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2002/05: Should government-funded agencies supervise chroming?

What they said ...
'At least Berry Street have had the guts ... to try something that was never going to be popular but actually has a real focus on the prevention of injury and death'
Peter Wearne, of the Youth Substance Abuse Service

'There is no such thing as safe chroming'
Professor George Patton, head of the Royal Children's Hospital's Centre for Adolescent Health

The issue at a glance
On January 22, 2002, it was revealed that a report by the Victorian Parliament's drugs and crime prevention committee indicated that the Berry Street child welfare agency, a Government funded body, had staff monitoring the solvent sniffing among some of the young people in its care.
This sparked an immediate media and Opposition campaign to have the Community Services Minister, Christine Campbell, held responsible for the Berry Street policy and removed from her position.
Both Ms Campbell and the Premier, Mr Bracks, claimed to have been ignorant of the approach being adopted at Berry Street. Each condemned the supervising of solvent sniffers while the minister tried without success to make a distinction between the 'monitoring' of chromers of which she had been made aware and the apparent 'supervision' of chroming of which she claimed to be unaware.
Berry Street Victoria no longer monitors young people chroming. The Government threatened to remove its $15 million annual funding unless Berry Street altered its policies.
The Premier initially supported his minister, however, she was ultimately removed some month later as part of a more general Cabinet reshuffle.
The question of how best to address the problem of chroming remains. Was the approach adopted by Berry Street appropriate?

Background
Chroming is the inhalation of solvents and propellents from spray paint. The aerosol paint is sprayed into a plastic bag from which the vapours are inhaled. Chrome paint is favoured because it has the least unpleasant taste and gives the best high. Users will inhale for an hour at a time, often several times a day.
The chemicals inhaled during chroming are rapidly transmitted to the nervous system and other parts of the body. Chroming damages the protective sheath around nerve fibres. Brain damage shows in impaired memory, learning difficulties, poor physical co-ordination, behaviour and personality changes, including increased aggression, and impairment of sight and hearing.
Long-term use damages the kidneys and liver, scars the lungs, impairs breathing and can cause death, most commonly from cardiac arrhythmia.
Chroming can produce hallucinations, feelings of self-confidence and lack of muscular co-ordination.
Users have been killed in falls from buildings caused by loss of co-ordination or hallucinations that they can fly. Users are also at risk of other forms of accident, particularly road or traffic accidents.
Chroming is claimed to be the most common form of drug use among children and teenagers in Melbourne and rural Victoria. It has been reported that some 24 percent of students have tried it at least once.
Frankston, Darebin, Melbourne, Moreland and Port Phillip have had the highest number of ambulance call-outs to children suffering the effects of chroming.
Chroming is not illegal. Shopkeepers are only barred from selling potential inhalants if they reasonably believe the product will be misused. Otherwise, there are no restrictions on the sale and use of chrome paints, aerosols and similar products.

Internet information
The Australian Drug Foundation (ADF) is an independent, non-profit organisation that aims to 'prevent and reduce alcohol and drug problems in the Australian community'. Some of the effects of 'chroming' can be found listed on the ADF's Internet site under the heading 'depressant drugs'. The information can be found at http://www.adf.org.au/parents/hdayyo.html#effects

More detailed information about chroming can be found on the ADF site in the section dealing with inhalants. This can be found at http://www.adf.org.au/drughit/facts/inhalants.html

On May 9, 2001, The Age newspaper published a report on proposed Drugs and Crime Prevention Committee inquiry into the practice of paint and glue sniffing. It is material in this report that brought the procedures being practised at Berry Street into the public eye. The Age article can be found at http://theage.com.au/news/2001/05/09/FFX5TWNJGMC.html

'Chroming's Stupid - A Submission to the Drugs and Crime Prevention Committee's Inquiry into the Inhalation of Volatile Substances' was written by Suzanne Carmody of University of Melbourne and John Honner of MacKillop Family Services.
It is one of many submissions presented to the Committee. It gives detailed information on the effects of chroming and on some of the legal and social issues involved in trying to reduce the practice.
It can be found at http://www.mackillop.org.au/html/chroming_submission.html

On May 10, 2001, The Age published a report among youths, especially Aboriginal youths, and chroming in the Latrobe Valley. The article was written by Julie-Anne Davies and was titled, 'In the blood tunnel, looking for a way out'.
The article can be found at http://theage.com.au/news/2001/05/10/FFX43X2ZHMC.html

Youth Substance Abuse Services is a youth support service that aims 'to continually develop leading responses to young people who engage in problematic substance use.'
The Service advocates a harm minimisation approach and has supported the monitoring strategies previously adopted by Berry Street Victoria.
The Service's Internet site has information on the effects of chroming and suggests a number of practices young people might adopt in an attempt to reduce the harm they suffer from chroming. This information can be found at http://www.ysas.org.au/drug/chroming.html

'The West Australian Drug Abuse Strategy Office - Solvents and Other Volatile Substances' guide supplies information on the topic for a number of different audiences.
It includes information on how parents can recognise if their children are sniffing inhalants. It also supplies information for retailers of solvents and suggests how the media might report incidents of solvent sniffing in ways less likely to aggravate the problem.
Please note these are all pdf files and require Adobe Acrobat Reader.
This information can be found at http://www.wa.gov.au/drugwestaus/html/contents/publications/campaigns/solvents/solvents.html

The Age 'Issues in the News' section gives a brief overview of chroming. This can be found at http://www.education.theage.com.au/pagedetail.asp?intpageid=124&strsection=students&intsectionid=0

Arguments supporting government-funded agencies supervising chroming
1. Agencies such as Berry Street aim to ensure that the young people in their care either are or become drug-free
Agencies such as Berry Street claim that they do not encourage those they look after to take drugs. They further claim that they attempt to have their clients become free of any drug habit they either have when they come into care or develop afterwards.
Ms Janine Kirk, president of Berry Street Victoria, has stated, 'We do not condone or support the taking of drugs of any kind and our stated aim is to ensure that young people in our care either become or remain drug-free.'

2. Agencies such as Berry Street do not support or encourage chroming
On the specific question issue of chroming, agencies such as Berry Street readily acknowledge the physical harm it causes those who practise it.
Ms Janine Kirk, president of Berry Street Victoria, has stated, '... with chrome comes potentially devastating physiological damage, possibly brain damage and even death.'
Ms Kirk has further stated, 'Berry Street Victoria does not and has never operated "sniffing rooms" in any of its residential or other facilities.
This inflammatory inference was incorrectly drawn by some media.'

3. Agencies such as Berry Street allow chroming on their premises only as a last resort
Agencies such as Berry Street note that they monitor the use of inhalants only as a last resort.
By this they appear to mean that where the agency has residents who refuse to stop the practice of chroming, staff allow them to remain at the facility, rather then send them onto the streets.
Further, staff at the agency will also monitor the chroming in an attempt to ensure these young people do not cause themselves any further injury while under the influence of the substance they have inhaled.
Ms Kirk has stated, 'Occasionally, despite all our best efforts, if one of our kids cannot be dissuaded from inhaling chrome, our workers are faced with a tragic and difficult choice, either turn them away from the units in which they live, knowing they will do it somewhere else (perhaps in a stormwater drain, a railway tunnel, or in a car park) or keep them close where we can take care of them, continue to persuade them not to chrome and ensure they get medical attention if they need it.'
Defenders of this monitoring chromers claim that it may be the only way of realistically restricting the harm they do themselves.
Peter Wearne, of the Youth Substance Abuse Service, has stated, 'At least Berry Street have had the guts ... to try something that was never going to be popular but actually has a real focus on the prevention of injury and death.'

4. The children cared for at Berry Street are in dire circumstances
Agencies such as Berry Street claim they are dealing with exceptional children. They claim that the young people whom they work with are in extreme circumstances. The implication appears to be that the level of support and tolerance they require is far greater than would be needed by other young people.
Ms Janine Kirk, the president of Berry Street Victoria, has made this point. Ms Kirk states, 'The kids that we care for, in particular those who live in our residential units across Victoria, are some of the most disadvantaged and abused in this state.
They come to us often as the agency of last resort, often with significant behavioural and some with drug-use problems.'

5. The harm minimisation approach adopted by Berry Street has the support of the Department of Human Services
Berry Street and other child welfare agencies adopt a harm minimisation approach. This means that rather than simply prohibiting the use of drugs by their clients, these agencies attempt to reduce the harm their clients do themselves through drug use. This means that they attempt to reduce some of the risk factors associated with drug use. One of the most well known instances of the harm minimisation approach is the free distribution of syringes to intravenous drug users. This practice is intended to reduce the risks associated with sharing needles - such as the contraction of HIV/AIDS and hepatitis.
Berry Street claims to follow a harm minimisation approach. They further claim that this strategy has the support of the Department of Human Services.
Ms Janine Kirk, the president of Berry Street Victoria, has stated, 'We have a comprehensive harm minimisation strategy, which we developed after extensive consultation and at all times we work very closely with the Department of Human Services.'
Sandie de Wolf, Berry Street's chief executive officer, has outlined the procedures. 'Individual management plans are developed for every young person with high risk behaviours ... These plans are developed in conjunction with the Department of Human Services, regional child protection workers and other professionals as appropriate. The misuse of substances is a category-two incident, as per DHS instructions, which must be reported to the regional office of the DHS within 48 hours.'

6. Chroming is not an illegal practice
Chroming is not an illegal activity and thus any government agency that monitors or supervises chroming is not turning a blind eye to an illegality.
Police Commissioner, Christine Nixon, has been asked whether the force was aware of the police of Berry Street Victoria of monitoring chroming. The Police Commissioner's sole response was, 'Chroming is not an offence.'

Arguments against government-funded agencies supervising chroming
1. Chroming is an extremely dangerous practice
Those who chrome regularly risk damaging their brain, heart, lungs, liver and kidneys. Some of the chemicals found in glues and petrol have also been found to increase the risk of leukaemia.
Critics of monitored chroming suggest that harm minimisation is a false concept as there is no safe exposure to chroming and whether monitored or not chromers face the risk of death. Forty-four people, mostly under 18, have died in the past ten years after sniffing solvents.
Professor George Patton, head of the Royal Children's Hospital's Centre for Adolescent Health, has claimed there is no such thing as safe chroming.
Professor Patton claims, 'For a start there is an immediate risk of death and that can occur for a number of reasons.
The evidence is also there of a variety of severe neurological syndromes associated with chroming.
Part of the danger is that the damage may not be reversible.'

2. Chroming is a very common practice among young people
Chroming, it has been claimed, is the most common substance abuse among children and teenagers. One survey has suggested that some 24 percent of school students have tried chroming.
It is claimed that chroming is not behaviour confined to children with extreme social/emotional/behavioural problems; rather, it is on the verge of becoming a mainstream practice.
It is claimed that Berry Street's justification of a monitoring system intended for children with extreme behaviours could influence government policy regarding a practice that is becoming disturbingly general.

3. Supervising chroming appears to condone the practice
Critics claim that the hazardous and widespread nature of this practice makes it very important that public health and child welfare agencies not be seen to appear to endorse chroming.
It has been claimed that 'monitoring' the inhalation of toxic, mood-altering substances appears to offer official sanction to that practice.
This point was made in a Herald Sun editorial published on January 22, 2002. The editorial states, 'Tolerance of the abuse of these dangerous substances sends an appalling message to impressionable children.'
A similar point was made in an Australian editorial published on January 25, 2002. The editorial states, 'It [monitoring] appears to condone, even support the practice, when what young people need to know is that society places a value on their lives even when they don't ...'

4. There are measures that could be introduced to reduce the incidence of chroming
A range of alternate strategies has been suggested to reduce the occurrence of chroming. The Western Australian Solvents Working Party has proposed a number of these. Among the proposals that have been made are that improved controls could be placed on retail outlets to prevent the sale of solvents to potential substance abusers. Among these proposals are that such substances should be kept below the counter or in locked cabinets. It has also been suggested that retailers should demand proof of age before selling such substances and that they not be sold to minors. It has also been proposed that manufacturers be required to place warning labels on aerosols and solvents and that an education campaign be conducted to make parents and young people aware of the dangers of these products. It has also been proposed that some substance be added to solvents and aerosols to make them induce vomiting or nausea. Such additives, it is hoped, would make these substances less appealing to potential substance abusers.

5. The community does not support supervised chroming
The Community Services Minister, Ms Christine Campbell, has stated that 'supervised sniffing' was out of step with public opinion and Government policy.
The Victorian Government was clearly concerned that state subsidised child welfare agencies like Berry Street were following strategies on chroming that were seriously out of step with public opinion.
In response to this concern the Government threatened to withdraw funding from Berry Street unless the organisation undertook to no longer monitor chroming among its young clients.

6. Increased government funding could reduce the incidence of chroming
It has been suggested that one of the reasons why staff at Berry Street had recourse to monitoring chroming was that the Government had devoted neither sufficient funding nor policy attention to the problem of solvent abuse.
This point was made in an editorial published in The Australian on January 25, 2002. The editorial states, 'It is suggested that Berry Street Victoria are overemphasising harm minimisation because they do not have the funding for more positive approaches. If that is true, the case for more or better targeted funding deserves serious consideration ...'

Further implications
The broader implications of this issue are significant. Up to a point it would appear to case doubt on Government support for the broad policy of harm minimisation which is largely the norm in Government funded agencies dealing with drug related problems.
Referring specifically to the question of chroming, the current controversy suggests that the issue has not received the level of attention it deserves. Staff working at Berry Street have expressed the hope that the Government will address the broader problems associated with reducing chroming.
Now that Ms Campbell is no longer a minister, media interest in the chroming issue appears to have subsidised. It would be a pity if interest in the question began and ended with the extent to which a Government minister should be held responsible for the policies adopted in a Government-funded agency.
The problem of disaffected youth remains. The problem of substance abuse among disaffected youth also remains. The current controversy would appear to indicate that there is little community or government support for what is seen as the too laissez-faire application of a harm minimisation approach. It is to be hoped that governments do not simply swing back in the opposite direction and decide that making chroming illegal would be a solution to the problem. All prohibition is likely to do is make solvent abusers more discreet in their choice of locations for sniffing. We need to address the complexity of the problem and direct serious effort and funding toward reducing it.

Sources
NOTE: This list has been revised since first being published. The price has also been brought down from the original $29.00 to $25.00. Only unnecessary items have been taken out.
The Age
23/1/02 page 1 news item by Gabrielle Costa, 'Welfare agency halts supervised "chroming"'
24/1/02 page 10 editorial, 'Setting limits on substance abuse'
26/1/02 page 3 (News Extra section) analysis by Julie-Anne Davies, 'Cheap trip to oblivion'
26/1/02 page 4 comments, 'Key players answer the key questions'
27/1/02 page 6 news item by David Roe, 'Defenders stand up for Berry Street'
28/1/02 page 3 news item by Gabrielle Costa, 'Ban on chroming to be considered'
29/1/02 page 3 news item by Gabrrielle Costa, 'Spray paint laws would deter graffiti and chromin: MP'
30/1/02 page 11 comment by Professor Chris Goddard and Joe Tucci, 'Chroming: whose fault?'

The Australian
23/1/02 page 5 news item by Ashleigh Wilson, 'Day the paint job grew thin'
23/1/02 page 5 news item by Sarah Stock, 'A substance not to be taken lightly'
25/1/01 page 8 editorial, 'Sniffers don't need adults to condone abuse'

The Herald Sun
22/1/02 page 1 news item by Nikki Protyniak, 'Safe houses for sniffing'
22/1/02 page 6 letter to the State Parliament Drugs and Crime prevention Committee, 'Mum's plea for dying girl'
22/1/02 page 18 editorial, 'Naivety and glue-sniffing'
23/1/02 page 5 news item by Nikki Protyniak, 'Boredom led to deadly habit'
23/1/02 page 5 news item by Nikki Protyniak, 'Sniffing reversal'
23/1/02 page 17 cartoon by Mark Knight
24/1/02 page 4 news item by Nikki Protyniak, 'Mum's plea for son'
24/1/02 page 17 letter to the editor from Warwick Murphy, 'Disturbing report'
25/1/02 page 5, news item by Nikki Protyniak, `Staff to watch sniffing'
25/1/02 page 19 comment by Janine Kirk, 'We just can't say know'
28/1/02 page 6 news item by Ashley Gardiner, 'Staff anger over blame'
28/1/02 page 16 comment by Matthew Pinkney, 'Treat the disease, not just symptoms'
29/1/02 page 19 comment by Paul Gray, 'The drugs dilemma'
31/1/02 page 13 news item by Nikki Protyniak, 'Stores stop chroming sale'
31/1/02 page 20 editorial, 'Ban spray cans for kids'