In this issue of American Family Ph...

In this issue of American Family Physician, Anderson and Loomis (1) provide a timely review of the prevalence and consecutions of inhalant abuse in children and adolescents. Although this form of substance abuse attitude s serious health risks, it may be inspected when family physicians discuss remedy abuse prevention with young patients and their families. The potential ill powers of inhalant abuse include damage to cardiac, pulmonary, neurologic, gastrointestinal, hematologic, renal, and dermatologic systems

Fortunately, inhalant use appears to lack about of the cachet that attracts adolescents and young adults to illicit remedys This factor may explain the relatively depressed prevalence and frequency of inhalant use. Evidence from the Monitoring the coming time survey (2) indicates that since 1995 there has been a small still steady decline in the one-year prevalence of inhalant use among school-aged children in the United States. The decline in use has been accompanied at an increase in the percentage of young family who disapprove of even occasional use of inhalants. In 2002 the percentage of 10th grade bookish mans who disapproved of trying inhalants (886 percent) was comparable to the percentages of those who disapproved of trying crack cocaine (880 percent) levigate cocaine (86.4 percent), or heroin (892 percent) and higher than the percentages of those who disapproved of occasional use of marijuana (cannabis; 578 percent) LSD (lysergic acid diethylamide; 746 percent) or Ecstasy (MDMA; 774 percent) Data from this examine also indicate that many young race are aware of the dangers associated with inhalant use.

The article by the agency of Anderson and Loomis (1) highlights the possibility that inhalant abuse may act as a gateway to the use of other illicit medicines This is an intriguing suggestion, given that about of the proposed mechanisms underlying the potential gateway force of cannabis use relate to the volume to which access to cannabis also may increase access to other medicines (3) However, these proposed explanations for the gateway meaning of cannabis use are not easily applied to inhalants, which are widely and freely available. It may be that preexisting factors, similar as personality and low income, take the lead of the onset of inhalant use and explain the association between the abuse of inhalants and other substances.

Inhalants also differ from other gateway substances in lifetime prevalence of use, which is typically higher for alcohol and cannabis. As Anderson and Loomis (1) note, the prevalence of inhalant use (and abuse) is relatively soft However, given the serious acute consequences of inhalant abuse, intensive efforts should focus forward preventing the onset of use and, when indicated, encouraging cessation of use.

Given the myriad factors that are associated with the storming of substance abuse (i.e., the [i]role[/i]s most at risk often are expos to multiple disadvantages and dysfunctions (4)) preventive efforts should be multifaceted and should target multiple risk factors. so broad preventive efforts must involve a innkeeper of institutions. Family physicians have a pivotal part in these preventive efforts: they are frequently the first point of contact, and they generally have well-established relationships with all family members. Furthermore, brief interventions from family physicians targeting alcohol and other remedy problems have been shown to be effective. (5) Thus, family physicians should be aware of the dangers of inhalant abuse, should assess patients who may be at risk, and should be prepared to intervene to obstruct the onset of inhalant use and to support and encourage cessation among abusers.

REFERENCES

(1) Anderson CE Loomis GA. Recognition and prevention of inhalant

abuse. Am Fam Physician 2003; 68:869-74876

(2) Johnston LD O'Malley PM Bachman JG Monitoring the future: national overlook results on drug use, 19752002 tome I: Secondary school students. Bethesda, Md: National Institute upon Drug Abuse. NIH publication no. 035375 Retrieved July 24 3003 from www.monitoringthefuture.org.

(3) Lynskey MT Heath AC, Bucholz KK Slutske W Madden PF Nelson EC et al. Escalation of unsalable article use in early-onset cannabis users v co-twin restrains JAMA 2003;289:427-33.

(4) Hawkins JD Catalano RF Miller JY Risk and protective factors for alcohol and other remedy problems in adolescence and early adulthood: implications for substance abuse prevention. Psychol male 1992;112:64-105.

(5.) gather S, Vaughan BL, Knight JR Office-based intervention for adolescent substance abuse. Pediatr Clin North Am 2002;49:329-43

Michael T Lynskey PhD is assistant professor of psychiatry at Washington University academy of Medicine, St. Louis, and is associated with the Missouri Alcoholism Research Center

Address correspondence to Michael T Lynskey PhD Washington University place of education of Medicine, 40 N. Kingshighway, Ste undivided St. Louis, MO 63108 (e-mail: mlynskey@matlock.wustl.edu). Reprints are not available from the author.

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