“I’m a deprived kid,
And no-one loves me,
So I turn to my glue bag,
To make me happy”
Corine, aged 15.¹

Volatile substance abuse (VSA) continues to be a major cause of mortality and morbidity among the teenage and younger population of the United Kingdom. Of the 1887 known deaths recorded between 1983 and 2003, over 50% involved people younger than 18 years of age; deaths have been reported in people as young as 7 and old as 75.²

Prevalence studies have repeatedly shown VSA to be the drug of choice in the 11- to 13-year-old age group in England and Wales, second only to marijuana among 14- to 15-year-olds.³

VSA is defined as the deliberate inhalation of a volatile substance to achieve a change in mental state.² Once synonymous with glue sniffing within the UK, the term now most closely applies to the inhalation of aerosols and gas fuels.

CURRENT ISSUES

This paper reviews the current issues relating to VSA in the UK, many of which have changed in recent years, such as the compounds most commonly abused, the methods of abuse, and direct clinical effects. While much has been published about VSA in other countries, we shall focus upon factors relating to VSA within the UK as they differ greatly from places where VSA is also a major problem, such as Australasia, North America and Japan.^4–7 Unlike existing review papers that discuss compounds such as toluene glues and nitrous oxide, we shall focus upon the post-CFC (chlorofluorocarbon) aerosol propellants and liquid petroleum gases such as butane, which are the cause of almost 90% of UK VSA related deaths in recent years.⁸

Most inhalants are readily available, inexpensive or free, and usually although not always legal to purchase. The “high” is achieved within …