Preventing volatile substance abuse

Many different strategies have been tried in an attempt to prevent the misuse of volatile substances. Some are similar to those used to prevent drug misuse. But because of the special status of volatile substances (they are readily-available products with legitimate uses) some of the prevention strategies are special to them.

Tackling supply -

product elimination

product modification

labelling

information and education for retailers

sales controls

Tackling demand -

legal controls

information and education for young people and for parents/carers

Tackling supply

Product elimination
Controlling the supply of sniffable products might reduce the problem of VSA. However, supply-side measures - on their own - are ineffective in dealing with illegal drug use and won't stop people sniffing. Volatile substances are ubiquitous in modern societies and it isn't possible to eliminate them. Even if some products were removed from sale, there are many others that young people could use instead. It would also be unfair to legitimate users to get rid of useful products.

But some products are particularly dangerous, and have satisfactory substitutes. In the UK, a government committee examining the problem of VSA was concerned about the large proportion of VSA-related deaths associated with sniffing butane cigarette lighter refills. The Committee recommended that the manufacturers withdraw from sale the large-size canisters, and restrict the size of refills to about 25 ml. (Advisory Council on the Misuse of Drugs 1995 Volatile Substance Abuse London: HMSO). Since the market for lighter refills was limited and changing as more people were using disposable lighters this change should have been relatively painless, but some companies still produce large canisters. It is too early to say whether this has had any effect on use or on deaths.

At the time of writing (May 1999) the UK Government intends to ban the sale of butane lighter refills to under-18-year-olds. There will be more information about this on an upcoming, related site which will contain information about VSA for retailers. Watch this space!!

In some developing countries there has been concern about the alleged neglect of the problem by manufacturers of volatile products. For example, Bruce Harris points out that H. B. Fuller, an American manufacturer, sells a shoe glue in Latin America that may not be sold in North America. Considerable profits are at stake: while 15 per cent of H B Fuller's sales are in Latin America, 26 per cent of their profits derive from this market.( Swift R 1995 'The NI Interview: Bruce Harris' New Internationalist July 1995 page 31) Harris' organisation, Casa Alianza, has pursued legal action against the company, alleging their responsibility in the death of a Guatemalan street child.

Product modification
If products can't be eliminated, perhaps they can be modified to make them more difficult or impossible to use to achieve intoxication? Three ways this might be done are -

modifying the product itself by changing the formulation so that it doesn't contain an intoxicating substance
adding something to the product so that it is unpalatable
modifying the container to make it more difficult to use.

The changes in the formulation of Tipp-Ex correction fluid, is an example of the first approach.( Tipp-Ex case study .) With its brand under pressure in English schools, many of which were banning the use of solvent-based correction fluid, one of Tipp-Ex's responses was to produce a non-abusable, water-based formula, aimed at this market and called School and Study. However, the solvent-based Tipp-Ex Original is still on sale and the water-based product is inferior to it.

An example of the second approach is the addition of 'stenching agents': unpleasant smelling chemicals. But many unpleasant-smelling substances are dangerous to health. And, of course, it would be impossible to add unpleasant odours to products such as hair sprays, deodorants and air fresheners. A review by NIDA in the USA concluded: 'After substantial effort, Texas and New York's efforts to identify product additives were terminated because there was insufficient agreement on what would be safe and effective additives. For example, there is limited research showing that the only additive currently in use, oil of mustard, may be carcinogenic.' (Sharpe C Beauvais F and Spence R (eds) 1992 Inhalant Abuse: A Volatile Research Agenda, NIDA Research Monograph 129. Rockville: National Institute on Drug Abuse.)

The third possibility is more practical. There are several ways of mechanically modifying products, including:

modification of the delivery system of aerosol products to prevent the gaseous propellant being extracted from the container separately from the product
the use of non-abusable propellants (such as carbon dioxide) via a modified delivery system
dispensers that only issue a limited amount of the product which is not sufficient to achieve intoxication.

Some of these methods are technically feasible for some, but not all, aerosol products. However, they would make the product more expensive, and in a world of free trade would probably not be able to command a large-enough market if cheaper, unmodified products were also on sale. Nevertheless, partly because of environmental concerns, some aerosol products are now available in pump-action containers with no need for a propellant. And halocarbon fire extinguishers are being replaced by extinguishers containing carbon dioxide. Controlling supply is one strategy, but it may have unexpected and harmful effects. Another approach is the provision of information and education. Labelling of products is one way to do this, but more detailed information can be provided through public advertising, leaflets and booklets, as well as education in schools.

labelling

If products can be harmful they should have a warning label. But this might draw attention to their intoxicating potential. However, most young people know that these products can be sniffed, so the chance of reducing harm in this way probably outweighs the risk.

But how effective are labels? We have no idea. And they are unlikely to be compulsory. In the UK, voluntary labelling with the wording: 'Solvent abuse can kill instantly' is used. This is sometimes referred to by the acronym of its initial letters: 'SACKI'.

Tipp-Ex Case study

What can companies do to address the problem of volatile substance abuse? This case study looks at the response of the leading brand in the correction fluids market, the German-owned company, Tipp-Ex. Like many companies selling abusable products, Tipp-Ex was under some commercial pressure to introduce changes. Although other companies have taken similar action, Tipp-Ex approached the problem in more comprehensive and imaginative ways than others.

What pressures were Tipp-Ex under that made them take action to reduce the abuse of their products?

Although they are not the main products implicated in sniffing-related deaths, in absolute terms a lot of deaths have been associated with thinners and correction fluids. Between 1971 and 1991 there were 92 deaths associated with typewriter correction fluids and thinners. This represents 7.5 per cent of all VSA deaths in that period.
As the brand-leader whose name was synonymous with correction fluids Tipp-Ex had a particular image problem when correction fluid-related deaths were reported in the newspapers, for most correction fluid thinner-related deaths were reported as Tipp-Ex deaths. So from a commercial point of view alone it was important for them to take action
Many schools banned solvent-based correction fluids, so sales were being lost. There were commercial opportunities in promoting existing water-based products that would be more acceptable to schools because they couldn't be misused
As human beings, and as mothers and fathers themselves, company staff were concerned to make safer products
Although the amount of 1-1-1 trichloroethane used in correction fluids is minuscule compared with other industrial uses, because of its toxicity and its harmful environmental effects, its use should be minimised, despite the difficulties with alternative formulations
The most important reason for withdrawing 1-1-1 trichloroethane was the Montreal Protocol, which required its withdrawal by 2005, and the European implementation of this part of the Protocol by the start of 1996.

The action that Tipp-Ex took included:

making themselves aware of the nature of the problem
trying to educate the media, whom they felt were stigmatising them
working with the Health and Safety Executive and ensuring their labelling conformed with current UK legislation
joining Re-Solv and seeking their advice
educating retailers and distributing Re-Solv's retail training pack to assist retailers to control sales
producing an 'availability card' for retailers, so that the product itself was not displayed and a card had to be taken to the check-out to make a purchase. This also helped to reduce theft of the product
discussing the problem with other manufacturers
researching alternatives to 1-1-1 trichloroethane · considering the addition of offensive smells to their products (but this was rejected, as the experience of other companies showed that legitimate consumers wouldn't buy these products)
renaming their existing water-based product, 'Aqua Fluid' as 'School and Study Fluid' to emphasise its suitability for the young consumer
producing new fluid products that were not abusable (first, 'Solvent-Free Fluid' and later, 'Natural Fluid', a non-abusable alcohol/water-based product as an alternative to Original Tipp-Ex). For this, they received endorsement from the World-Wide Fund for Nature, enabling them to display their Panda symbol on the bottle.
producing new types of correction products: pens, sticks and cassettes, that can't be abused
changing packaging to make it less attractive to the younger consumer; giving a more 'recessive and unattractive' label to the 1-1-1 trichloroethane-based product, and increasing the size of the hazard warning sign
'jazzing up' the packaging of the water-based and new products and targeting advertising of these products at the young consumer: for example, advertising in magazines such as Just 17 and introducing the 'Tex' character, who was designed to appeal to children
mailing all 30,000 schools in the country three times to inform them about the new low-risk and non-risk products
discontinuing retail sales of thinners and 'twinset' packages ('twinsets' consist of a bottle of fluid and a bottle of thinner packaged together)
phasing out the sale of thinners completely.

Has all this activity solved the problem? No, because some alternatives to 1-1-1 trichloroethane are potentially abusable, and, although Tipp-Ex isn't yet manufacturing these, they say: 'If the market shows a preference for the petroleum-based products, then we would have to make a product offering in this area. If the market rejects our formulation, we cannot commit commercial suicide as a company.'

(This case study is adapted from Ives R Problems with Solutions: A manual for work with solvent sniffers and other young drug users London: ISDD )

Legal controls

Supply controls, that is controls on sales of volatile products, are quite common around the world (DETAILS). But only a few countries have made VSA an offence.

In the UK it has generally been considered impractical to make VSA an offence. Proscription would make misusers even more secretive and harder to help. However, the police in the UK do have powers to intervene in certain cases. The Public Order Act, 1936 curbed insulting or threatening behaviour, and Section 5 of the Public Order Act, 1986 gave the police powers to deal with 'harassment, alarm or distress', where 'awareness impaired by intoxication' was not a defence, intoxication being defined as by 'drink, drugs or other means'. The Road Traffic Act, 1988 enables prosecution of those who drive motor vehicles under the influence of volatile substances. Sometimes, archaic laws have been used to deal with users, such as the Ecclesiastical Courts Jurisdiction Act of 1860. Bylaws controlling behaviour in public parks and intoxication on railway property have also been used. The Children Act, 1989 has implications for the welfare of young people who are 'sniffing' and would also apply in some cases where parents of young children used volatile substances.

In Japan 'the consumption or inhalation of poisonous or deleterious substances or possession of such substances for the purpose of consumption or inhalation' is a criminal offence punishable by up to two years imprisonment, or a fine of up to 50,000 yen, or both. In Singapore, the Intoxicating Substances Act of 1987 has made inhalant use an offence. Under the Act, suspected inhalant users can be subjected to blood tests. 'Those detected for the first time can be placed under the supervision of officers from the Central Narcotics Bureau. Recalcitrant offenders may be admitted for treatment and rehabilitation in approved institutions and afterwards are placed under supervision. Those who breach the supervision are punished. In addition to these deterrent measures and the legislation, a three-month anti-glue sniffing and anti-inhalant use campaign was launched in 1988.' Inhaling is also an offence in the Republic of Korea, where people using glues or thinners for purpose of hallucination and stimulation can be prosecuted.