Addictive Behaviors, Vol. 21, No. 4, pp. 537-542,1996 Copyright 0 1996 Elsevier Science Ltd Printed in the USA. All rights reserved
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BRIEF REPORT DELINQUENCY AND FAMILY PROBLEMS IN INCARCERATED ADOLESCENTS WITH AND WITHOUT A HISTORY OF INHALANT USE E. L. MCGARVEY,
R. J. CANTERBURY,
and D. WAITE
University of Virginia, Charlottesville, VA, USA
Abstract - In this retrospective
study of incarcerated adolescents, inhalants were used by significantly more nonminority than minority youth. Among both minority and nonminority groups, family problems and delinquent behaviors were higher among those youth with a history of inhalant use than those who reported no use. Family problems included history of running away from home, breaking rules, fighting with parents, and having relatives who had attempted suicide. Delinquent behavior included earlier personal use of drugs, selling illegal drugs, buying drugs from dealers, committing crimes while under the influence, committing crimes to get money to buy drugs, and threatening to hurt people.
The rubric “inhalants” refers to volatile solvents, volatile nitrites, anesthetics and related substances which can be “sniffed” or “snorted” (nasal inhalation); “huffed” (by breathing fumes from inhalant soaked rags placed in mouth): or “bagged” (inhaling fumes from substances placed in plastic bags) for the purpose of producing an anticipated intoxicating effect in individuals using them (National Institute on Drug Abuse [NIDA] 1994). The prevalence of inhalant abuse is a significant, yet under studied problem in the adolescent population in the U.S. Rates of use are higher than those of a number of more commonly recognized abused substances which have been targeted for prevention and treatment services nationwide. For example, data from The Monitoring the Future Study, 1975-1992 (NIDA, 1993) show a lifetime prevalence rate for inhalant use (excluding amyl and butyl nitrites) ranging from 15.7% to 17.7%, while lifetime prevalence for crack use ranges from 2.1% to 3.3%, and lifetime prevalence of other forms of cocaine is reported by 4.7% and 6% of the adolescent population. The problem of inhalant abuse may be overshadowed in the media by other illegal drug use because of the more direct association with criminal activity and violence. The prevalence of inhalant use varies by ethnic groups: Black youth have typically been found to report the lowest rates of use at 8% lifetime prevalence (NIDA, 1993) compared to White, Native American, and Hispanic youth, who report the highest rates (NIDA, 1993; Oetting & Beauvais, 1987; Young, 1987). Regardless of ethnicity, inhalant abuse has been shown to produce a number of harmful effects that are rarely anticipated by adolescents users. Inhalant use has been associated with a number of negative psychosocial outcomes. Physical effects include disorientation and convulsions, to more serious and possibly irreversible damage to an abuser’s kidneys, heart or liver (Byrne, Kirby, Zibin, & Ensminger, 1991; Johns, 1991; This research was funded by the National Institute on Drug Abuse (Grant DA07900-OlAl) to Randolph J. Canterbury, MD, Principal Investigator. Requests for reprints should be sent to Dr. Elizabeth L. McGarvey, Institute for Substance Abuse Studies, Blue Ridge Hospital-Box 16, University of Virginia, Charlottesville, VA 22901. 537
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Rosenberg & Sharp, 1992). Negative psychological and psychiatric implications are indicated by associations between inhalant abuse and antisocial personality disorder, social phobia and substance abuse disorders (Compton et al., 1994). Negative social outcomes include social deviance, family dysfunction, and criminal behaviors, which have been found in the backgrounds of adolescents who abuse inhalants (Compton et al., 1994; Jacobs & Ghodse, 1988; Oetting & Webb, 1992). Additionally, inhalant users have also been found to be polydrug users (Schutz, Chilcoat, & Anthony, 1994) and to have been more involved in violence resulting from accidents, homicides, or suicide (Garriott, 1992). This paper reports the results of an exploratory, retrospective investigation of inhalant use and a number of associated psychosocial factors in adolescents who are incarcerated in the Juvenile Correctional Facilities in Virginia. Adolescents with a history of inhalant use were compared to those without a history of use in two major areas: (a) family relations and (b) delinquency. The following research questions directed the study: 1.
2. 3.
Do incarcerated adolescents who have been inhalant users have more delinquent/ criminal behaviors relating to drugs than do those without a history of inhalant use? Do incarcerated adolescents who have been inhalant users have more family problems than those without a history of inhalant use? Are there ethnic differences in delinquency and family problems in the sample of incarcerated adolescents by history of inhalant use? METHOD
A sample of 619 youth between the ages of 12 and 19 volunteered to be interviewed for a NIDA-funded study on AIDS risk and substance abuse issues. Researchers conducted semistructured interviews using the Demographic and Descriptive Interview (DADI) as part of the larger study. The following item on inhalant use appears on the DADI: “Have you ever used solvents (glues, aerosols, toluene, amyl nitrite) to be high? If yes, how many times ? If yes, how old were you when you first used them?” This item was used to identify adolescents who had a history of inhalant use. Subgroup categories of users and nonusers were constructed for analysis. DATA
ANALYSIS
Data on minority adolescents, Black and other races, were combined because of the small numbers who reported inhalant use (n = 11) and were analyzed separately from data on nonminority adolescents (i.e., White youths). Chi-square statistics were used to compare users and nonusers in the nonminority population. Percentages only are presented for the minority reports of inhalant use because the numbers of users are too small for meaningful analyses. RESULTS
In the total sample of 619 youth, 88% were male and 12% were female, with Black youth constituting 54% of the total, Whites 40%, and youth of other races (Hispanic Americans, Asian Americans, and Native American youth) 6%. Inhalant use was reported by 14.6% of the sample. However, when separating the sample by race, the
s39
Delinquency and family problems
of inhalant use is significantly altered. The prevalence of inhalant use in the minority groups was significantly lower than in the nonminority group: 30% of White adolescents (n = 75) reported inhalant use at some point in their lifetimes while only 3% of Blacks, Asian Americans, Hispanic Americans, and Native Americans, combined (II = ll), reported use. Of all users, 25.9% reported use on 1 or 2 occasions; 27.1% on 3-19 occasions; 18.8% on 20-39 occasions and 28.2% on 40 or more occasions. Use of inhalants among males was 14%, compared to 11% of females.
prevalence
FAMILY
CHARACTERISTICS
Table 1 illustrates the differences tory of inhalant use and ethnicity.
OF in family
INHALANT
problems
USERS
of incarcerated
Living situation During the six months prior to incarceration, significantly ant users lived with family or relatives than did nonusers:
youth
by his-
fewer nonminority
inhal-
23% of users and 11% of nonusers reported living some place other than with family or relatives (x2 = 6.28, df = 1, p = .Ol). Of minority inhalant users, 27%, compared to 13% of nonusers, lived elsewhere. History of running away
Significantly more nonminority inhalant users (81%) than nonusers (59%) reported running away from home (x2 = 10.5, df = 1, p < .OOl). Nonminority inhalant users were three times more likely to have run away from home than were nonusers. The odds ratio was 3.01 (95% CI: 1.5-6.1). Among minority users, 36%, compared to 33% of nonusers of inhalants, reported a history of running away from home. Family relations
More difficulties were reported in the family relations of inhalant users than in nonusers in a number of areas. Among nonminority adolescents, 75% of inhalant users, compared with 63% of nonusers, reported breaking rules at home, but this difference was not statistically significant (x2 = 2.67, df = 1, p = .lO); 52% of nonminority inhalant users, compared to 38% of nonusers, reported fighting with parents (x2 = 3.6, df = 1, p = .05); 43% of nonminority inhalant users, compared to 24% of nonusers, re-
Table 1. Comparison of family relations of incarcerated youth by history of inhalant use and race (N = 619) Nonminority User
Characteristic
(n = 75)
Nonuser
(n = 176)
Minority User
Nonuser
(n = 11)
(n = 357)
Did not live with family History of running away Broke rules at home Fought with parent(s) Trouble with parents caused problems Relatives who attempted suicide
23% 81%
11% * * 590X***
27% 36%
13% 33%
75%
63%
73%
52% 43% 57%
38% * 24%** 39%**
27% 36% 56%
S7% 18%
Feel closest to mother
72%
68%
82%
*p <
,05;
**p
<
.Ol; ***p -=C.OOl.
17% 18% 77%
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E. L. MCGARVEY
et al.
ported that trouble with their parents caused them significant problems (~2 = 8.06, df = .Ol); 57% of users, compared to 39% of nonusers, reported having relatives who had tried to commit suicide (x2 = 6.28, df = 1, p = .Ol). Between groups of nonminority users and nonusers of inhalants, there were no differences reported in feelings of closeness to mother (x2 = .08, df = 1, p = .76). Among minority youth, differences in family relations reported by inhalant users and nonusers were found: 73% of users, compared to 57% of nonusers, reported breaking rules at home; 27% of users, compared to 18% of nonusers, reported fighting with parents; 36% of users, compared to 17% of nonusers, reported that problems with parents caused them significant problems; 55% of users, compared to 18% of nonusers, reported having had relatives who had attempted suicide. As with nonminority youth, reported feelings of closeness with the mother were about the same, with 82% of users, compared to 77% of nonusers, reporting feeling close with their mother. DELINQUENT
BEHAVIORS INHALANT
AMONG USERS
Other drug use
Inhalant users reported significantly higher polydrug use than nonusers: 97% of users, compared to 70% of nonusers, smoked marijuana (x2 = 25.3, df = 1, p = .OOOOl); 64% of users, compared to 12% of nonusers, had used hallucinogens (x2 = 120.9, df = 1, p = .OOOOl);34% of users, compared to 4% of nonusers, reported use of downers (x2 = 85.1, df = 1, (p = .OOOl);63% of users, compared to 8% of nonusers, reported use of amphetamines (x2 = 161.6, df = 1,p = .OOOOl);22% of users, compared to 6% of nonusers, reported use of opiates (x2 = 25.84, df = 1, p = .OOOOl);70% of users, compared to 12% of nonusers, reported use of cocaine (x2 = 45.3, df = 1, p = .OOOOl). The mean age of inhalant users who reported first drinking alcohol was 10 years, compared to a mean age among nonusers of 12.4 years (respective mode was 12 years and 14 years). Table 2 shows a comparison of delinquent and criminal behaviors of nonminority and minority youth with and without a history of inhalant use. Among nonminority youth, inhalant use is a risk factor for more delinquent and/or criminal behaviors in all categories. Earlier use of drugs
Nonminority inhalant users were almost five times more likely to self-report using drugs before their peers. The odds ratio was 4.9 (95% CI: 2.64-9.14). Minority youths Table 2. Comparison of delinquent criminal behaviors of incarcerated by history of inhalant use and race (N = 619)
youth
Minority
Nonminority
Characteristic Earlier use of drugs Sold drugs Bought drugs from Threatened to hurt Committed crimes Committed crimes
dealers people while under the influence to get money to buy drugs
*p < .05; **p < .Ol; ***p < .ool.
User (n = 75)
Nonuser (n = 176)
User (n = 11)
Nonuser (n = 357)
67% 71% 81% 56% 65% 44%
29%*** 40%*** 49%*** 35% ** 29%*** 13%***
27% 46% 46% 60% 40% 20%
28% 46% 34% 28% 21% 6%
Delinquency and family problems
showed little difference in the percentages comparing inhalant users to nonusers.
who reported
541
earlier use of drugs when
Sold drugs
Significantly more nonminority inhalant users (71%) reported having sold drugs than did youth with no history of inhalant use (40%) (x2 = 18.8, df = 1, p < .OOl). Nonminority inhalant users were almost four times more likely to have sold drugs than their noninhalant using peers. The odds ratio was 3.6 (95% CI: 1.96-6.81). Among minority youths, however, 46% of inhalant users and 46% of nonusers reported having sold drugs. Bought drugs from dealer
Significantly more nonminority inhalant users (81%) reported having bought drugs from a dealer than did nonusers (49%) (x2 = 21.5 df = 1, p < .OOl). Nonminority inhalant users were over four times more likely to have bought drugs from a dealer than were nonusers of inhalants. The odds ration was 4.5 (95% CI: 2.27-9.24). Among minority youth, 45% of inhalant users reported having bought drugs from a dealer, compared to 34% of nonusers. Threatened to hurt people
Significantly more nonminority inhalant users (56%) reported having threatened to hurt someone else than did nonusers of inhalants (35%) (x2 = 8.51, df = 1, p < .Ol). Among minority youth, 60% of inhalant users, compared to 28% of nonusers, reported threatening to hurt people. Committed crimes while under the influence
Significantly more nonminority inhalant users (65%) reported committing crimes while under the influence of drugs or alcohol than did nonusers of inhalants (29%) (x2 = 27.5, df = 1, p < .OOl). Nonminority inhalant users were more than four times more likely to have committed crimes while under the influence of drugs or alcohol than were nonusers of inhalants. The odds ratio was 4.6 (95% CI: 2.49-7.49). Among minority youth, 40% of inhalant users, compared to 21% of nonusers, reported criminal activity while under the influence of drugs or alcohol. Committed crimes to get money to buy drugs
Significantly more nonminority users (44%) than nonusers of inhalants (13%) reported committing crimes to get money to buy drugs (x2 = 27.27, df = 1, p < .OOl). Nonminority inhalant users were five times more likely to have committed crimes to obtain drug money than were nonusers of inhalants. The odds ration was 5.2 (95% CI: 2.64-10.3). Among minority youth, 20% of inhalant users, compared to 6% of nonusers, reported committing crimes to obtain money to buy drugs. DISCUSSION
The results of this study indicate that inhalant use is a “red flag” for a certain subgroup of incarcerated adolescents who exhibit significantly more problems with other drug use, family relations, and criminal and/or delinquent behavior. While it is apparent from this retrospective study that fewer Black youths than White youths use inhalants, those minority youths who do use inhalants seem to also exhibit more severe
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family problems and delinquent behaviors than do nonusers. The context of ethnic differences among the groups of inhalant users needs further investigation. More research is needed on the cultural norms relating to use of inhalants, including more information on the youth (psychosocial assessments), peer networks (rejection of support for use of inhalants), the family, and the culture to explore inhalant use in more depth. Until that time, the current findings on inhalant use are important to increase awareness of this drug problem among adolescents who are incarcerated and those who are not incarcerated. REFERENCES Byrne, A., Kirby, B., Zibin, T., & Ensminger, S. (1991). Psychiatric and neurological effects of chronic solvent abuse. Canadian Journal of Psychiatry, 36,7X-139. Compton, W. M., Cottler, L. B., Dinwiddie, S. H., Sptiznagel, E. L., Mager, D. E., & Asmus, G. (1994). Inhalant use: Characteristics and predictors. The American Journal on Addiction, 3,263-272. Garriott, J. C. (1992). Death among inhalant abusers. In Inhalant Abuse: A volatile research agenda. NIDA Research Monograph Series (NIH Publication No. 93-3480, pp. 181-191). Rockville, MD: National Institute on Drug Abuse. Jacobs, A., & Ghodse, A. (1988). Delinquency and regular solvent abuse: An unfavorable combination? British Journal of Addiction, 83.965-968.
A. (1991).Volatile solvent abuse and 963 deaths, British Journal ofAddiction,86,1053-1055. National institute on Drug Abuse. (1993). Inhalant abuse: A volatile- research agenda. NIDA Research Monoeranh Series (NIH Publication No. 93-3480). Rockville. MD: Author National I&tiiute on Drug Abuse. (1994). Inhalant Abuse: Its Dangers Are Nothing to Sniff at. (DHHS Pub. No. 94-3818). Rockville, MD: Author. Oetting, E., & Beauvais, R. (1987). Peer cluster theory, socialization characteristics and adolescent drug use: A path analysis. Journal of Counseling Psychology, 34.205213. Oetting, E. &Webb, J. (1992). Psychosocial characteristics and their links with inhalants:A research agenda. In Inhalant Abuse: A Volatile Research Agenda. NIDA Research Monograph Series (NIH Publication No. 93-3480, pp. 50-97). Rockville, MD: National Institute on Drug Abuse. Rosenberg, N., & Sharp, C. (1992). Solvent toxicity: A neurological focus In Inhalant Abuse: A Volatile Research Agenda. NIDA Research Monograph Series (NIH Publication No. 93-3480, pp. 117-171). Rockville, MD: National Institute on Drug Abuse. Schutz, C. G., Chilcoat, H. D., & Anthony, J. C. (1994).The association between sniffing inhalants and injecting drugs Comprehensive Psychiatry, 35,99-105. Johns,