What's the harm in a huff?

Psssssssssssssssssssssssssht.

There’s a quiet killer in our communities, almost silent but for the soft spray of an aerosol and the whirl of the ball bearing at the bottom of the can.

You might know it as huffing, glue sniffing, dusting or bagging – but the technical term is volatile substance abuse (VSA), and more than 60 people have died from it between 2000 and 2012. Last year, a Health Quality and Safety Commission report [pdf] found VSA to be the leading cause of accidental poisoning for those under 24, beating out alcohol and prescription drugs.

To put it simply, VSA is the inhalation of substances – usually aerosols, butane-based gases and other solvents – for the purpose of getting high. When inhaled, they race into your system through the lungs, and straight into the brain within seconds. It’s a nasty high: it slows you down, causes you to vomit or hallucinate, makes you confused, aggressive and uncoordinated. It can kill you.

But unlike most other drugs, these are easy to get, if not immediately accessible: they’re in our houses, our garages, at the dairy on the corner. They’re cheap, too; for some, you’ll get change from $10.

The facts [pdf]: About two per cent of New Zealanders have tried huffing. Of the related deaths between 2000 and 2012, the majority (55) were people under 24, meaning one young person dies almost every two months from VSA. Of the 55, 24 were under 17; the youngest was 12.

“The numbers are quite big,” says Neil MacLean, Chief Coroner. “We picked up 63 deaths over a 12-year period – that’s 63 too many.”

Just under half of that figure were men; half of the deceased were Māori. “If there is a pattern, it is that they were on the outer edges of their own community, or they were not in good relationships generally – feeling a bit out of it, shunned by their friends, not understood by their parents,” says MacLean. “The common perception is that these people are losers.

“But what we’re seeing is that quite ordinary, decent young men can get involved in this, either [after] getting into bad company, with others who are doing it, or for their own particular reasons feeling a need to escape from reality.”

That aligns with the experience of Ross Bell, the executive director of the New Zealand Drug Foundation. “People do it because they like the … kinda drunken effect,” he says. “If your life is a bit shit – you’ve been kicked out of school, you’ve got no money – then that being removed from reality is the perfect feeling for you as well.”

As director of Aroha ki Te Tamariki Trust, Deb Fraser works with young people who are huffing. She says the fact that really young people are looking to get wasted is symptomatic of problems in wider society, and part of the service’s approach to people seeking help is to build a picture of their lives, and how substance abuse fits in.

She has worked on high-profile cases of huffing gone wrong, and says the risks of huffing are not well understood. “I think they know some of the risks, but [no one] actually considers that it is highly dangerous. The lack of oxygen compromises people’s function. It puts people at risk of unconsciousness, blacking out, or death.”

“There was a high degree of ignorance amongst everybody, including young people, about how dangerous it is,” says Coroner MacLean. “A young person would see others doing it, not dying, and then suddenly, whammo, someone would die.”

Bell says people are often oblivious to the warning signs until it’s too late. “Families can be really naïve – they empty out all these cans from his bedroom, and say ‘I wasn’t worried about [VSA], I was worried about him drinking, or his girlfriend’, or something else,” he says. “To break that naivety, awareness has to be raised – but carefully and to the right people.”

Bell’s alluding to the fact that there’s always the risk that in talking about the issue, you’re going to pique the curiosity of vulnerable or naïve young people. The evidence shows that irresponsible education or media coverage of VSA results in more deaths. (As such, we’ve been careful not to mention or show the substances in question.)

“If you start to provide too much information you may be laying yourself open to telling young people how to get access and what to use,” says MacLean.

But he concedes that most young people don’t learn how to huff from the mainstream media.

“They get it from their friends or Facebook or any of the various sites – it’s not difficult for them to find out everything,” he says. “I tend toward the view that people these days, particularly young peoples, that there is no point trying to hide anything from them.

“The more you hide it, the more you’re saying ‘This is naughty, dangerous stuff, don’t go here’. Ironically, you may end up making it more attractive.”

For this reason, MacLean says the best way to get the message through to young people is through their peers.

“If you see your friend’s been huffing and he’s suddenly behaving oddly, or seems to have gone to sleep, don’t just think that’s fine, he’ll sleep it off and get over it – actually do something,” he says. “Look after him. Call an ambulance. Because sometimes people don’t recover.”

MacLean says his 2012 report, and others’ work since, have raised awareness to a certain extent, but a concerted strategy is necessary. “We have scares and public concerns, be it teenage suicide, teenage huffing, boy racers – everyone gets in a panic, we pull out some facts and run around in small circles, and say ‘Yes, we’ll do this, we’ll form committees to do that’, he says.

“This is not the first time we’ve had a scare with young people and a mind-affecting substance … I’ve got no illusions that, as time goes by, people will forget and there will be something new, and [the issue of VSA] will catch us all by surprise.”

They have to step up, and keep an eye on this, and put resources into it forever.

Bell thinks we should be more pissed off about this than we are. Interventions to prevent deaths from VSA exist, but need resourcing – and that only comes when deaths make headlines.

“Politically, who does VSA even sit with? It needs political leadership,” says Bell. “It needs sustainable funding. A minister to put their hand up – we think it needs to be the Social Development Minister – and say “I own this problem”. That’s been the advice. They have to step up, and keep an eye on this, and put resources into it forever.”

In the short term, Bell thinks retailers could do more to prevent VSA-related harm. He praises efforts by retailers like The Warehouse and Mitre 10 for showing leadership on the issue by locking up related products, putting up signage, and educating staff – but he suspects corner dairies have some way to go.

The police have a role to play too, says Bell. “Often you’ll talk to cops and they’ll say they know all these kids are around and they want to slap them around the ears. The message to the cops is that if you do know of a group of kids who are at a certain park they, where there are cans left behind, they’re huffing – and the last thing you want to do if you see those kids is to chase them. The risk is that you’re going to kill them.”

In the meantime, the intervention of parents and friends seem to be the best hope for preventing and reducing VSA-related deaths. If you think someone you know is huffing, Bell says you need to have a tricky conversation – and, if necessary, contact support services. “If you find empty spray cans or gas canisters or other solvents in [their] room, that’s not the point you sit on your hands and think ‘I hope we get past this’,” he says. “This is not an issue you can hope they’ll grow out of. Because the next time they could be dead.”

For more information about VSA visit volatilesubstances.org.nz

If you or someone you know is huffing then call the Alcohol and Drug Helpline on 0800 787 797.

Disclosure: Jackson used to work for the New Zealand Drug Foundation.