Taken from an early submission by Syed Ali Naveed Arshad (of Pakistan)

Even though a thorough research on the topic was not concluded due to the simple lack of availability of information on the topic since this aspect of drug abuse has been significantly, if not at all, been neglected, the information gathered none the less presents a horrific picture. Moreover another hinderance in the research is the highly sensitive nature of the problem, diffculties in accessing this population, complicate group of dynamic and ignorance of the local authorities regarding the subject.

The research as to the extent of the situation is based on the information gathered from direct and indirect involvement through general contact and surveys by the United Nations Office on Drugs and Crime in Pakistan, Substantial Development Networking Program Pakistan (SDNPK) and Azad Foundation Charity, a major NGO involved in helping and rehabilatating street children. Health and Medical issues are based on a variety of articles and journals issued both locally and internationally.

The research has shown that adhesive glue/gum forms only a part of the sniffing problem. The products involved are spread over a fairly large number of products which are not only easily available at extremely cheap prices through the market but also various items which may easily be found in any household. The following list provides a basic idea of the substances/products involved creating the issue:

These products shall hereinafter be referred to as "Volatile Substances" and the issue hereinafter shall be discussed as "Solvent Abuse" or "Volatile Substance Abuse (VSA)". Moreover the general age of the people involved in the choronic abuse is spread over 9 - 19 years, with the highest levels being reported among 15 and 16 years old with the greatest tendencies of abuse as to regard to categories 4 (90% choice), 5,6 and 7. Category no. 8 is found to be less than insignificant with only a few incidents of its abuse.

Even though there is no exact figure present, however, the organisations involved above; mention significant member of the young children and youth being involved in VSA especially in the urban areas. Amongst the street children the situation is assessed by Azad Foundation to be 80% of all street children in Pakistan being involved VSA of which 70% are involved in chronic abse. With an estimate number of street children exceeding more than 10,000 in all major urban cities the situation is no less than alarming. With regard to other children the matter remains even worse due to lack of availability of thorough information. However it presumed in a few journal articles that the matter is within a mean range of 30%-35% / 40%-45%. Even though it is not known how both of these figures were reached nonetheless they cause and create alarm since such children are considered to be more insulated and shielded from most drug abuse simply out of the reason of them being looked after and being in the care of their families and receive more information as to the effect of drugs in general. However this figure may be connected to the fact that there is a general ignorance of the issue amongst most parents and the local authorities. The government has as of till yet no policy on either curbing down or at least controlling the problem while the major drug enforcement agencies (Police, Customs and the Anit Narcotics Force) are busy dealing with only the more potent drugs such as heroine, cocaine and hash.

The introduction of policy and reforms required as a first step go no further than to regulate the sale of such products and their maintenance on both domestic and commercial premises since 95% of all children included in the research have indicated that they do not face any difficulty in procuring the solvents.

Effects of VSA

Small doses of VSA can rapidly lead to euphoria and other disturbances similar to alcohol and may also induce dellusions and hallucinations.

Medical research shows that the inhaled chemicals are rapidly absorbed through the lungs into the blood stream and quickly distributed to the brain and other organs. Chemical substances found produce acute effects similar to sub anaesthetic concentrations of general anaesthetic as awell as to the effects of classic Central Nervous System depressant drugs.

Accidental deaths or injury are reported to occur especially if users are in an unsafe environment. Becoming unconscious also carries with it the risk of death through choking and asphylxlation.

Medical and Health Problems

Major medical and health issued associated with VSA. General health issues are listed below:

1. Respiratory tract infection
2. Fever
3. Gastreointestinals upsets
4. Skin infections
5. Headaches
6. Generalised myalgias
7. Weakness
8. Eye infections
9. Urinary infections
10. Vomiting
11.Memory loss and damage to the brain
12. Liver infections

Constant VSA has been associated with a number of serious, long term and often irreversible health problems including loss of hearing, damage to the brain and bone marrow and deficiency of oxygen in the blood. Some of the long term effects include suffering from burnt nose membrances, perforation of the gall bladder, blindness and even death. Since "Toulene" forms the basic VSA in Pakistan health hazards from breathing in Toulene are discussed further below along with detailed health issues of VSA.

Dependence

One of the biggest hazards of compulsive drug use is that it fosters drug dependence and addiction. Users continue to take drugs despite the adverse social and medical consequences and behave as if the effects of the drugs are needed for continued well being.

The relationship between the use of solvents and other drugs is a complex one. Although a possibility can be linked as to it, but the research is at the moment is unable to answer whether the use of solvents lead to abuse of more potent addictives drugs such as heroine, etc in the future especially in Pakistan. There is, however, evidence of this in other countries. Nonetheless the use of hash and marijuana is found to be significantly prevalent amongst amongst chronic cases of street children either as both past or current users.

A lifetime prevalence of tobacco was also seen in the research amongst the children with chronic VSA.

A chronic addiction of the majority of street children is leading them to be involved in commercial sex to arrange money for the solvents and other drugs.

Causes of VSA

Amongst street children a majority of the children involved in VSA had been the subject of abuse either at home or at workplace. Moreover a fair number of the children had one or more person in their immediate family or relatives abuse other substances. However there has also been a significant number of children involved through peer pressure.

The Problem

At present there is no statutory framework regulating the sale or the maintenance of such substances and/or solvents at both domestic or commercial premises. More than half of the cases in which Police officials are reported to having taken such children into custody, are obliged to release them due to the absence of any avialable facilities and consequently no remedial action can be taken.

Hardly ever a reported child with VSA has been referred to a drug detoxificaiton centre for treatment and the issue of VSA is still alien to a significant number of drug treatment service providers and henceforth there are either no services available or those that exist do not provide it in an efficient and appropriate manner. By and large all the facilities are designed to cater for the treatment of more potent drug addiction i.e. heroine.

Moreover the police cannot interfere with the sale of such substances to the children simply due to the lack of regulation and such conduct by shopkeepers is neither unlawful and nor is accounted for in any case law in the creation of the common law negligence. VSA substances also amount to various household/commercial products where there is often lack of care and knowledge on part of the parents and guardians/employers.

At the moment there is also a reported lack of clarity regarding their treatment methodology and a rehabilitation program is non existent. While focus has been started on the establishment of rehabilitation centres and training of staff for this purpose and the increase in general awareness as to it. This will, however, be a gradual process which will take considerable time, effort and incur substantial costs and at the moment there is no time frame as to when such steps would have taken complete shape and will be in force.

It is therefore pertinent in order to curb and control VSA that it sale, distribution and maintenance should be regulated both at domestic and commercial premises.

General Statement of the Problem

One of the purposes of this section is to raise the awareness of the problem and to galvanize the politicians into action. Ali was addressing a widely unrecognized social problem, Volatile Substance Abuse (VSA). Thus, Ali needed to include enough information about the impact VSA has on Pakistani society to convince decision-makers that VSA is a significant social problem, and that scarce resources should be used to address it.

Ali's first task was to describe the nature and scope of the difficulty's superficial manifestations as they affect human, physical or financial resources. He asked questions such as:

• Who engages in VSA?
• How widespread is VSA?
• How do users obtain harmful substances?
• How are users harmed?
• How do officials respond to VSA?

Ali has demonstrated that VSA is widespread, and that some people who engage in VSA suffer certain harms.

Additional facts will strengthen the general statement of the problem:

• What percentage of users suffer the stated harms?
• What does VSA cost Pakistani society, families, etc..

Ali noted that he was not able to locate all of the quantitative information that he desired because few studies of VSA had been conducted in Pakistan. This is a case where general social scientific literature and epidemiological studies may prove probative. Pakistan's experience with VSA will not be identical to other countries' experiences with VSA, but other countries' experiences can help us to form hypotheses (educated guesses) about the scope, nature, and effects of VSA abuse in Pakistan. Ideally these hypotheses will be tested with country-specific information about the nature and scope of the problem.

Sufficiency of Evidence

Though additional information can strengthen the argument that VSA abuse is a serious problem in Pakistan, Ali has already made a compelling case for legislative action to curb VSA. However, a stronger statement of the social problem may be needed if the proposed solution is extremely costly.

Identifying Role Occupants

Persons engaged in VSA are primary role occupants. Thus far, the majority of the discussion has centered on VSA by street children. Limiting the discussion to VSA by street kids may lead to a solution that exclusively targets street kids. Before focusing exclusively on VSA by street children it is important to at least survey how widespread VSA abuse is among members of the general population (either to justify focusing on VSA by street children or to re-orient the project towards a solution that will effectively reduce VSA among all categories of abusers).

It is also important to identify secondary role occupants. A secondary role occupant’s behaviors indirectly contribute to, or cause, the problem. In this case, the manufacturers of glue, and other commonly abused substances; employers; parents and teachers may all be secondary role occupants. Are the employers where the children work, the factories which produce such products, and the shops which sell them partly contributing to the problem? Describing WHOSE behaviors constitute the social problem requires investigating the roles of all those whose behaviors are blamed for the problem.

Elaborating on the Social Problem:

This draft was submitted in the second week of the distance course. As such, it reflects preliminary research on the scope and nature of the social problem. During the next two weeks, Ali will conduct additional research into both the scope of the problem, and into the behaviors that constitute it.

Some additional questions to ask: Does the problem exist among both the rich and the poor children? Is there a linkage between the problem and the working children? Is there a relation between abusing these substances and the workplaces where children are employed? A shoemaker, for example, uses glue; is glue sniffing more common among children working in such places?

The "Statement of the Problem" should be Descriptive