Glues or Paint Thinner: Nature and Extent of Inhalant Use in Turkey

1
Glues or Paint ThinnerNature and Extent of
Inhalant Use in Turkey

• Kultegin Ogel, MD, Assoc. Prof.
• Bakirköy State Hospital, Inhalant Addiction
  Treatment Center
• YENIDEN Health and Education Foundation
• Acibadem Health Group

2
Overview

• Epidemiologic data
• Characteristics of inhalant use
• Treatment program

3
Commonly used inhalants in Turkey
Glues
Paint thinners
4
Lifetime prevalence of inhalant use among 10th
grades ()
Inhalants
Cannabis
Ecstasy
(Ogel K et al, 2000)
(Ogel K et al, 2003)
(Ogel K et al, 2005)
5
Gender differences, 2001 (odds ratios)
Ogel K et al, 2005
6
Characteristics of inhalant users, 10th graders,
2001

• Planning to quit inhalant use
• 76.4
• Difficulty in stopping inhalant use
• 45.9

7
Types of drugs used by street children (past
year, )
8
Choice of drugs among special youth populations
(past year, 2004, )
9
Criminal activity among experimenters (school
survey, 2004)

• Criminal activity
• OR
• (user/non user)
• Inhalant user 9.2 11.8
• Ecstasy user 12.2 14.5
• Cannabis user 9.8 13.2

Ogel et al, 2004
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Criminality among hospitalized inhalant users
(n300)
p 11
Glues or Paint Thinners? ()
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Differences of glue and thinner users

• Glues Euphoric and hallusinogenic effects are
  higher (Bally Genie/sprite). Contain less
  toluene comparing to thinners.
• Preferred by girls or adolescents who lives with
  their family
• Used for fun
• Paint thinners Sedative and anesthetic effects
  are higher. Contain more toluene comparing to
  glues.
• Preferred by street children or experienced drug
  users
• Used to heal traumas, to make easy to involve in
  criminal activities etc

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Characteristics of inhalant users

• Onset of drug use is earlier

Low educational levels
Prevention for early ages School based
intervention programs
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Characteristics of inhalant users

• Cognitive impairment is prevalent

Developmental deficiencies
Early interventions
(Aydin et al, 2002)
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Characteristics of inhalant users

• Socioeconomic status is low
• Mostly live in suburbans

Criminality is higher
Social support programs
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Characteristics of inhalant users

• Family problems (parenting problems, abuse,
  conflict among parents, etc)

Involving in gangs Living in streets
Family interventions
17
Characteristics of inhalant users

• Inhalant users commonly experienced
  physical/sexual abuse in streets

Frequent psychological problems (PTSD,
Depression, Personality problems etc)
Harm reduction
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Characteristics of inhalant users

• Stigmatization
• is very high

Marginality
Continue to use drugs
Paint Thinner user terror!
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Stigmatization

• A new and a special term appeared in Turkish
  language to define paint thinner users
• Tinerci (thinnerchy)
• Aggressive, criminal, merciless

20
Protest of education system by students
We do not to want be a paint thinner user or
pick pockers (snatch thief), we want education
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Treatment Program in Inhalant Addiction
Treatment Center(UMATEM)
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UMATEM

• Specialized clinic
• Ten beds for drug using adolescents who live with
  their family
• 22 beds for street children who use drugs
• Approximately 120 inhalant user inpatients/year

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Characteristics of hospitalized inhalant users
(n300)
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Mode of interventions
Outpatient program
Inpatient program

• Group therapy for adolescents
• Group education for families
• Individual therapy for adolescents
• Family therapy (where necessary)

Group therapy for adolescents Group education for
families Individual therapy for
adolescents Family therapy (where necessary)
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Type of Interventions

• Medical interventions
• Psychosocial interventions
• Individual interventions
• Education

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Medical Interventions

• Medical assessment
• Too many medical problems due to living in
  streets or low SES
• Detoxification
• It may continue more than 4 weeks because the
  effects of toluene persists
• Symptomatic treatment

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Psychosocial interventions

• Family trainings and therapy
• Improving psychosocial skills
• Maintaining social support in collaboration with
  social services

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Individual interventions

• Dialectical behaviour therapy (modified)
• Relapse prevention

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Education

• General education programs in clinic with
  teachers (literacy, mathematics, etc)
• Health education

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However

• No effectiveness research
• Drop out rates (3 months)
• Inpatient program 18
• Outpatient program 26

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YENIDEN Health and Education Foundation

• Developed Inhalant Use Severity Questionnaire
  (YUKUD)
• Trained 24,000 teachers on inhalant use in
  Istanbul (2003)
• Continuous training program for 45 counselor
  teachers every month in Istanbul since 2002.

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Conclusion

• Inhalant use is more complex and complicated drug
  use and need for comprehensive treatment programs
• Different programs for different groups
• Street/Family
• Male/female
• Glue/paint thinner
• Need information on natural course of inhalant use