Toolkit 1
Volatile Substance Abuse:
Still a Problem?
Aims
Toolkit completion aims
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Understand what Volatile Substance Abuse (VSA) is
Understand the broad dangers associated with VSA
Know VSA mortality rates and trends
Know prevalence rates as far as is possible
Know what products are used in VSA
Understand supply side legislation
What is VSA?
VSA has not gone away
The products abused* change over time
The glue sniffing of the past has become the butane
gas and aerosol buzzing* of recent years
*see slide notes
What is VSA?
VSA definition
The deliberate inhalation of volatile chemicals,
gases and solvents found in consumer and
industrial products through the mouth and/or
nose, for the sole purpose of achieving a ‘high’.
What is VSA?
What are volatile substances?
• Common terms for VSA include ‘buzzing,’ ‘huffing,’ ‘sniffing,’
‘bagging’.
• Volatile Substances* comprise a large group of gases and
compounds.
• Butane in cigarette lighter refills is the most commonly used
volatile substance in recent years. It is colourless and
odourless.
• Butane and propane are used as the propellant in aerosols.
*see slide notes
What is VSA?
The effects of volatile substances
• Inhalation produces rapid, short acting intoxication.
• Recovery from the psychoactive* phase is rapid - within
15 - 30 minutes; from the intense phase just a few
minutes.
*see slide notes
What is VSA?
Appeal of volatile substances
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Accessible*
Inexpensive
Legal, innocuous*
The effect: extreme, hallucinations often reported
Readily available despite legislation
Easy to conceal
Control: rapid intoxication and rapid resolution of
intoxication: can use and return to a ‘sober’ state quickly
*see slide notes
What is VSA?
Some reasons why people use*
• “I buy mine from supermarkets online. I felt too conspicuous in shops,
but no one ever questioned why I was buying 15 deodorants at a time”
• “There’s no dunt like a gas dunt.”
• “I bet I could find something in this room.”
• “Buzzin’ takes me to another place….away from all the crap in my life.”
• “It’s been my road to hell.”
• “My brothers were doing it so I tried it.”
• “My ma drinks..….this is my drink.”
• “Yeah, I know I can die doing it. So what? I don’t care.”
• “I saw my cousin sniffing hairspray. I only did it once. Am I addicted
now?”
*see slide notes
VSA Dangers
“VSA is too dangerous – don't do it”
ACMD
(Advisory Council for the Misuse of Drugs)*
*see slide notes
VSA Dangers
Why is VSA of concern?
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VSA can and does kill - even on the first use.
Sudden Sniffing Death is unique to VSA (see next slide).
Almost 2,400 recorded deaths in the UK.
Absolute Harm Reduction is not an option – there are no ‘safe’
methods of use.
Very hidden activity.
Associated with young people – youngest deaths aged 7 (1997,
2003).
But not exclusively – oldest death 85 (2008).
Legislative control of the products used in VSA is extremely
difficult, if not impossible.*
VSA is not illegal.*
Can cause an aggressive effect.
*see slide notes
VSA Dangers
Sudden Sniffing Death*
Gases, aerosols, and solvents can make the heart oversensitive to the effect of
adrenaline. A burst of activity leads to more adrenaline, leading to an even
greater risk of death.
This oversensitivity can remain for several hours following recovery from the
psychoactive phase.
A heart that stops beating as a result of VSA can be very difficult to resuscitate.
Defibrillation needs to be administered within 10 minutes.
*see slide notes
VSA Mortality
Mortality
Medical research teams at St George’s, University
of London, have provided the Trends in UK Deaths
Associated with Abuse of Volatile Substances
Report since 1971.
Mortality details on the following 3 slides all taken from the most
recent report.*
*see slide notes
VSA Mortality
Mortality
11%
Since 1971, VSA has claimed over 2,390 lives
in the UK, with 327 deaths in Scotland.
Deaths by primary
substance abused in
2009 in the UK
11%
Up to 2000, almost 2/3 of deaths were of
young people under the age of 19 with the
most common age of death being 15.
11%
The mean age of death in the UK from 20002009 is 30.
67%
The youngest deaths reported were of
7-year-olds (2003, 1997).
VSA kills more young people aged 15 and
under than all illegal substances.
gas fuels
aerosols
nitrous oxide
other
VSA Mortality
Mortality
Standardised Mortality Ratios (SMRs)*,
2000-2009. All ages.
Government Region
North East
North West
Yorkshire/Humber
East Midlands
West Midlands
East
London
South East
South West
England (all)
Wales
Scotland
Northern Ireland
SMR
129
73
112
129
111
89
70
83
74
90
91
172
179
2009 deaths
3
5
3
2
2
4
3
3
0
25
1
17
3
172
129
179
112
73
111
89
91
74
*see slide notes
129
70
83
VSA Mortality
Males are at higher risk of death
Gender distribution of VSA death
2009
2000-2009
Male
35 (73.9%)
420 (78.5%)
Female
12 (26.1%)
115 (21.5%)
However, the proportion of adult females (18-years or older) dying from
VSA has increased over time, from 1% between 1983-87 (6 deaths) to 17%
between 2003-07 (45 deaths).
VSA Prevalence
VSA prevalence:
difficult to determine
• Experimental users rarely engage with substance misuse services
• Chronic users often report that self stigma prevents them from
disclosure and/or service engagement
The British Crime Survey* measured substance use amongst 16-59 year olds in
England & Wales. Figures from the survey for 2010/11:
Ever Used
Cocaine
9.6%
VSA
2.3%
Heroin
0.8%
*see slide notes
VSA Prevalence
Reported Use of Individual Substances, Ever: 13 and 15 years old
Solvents, glues and gases
2008
2010
13 year-olds
2%
2%
15 year-olds
4%
3%
Poppers*
2008
2010
13 year-olds
1%
1%
15 year-olds
5%
3%
Extract: from Table 4.6 SALSUS (Scottish Adolescent Lifestyle And Substance Abuse Survey) 2010*
*see slide notes
VSA Prevalence
Individual Substances Offered, Ever: 13 and 15 years old
Solvents, glues and gases
2008
2010
13 year-olds
5%
5%
15 year-olds
9%
7%
Poppers
2008
2010
13 year-olds
2%
1%
15 year-olds
12%
6%
Extract: from Table 4.16 SALSUS (Scottish Adolescent Lifestyle And Substance Abuse Survey) 2010*
*see slide notes
VSA Prevalence
ESPAD 2011
Lifetime VSA of 15-16 year old students in 36 European Countries.
The average across these Countries is 9%.
Highest Prevalence
Lowest Prevalence
Croatia
Latvia
Slovenia
Monaco
Greece
Malta
Sweden
United Kingdom
Ireland
Cyprus
Lithuania
Ukraine
Italy
Moldova
28%
23%
20%
15%
14%
14%
11%
10%
9%
8%
7%
3%
3%
2%
2011 ESPAD: The European School Survey Project on Alcohol and Other Drugs*
*see slide notes
VSA Prevalence
Who tries VSA?
• VSA cuts across all demographics – there is no stereotypical VS
user.
• Higher risk is associated with history of trauma - just as with any
type of substance misuse.
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High rates of 12-16 year-olds reporting ever having used VSs were
identified in the following*
Those excluded from school (48%),
Those who truant from school (41%)
Those with impoverished living conditions/street homeless (43%)
Those with a record of delinquency/criminal behaviour (26%
serious offenders, non offenders 2%)
*see slide notes
VSA Products
What products are used?
Hundreds of products found in supermarkets,
newsagents, chemists, the home, DIY outlets,
schools, offices, industrial sites…etc.
Suggested classroom activities*
ACTIVITY SLIDE
*see slide notes
VSA Products
Products abused today*
Volatile solvents:
• Petrol
• Industrial glues
• Nail polish remover
• Paint stripper
• Some correctional fluid
Gases
• Fuel gas
• Butane lighter gas
• Nitrous oxide (whipped
cream
canisters)(whippets)
Aerosols:
• Hair spray
• Deodorants
• Spray paint
• Pain relief spray
• Air freshener
Nitrites: known as poppers
• Video head
cleaners
• Room odourisers
*see slide notes
VSA Products
Helium
• Helium is an inert gas (not a volatile substance) and causes death by
asphyxiation, displacing bloodstream oxygen. Using a mask or bag,
unconsciousness occurs within seconds, potentially permanent
brain damage in 2 minutes, then death.
• The St George’s VSA Report has included an early warning on deaths
associated with Helium since 2001.
• There were 111 Helium deaths* in the period 2001–2009. 26 deaths
in 2008, 46 deaths in 2009, 33 deaths in 2010.
• 93% of deaths were suicides caused by asphyxia, 6% recorded as
open verdict and 1% as misadventure.
*see slide notes
VSA Products
The SACKI Logo*
Introduced in 1997, the use of the SACKI logo is
voluntary. It does not appear on every product that
may be abused.
This may lead young
experimental users to
identify a product
without the logo as
‘safer’ than products
bearing the logo.
*see slide notes
VSA & The Law
VSA supply - legal matters UK
1. The Cigarette Lighter Refill (Safety) Regulations 1999
Butane gas cigarette lighter refills may not be supplied or sold to under
18-year-olds. This regulation, part of the Consumer Protection Act, was
added due to the large number of deaths associated with gas lighter
refills.
2. Intoxicating Substances (Supply) Act 1985 (does not include Scotland: see
next slide)
This act prohibits the sale or supply to persons under the age of 18 of
substances which may cause intoxication if inhaled, if the supplier knows
or has reasonable cause to believe that the substance is likely to be
inhaled for the purposes of intoxication.
The penalties for breaking either law is a maximum fine of £5,000 or up to six months
imprisonment, or both.
VSA & The Law
Legal matters – Scotland
not just age restriction*
Scottish Common Law
Selling/supplying any product to anyone of any age knowing that
the product will be abused for VSA has been held to constitute
criminal conduct. Fines of up to £12,000 and prison sentences of
2 years have been imposed.
VSA is sufficient singular cause for referral of a young person to
the Children's Panel due to the danger presented during each
and every episode of VSA.
*see slide notes
Contact details
Scotland: Marina Clayton
Development Manager Scotland
07505 000024
scotland@re-solv.org
Re-Solv UK Head Office
01785 817885
information@re-solv.org
Questions?
Published August 2013. Review date August 2014.