Volatile substance misuse: a review of interventions: monograph series no. 65

7.1 Information and education about VSM

Page last updated: 2008

As with other forms of drug use, education about VSM can be either universal or targeted. We consider in turn universal education, education targeted to known users and education targeted to communities.

7.1.1 Universal drug education
7.1.2 Education provided to known misusers of volatile substances
7.1.3 Education targeting communities

7.1.1 Universal drug education

Roper and Shaw (1996, p. 15) argue that education about VSM only draws attention to the practice and that information about VSM should not be offered to non-users in schools, a stance endorsed in several Australian jurisdictions. Some state education policies specify that schools should provide information about risks associated with VSM products through occupational health and safety rather than a drugs curriculum except where students are considered to be at risk of VSM or are already known users (Department of Education and Training, 2000; Drug and Alcohol Office (Western Australia), n.d.). A national policy statement on inhalant abuse recently endorsed by the Australian Ministerial Council on Drug Strategy also supports this approach (National Inhalant Abuse Taskforce, 2006). A Western Australian report on butane inhalation, however, found very little evidence on which to ground a decision whether or not to include VSM within mainstream drug education curriculum: 'it appears that the approach is based on the repeated enunciation of basic behavioural principles rather than a significant body of research evidence' (Western Australian Taskforce on Butane Misuse, 2006, p. 29). MacLean (2007b) has argued that the policy of excluding inhalants from mainstream drug education due to fear of exacerbating the practice is predicated on most children's ignorance of the potential psychoactive effects of household products. This assumption is unlikely to hold for many young people growing up in disadvantaged areas.

In England and Wales it is a statutory requirement that schools teach a drug education curriculum including information about solvents (Advisory Council on the Misuse of Drugs, 1995). International research suggests that providing education about the effects of inhalant use to all young people might reduce subsequent drug experimentation and associated harm, although there is some dispute on this matter. Researchers in the UK have noted that inhalant-associated mortality has decreased since the early 1990s. They link this trend with a national campaign educating parents about inhalants, alongside inclusion of the issue of VSM as part of personal and social education in schools (Field-Smith et al., 2006). Nonetheless, Ives (2006) argues that that education provided within UK schools has had little effect on young people's assessments of the dangers of inhalant use.

In the US, epidemiological data links a national anti-inhalant advertising campaign in 1995 with both an increase in 'perceived risk' associated with inhalant use among adolescents and a gradual decline in inhalant use. By 2003, when the campaign had ceased, this trend was reversed with an increase in use and corresponding reduction in the percentage seeing 'great risk' in using inhalants regularly (Johnston et al., 2006).
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Early use of inhalants is associated with increased likelihood of a range of later problems. Wu et al. advise that any measures such as education to delay VSM initiation 'may help reduce the risk of progressing to abuse or dependence' (Wu et al. 2004, p. 1213). Where education is provided universally on VSM, it should be designed in accordance with best practice research (see, for example, Coggans, Sherwan, Henderson, & Davies, 1991; Midford, 2006). UK and US researchers have recommended that volatile substance education be introduced early, during the late-primary school years (Coggans et al., 1991; Skellington Orr & Shewan, 2006; Substance Abuse and Mental Health Services Administration, 2003). Notwithstanding this, studies also acknowledge that raising the subject of VSM may have the unintended effect of encouraging initiation among students.

The UK Government is currently funding a five-year follow up study of the impact of school-based drug education for 11–13 year olds on subsequent drug use (Department of Health, Home Office, & Department for Education and Skills, 2005). In the absence of a comparable Australian study, the impact of UK drug education on levels of VSM will be important to monitor.

7.1.2 Education provided to known misusers of volatile substances

The Senate Select Committee on Volatile Substance Fumes (Commonwealth of Australia 1985, pp. 217–18) reported widespread agreement that juvenile sniffers were well aware of the dangers of petrol sniffing, and that providing information on the dangers of sniffing was not only likely to be ineffective, but might prove counter productive, especially if scare tactics were used.

Hayward and Kickett's (1988) findings add weight to the Senate Committee's conclusions. Hayward and Kickett interviewed 103 school children from seven Western Desert communities. They found that 72 per cent of petrol sniffers considered petrol sniffing to be harmful, and 77 per cent agreed that 'petrol sniffing can kill you' (Hayward and Kickett 1988, p. 27). Sandover et al. (1997) found that Aboriginal petrol sniffers interviewed in prison knew of the dangers of petrol sniffing but felt powerless to cease the practice. McFarland (1999) argues that young Aboriginal people's lives are full of danger and risk and in this context petrol sniffing does not appear to be particularly hazardous. As Brady (1992) points out, sniffing has been present in some Indigenous communities for over 20 years, with a result that some young people today are the children or relatives of former sniffers, some of whom show no apparent signs of lasting damage.

It does not, however, follow from these observations that education about VSM has no place. Treatment guidelines advise that clear information should be provided to inhalant users on harms associated with the practice (Department of Human Services, 2003; Substance Abuse and Mental Health Services Administration, 2003). Interviews with current and ex-petrol sniffers in Maningrida suggested that neurological effects such as impaired coordination worried petrol sniffers, and that this was particularly the case if they felt that it may impact on their ability to play sport (Burns, d'Abbs et al., 1995). The authors recommend that educational programs focus consequences of this sort rather than more dramatic outcomes such as brain damage and death. A Melbourne-based study also found that dramatic or threat-based injunctions not to chrome in some instances also intensified the sense of danger and excitement associated with VSM. Young people in this study also felt they lacked credible information about the effects of VSM (MacLean, in press).Top of page

7.1.3 Education targeting communities

The role of education aimed at communities and parents is much clearer than that of education provision in schools. The 1985 Senate Committee saw a need for the education of parents, and of others associated with Aboriginal communities, such as health and welfare personnel, teachers, youth workers, police and counsellors.

Material such as films, videos and pamphlets need to be produced in languages appropriate for each region and should be presented in a way that encourages optimism and increases confidence, rather than generating despair and increasing the already evident sense of hopelessness in dealing with the problem (1985, para. 9.44).
Education and other forms of support for parents are useful, particularly as those who used experimentally in their own youth may not be aware of the consequences of more intensive VSM. Targeted education campaigns in Native American communities have been linked with decreasing levels of VSM since the mid-1990s (Beauvais, Wayman et al., 2002). An educational pamphlet for parents has been produced by the Australian Drug Foundation (Jacobs, 2005). Education tools which use Indigenous culture to explain VSM and its effects are described in section 7.2.

Providing information to communities about the health effects of sniffing, what other communities have done in response to it, and fostering links between communities for exchange of such information has been a useful strategy in the past. This is an important function of Central Australian services such as Petrol Link-up and CAYLUS.

In 2000 the Aboriginal Drug and Alcohol Council (ADAC) of South Australia published a resource kit Petrol Sniffing and Other Solvents (Aboriginal Drug and Alcohol Council (SA) Inc, 2000). One of the booklets in the kit deals specifically with forms of VSM other than petrol sniffing. A copy of the earlier version of this review (d'Abbs & MacLean, 2000) is also included. Evaluation of the kit found that it provided a valuable resource and workers reported that having the kit increased their sense of capacity to address VSM. The kit was found to be most suited to the needs of professionals and policy makers working indirectly with communities and least useful for community members and parents (MacKenzie & Johnson, 2004).

The ongoing accumulation of knowledge and experience about VSM makes it necessary for resources to be updated frequently. The team evaluating the ADAC kit recommended that specific information formats be devised for use in Indigenous communities including flipcharts, interactive games (as board games or computer games), videos, CDs in local languages, flow charts and program outlines (MacKenzie and Johnson, 2004, p. 63). They suggest an updated version of the kit might be used as a template so that resources could be developed to meet the specific needs of local communities, by adding local images, language and context. All new resources, the authors argue, should be tested with Indigenous audiences prior to production.

Professional staff in contact with people using volatile substances, such as teachers, health workers and council workers, can also benefit from education and training about sniffing. Many users of inhalants access health or welfare services rather than specific drug and alcohol services (National Inhalant Abuse Taskforce, 2006). This means that staff of generalist health and welfare services (general practitioners, community health centre staff, mental health practitioners, and juvenile justice and child protection workers) should be equipped to assist people disclosing VSM. In the UK, focus groups were conducted with social workers, residential and foster carers and also with young people to determine social service staff's training needs in relation to VSM (Boylan, Braye, & Worley, 2001). A resource for social service staff entitled Tackling VSA has been developed in the UK and is available for order from the Re-solve website (www.re-solv.org). In Australia the recent evaluation of the ADAC kit found that workers require training in how to use information kits when working in communities (MacKenzie & Johnson, 2004).