We all see it but do nothing

SNIFFING glue takes away hunger pains.

We all see it and do nothing about it: street children inhaling liquid glue from a plastic bottle or bag clear enough for us to know what it is all about.

Their blatant display—and our shameless indifference—tells the story of substance abuse reduced in all its nakedness at street level.

The United Nations 2008 World Drug report ranks the Philippines No. 1 in Southeast Asia with the most number of drug users, at last count 6.7 million.

The report puts shabu (methamphetamine hydrochloride) users at 6 percent of Filipinos between 15 and 64—the world’s highest prevalence rate. It is followed by marijuana (4.2 percent), placing the country No. 1 in East Asia in that age bracket.

While cocaine use is negligible, at 0.03 percent and one of the lowest in the world, a Dangerous Drugs Board (DDB) survey finds that 6.7 million Filipinos use shabu and Ecstasy.

A party drug, Ecstasy is the third most popular illegal drug, next to shabu and marijuana, according to the Philippine Drug Enforcement Agency (PDEA).a

The PDEA says the illicit drug trade is an $8.4-billion industry.

Not all household glues are used to get high, says Dr. Irma Makalinao, a professor at the University of the Philippines-Manila (UPM) College of Medicine-Department of Pharmacology.

Only those with toluene are used because it is the ingredient that gives the high, she explains to The Manila Times.

Toluene is a clear liquid widely used as an industrial feedstock and as a solvent. Like other solvents, toluene is also inhaled for its intoxicating properties.

It is used as fuel for Formula 1 race cars, in the manufacture of polyurethane foam and TNT, can be used to extract hemoglobin in biochemistry experiments and to remove cocaine from coca leaves.

Toluene, when inhaled, causes tiredness, confusion, weakness, drunken-type actions, memory loss, nausea, loss of appetite, and hearing and color vision loss.

These symptoms usually disappear when exposure is stopped but an overdose can also cause unconsciousness and even death. It may affect kidney function.

Toluene-based household glue gained popularity in the Philippines in the 1970s when the availability of heroin and morphine declined during martial law. By 1992, toluene-based glue was among the 10 most commonly abused drugs.

Other volatile substances are abused, especially by elders: nail polish remover, paint, lacquer, thinner, floor polisher, insecticide spray—and gasoline.

The most common methods of inhaling these substances is through the use of plastic bags (particularly for household glue) and the use of rugs or cotton cloth for volatile substances such as solvent and acetone.

Many are hand held and sniffed directly from the container.

The relative ease of procuring, its low cost and accessibility make household glue popular, says Makalinao.

There is no comprehensive data on the magnitude of inhalant abuse among children and teenagers, but the United Nations Children’s Fund (Unicef) estimates there are 80,000 street children in the Philippines. Nongovernment organizations put the number at 1.5 million.

Half of them, at one time or another, have used household glue to take the edge off hunger, Makalinao says, adding the longer these children live on the streets, the more likely they will use shabu.

Among the most common substances abused—as reported in emergency cases at the UPM National Poison Management and Control Center—are shabu, alcohol, marijuana and “volatile organic solvents” particularly toluene-based household glue.

The most common symptoms: chest tightness, chest pain and altered mental status.

A study made by Makalinao and colleagues at the poison control center shows that chronic solvent abuse among street kids results in cognitive dysfunction (particularly memory impairment); poor performance in visual-motor coordination; hyperactivity; malnutrition and anemia.

Inhaling household glue results in a high that includes euphoria, delusions and—to a lesser extent—visual and sound hallucinations. It is followed by depression with prolonged exposure resulting in confusion, disorientation and a serious lack of coordination of muscle movements.

The study found that glue inhalers were exposed to more than 1,000 parts per million (ppm) of toluene.

Exposure to just above 600ppm results in confusion and delirium, Makalinao warns. –Paul M. Icamina, Special Reports Editor