo y se discute el efecto de algunas variables involucradas