Central
Journal of Substance Abuse & Alcoholism
Cite this article: Bhad R, Jain R, Dhawan A, Mehta M (2014) Biochemical Assessment of Inhalant Use among Adolescents: A Pilot Study from Tertiary De-
Addiction Center of India. J Subst Abuse Alcohol 2(3): 1021.
*Corresponding author
Raka Jain, Rm. No. 4090, Department of Psychiatry,
4th floor, Teaching Block, All India Institute of Medical
Sciences, New Delhi- 110029, India, Tel: +91-011-
26593236; 26593595; Fax: 91-011-26588663, 26588641;
Email
Submitted: 16 October 2014
Accepted: 03 December 2014
Published: 05 December 2014
Copyright
© 2014 Bhad et al.
OPEN ACCESS
Research Article
Biochemical Assessment
of Inhalant Use among
Adolescents: A Pilot Study from
Tertiary De-Addiction Center of
India
Roshan Bhad
1
, Raka Jain
2
*, Anju Dhawan
3
and Manju Mehta
4
1
Senior Resident, Department of Psychiatry and National Drug Dependence Treatment
Centre, All India Institute of Medical Sciences, New Delhi-11029, India
2
Professor, National Drug Dependence Treatment Centre and Department of Psychiatry,
All India Institute of Medical Sciences, New Delhi-11029, India
3
Professor, National Drug Dependence Treatment Centre and Department of Psychiatry,
All India Institute of Medical Sciences, New Delhi-11029, India
4
Professor, Department of Psychiatry, All India Institute of Medical Sciences, New
Delhi-11029, India
ABBREVIATIONS
GLC: Gas Liquid Chromatography; NPD: Nitrogen
Phosphorous Detector; TLC: Thin Layer Chromatography; UCL:
Urine Creatinine Level; UHL: Urine Hippuric Acid Level; I.Q.:
Interquartile Range
INTRODUCTION
In the last few decades inhalant abuse is on rise and has
become an issue of great concern worldwide. Factors responsible
for this increasing use include easy availability, accessibility and
affordability. However among adolescents in India, inhalant
abuse appears far more complex and multidimensional [1–5].
More challenging is the management of inhalant abuse, which is
known to cause extensive medical, psychiatric, and psychological
damage but there are hardly any pharmacological or non-
pharmacological interventions available to tackle this problem
[6–8]. There is a dearth of research in area of management of
adolescent inhalant abuse. Additionally, objective assessment is
limited by non-availability of any screening test to detect inhalant
use.
Toluene, an important industrial organic solvent, is the
most commonly abused inhalant across the world and in India
[2,3,9–11]. Its exposure remains significant in an occupations
involving manufacture of paints, glues and adhesives. Laboratory
analysis of inhalant abuse requires the analysis of biological
fluids, commonly using gas chromatography [12]. Hippuric acid,
a primary urinary metabolite of toluene has been biochemically
detected in urine for its occupational exposure in past [12–15].
However, there is paucity of literature for biochemical validation
of toluene abuse among inhalant users in a clinical setting. We
conducted a pilot study among adolescent inhalant users, which
aimed at biochemical assessment of inhalant use by an objective
method in a clinical setting.
Keywords
• Inhalant abuse
• Adolescent substance use
• Toluene
• Biochemical validation
• Screening test
Abstract
Inhalant abuse is a serious problem worldwide, particularly in disadvantaged
populations and among adolescents. However, very few studies are available on
objective measurements of inhalant abuse among adolescents. A pilot study was
conducted on twenty-three adolescent inhalant users with recent use within one month on
self-report, with the aim of biochemical validation of inhalant use by objective method
in a clinical setting. Urine hippuric acid level was measured using gas chromatography
with NPD (Nitrogen Phosphorous Detector) detector as a part of biochemical validation.
More than fifty percent of adolescents were confirmed positive for intentional exposure
of toluene in urine. The study findings are indicative of feasibility of biochemical
testing for assessment of inhalant use and envisage the development of screening test
for inhalant abuse in near future. Such objective validation would be beneficial for
management of inhalant abuse problem among adolescents.