Prevention and early detection is the key

Prevention of inhalant abuse is the ultimate goal. Prevention needs to involve the entire community, including healthcare professionals, teachers, parents, peers, law enforcement, and retailers. This section provides information for nurses to assist in the education of others.

Routine annual medical visits

Routine annual medical visits in doctor's offices, clinics, and schools provide an opportunity to provide education and to ask adolescents about drug use. There are standardized screening tools available to determine an adolescent's level of involvement (if any) in inhalants, tobacco, alcohol, and illicit and nonmedical prescription drug use. It is also possible to assess the severity of use for early intervention.

Reaching school children

According to Wu, Pilowsky, & Schlenger (2004), early use is associated with progression to abuse and dependence; prevention programs should target elementary school-age children.
According to the American Academy of Pediatrics (2005), some states have laws to try and deal with inhalant abuse, and such laws are not always easy to enforce. The Academy recommends the best way to fight inhalant abuse is to educate children about how harmful these products are. They advocate explaining how they can cause short- and long-term health problems, further drug abuse, and death. This is an excellent opportunity for school nurses to assess and educate school children.

Agerwala & McCance-Kaatz (2012) demonstrated the benefit of detecting substance use among teens using a structured screening protocol. Ultimately the use of these protocols led to a 68% decrease in drug use. In addition, the use of computerized protocols, according to Alayan and Shell (2016), in New York public schools showed a 42% substance use amongst 6 to 12th-grade students.

CRAFFT is the most widely used screening tool for students under 21, with solid recommendations by the American Academy of Pediatrics for teens according to Alayan and Shell. The authors and the National Association of School Nurses (NASN) strongly recommend health screening as part of the role of Nurse practitioners in school settings. They state NPs working in school settings are exceptionally qualified to administer screening tools.

The CRAFFT includes six questions about alcohol, marijuana, and other drug use, including those that are sniffed or huffed. The CRAFFT also includes questions about drug users' associates, using drugs to relax or feel better, comments from others about cutting down on drug use, and if the teen has gotten into trouble using alcohol or drugs. The CRAFFT maybe
administered by a clinician or can be given in a private place.

The Boston Children's Hospital copywrites the CRAFFT tool. To obtain copies that can be used, information about contacting them is available on their website, https://crafft.org/get-the-crafft/#dl-clin

Conclusion

Inhalant abuse is a frightening problem. This decade shows an increase in inhalant abuse across America. Although it is often a transient phase of drug experimentation, inhaling may lead to addiction or other drug usages. First-time use can also result in death or permanent disability. Nurses must have full access to information that would help them identify inhalant abuse.

Nurses can take the leadership in assessing youth, in educating health care professionals, educators, and the public. Inhalant abuse should not remain an invisible problem.

References

Agerwala SM, McCance-Katz EF. Integrating Screening, Brief Intervention,
and Referral to Treatment (SBIRT) into clinical practice settings: a brief
review. J Psychoactive Drugs. 2012;44(4): 307-17.

NIDA. 2020, June 2. Principles of Adolescent Substance Use Disorder Treatment. Retrieved from https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/principles-adolescent-substance-use-disorder-treatment on 2021, September 16

Wu, L., Pilowsky, D. & Schlenger, W. (2004). Inhalant abuse and dependence among adolescents in the United States. J Am Acad Child Adolesc Psychiatry. 43(10),1206-14.

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