Fairbairn, Rowan; Murray, David --- "Chroming - Legislative Change and Practical Dilemmas" [2003] IndigLawB 41; (2003) 5(25) Indigenous Law Bulletin 19

Chroming – Legislative Change and Practical Dilemmas

by Rowan Fairbairn and David Murray

In April 2001, the Victorian Drugs and Crime Prevention Committee (D&CPC), which is a Committee of the Victorian Parliament, was given a reference to examine the issues associated with the abuse of volatile substances for the purposes of intoxication or ‘chroming’.

In May 2001, Berry Street Victoria (‘BSV’) received a best practice award from the Minister for Community Services for the development of a report and resource kit titled Managing Client Substance Misuse that it had produced after being funded by the Department of Human Services. The report and resource kit were the result of extensive consultation involving Berry Street staff, the Department of Human Services, Victorian Police, the Victorian Youth Substance Abuse Service (‘YSAS’), and staff from other welfare services and alcohol and other drug (‘AOD’) services. The report and resource kit were based on harm minimisation principles, and emphasised the need to reduce net harm for the individual as well as the community.[1 ]

While the report and resource kit supported young people being encouraged to cease their use of drugs, it was recognised that not all of them would wish to modify or change their pattern of drug use. Berry Street staff were encouraged to work with these young people by focussing on developing a strategy that would result in the best health outcome for the individual and others involved, without adopting a legal or moral position on the young person’s use. Workers were encouraged to review and constantly monitor every strategy that was developed and implemented.[2] The report and resource kit were well received by the sector at a workshop attended by staff from the Department of Human Services, Berry Street Victoria, and other AOD and welfare services.

In January 2002, after receiving a number of written submissions and hearing presentations from a variety of individuals and organisations over a number of months, the D&CPC released a Discussion Paper.[3] The Paper raised a number of issues and sought comment on them. Included in the discussion was the plea that ‘someone should do something about young chromers’.[4] On 22 January 2002, a story appeared in the Herald-Sun newspaper that accused Berry Street of operating a network of safe sniffing houses for young chromers, and that residents were being taught how to minimise the risks and side effects associated with sniffing. It was alleged that workers condoned chroming by at-risk children and young people in their care.[5]

When the State Government was confronted with this news on the front page of the State’s highest selling newspaper, it responded immediately. The Premier instructed Berry Street to immediately cease the practice of supervising young people engaged in chroming. The Premier thus proved that he had done something about young chromers. But what were the consequences?

The immediate result of the Government’s policy directive was that young people who had previously used volatile substances on the premises of residential units, where staff were able to actively engage them and monitor their well-being, were now forced out onto the streets into such places as parks and railway stations. One report recounts how a neighbour ‘ran up and down outside a children’s home (she hadn’t known it was one) after seeing a youngster on the street with his head in a plastic bag’. ‘Do something!’, she shouted, ‘for God’s sake, someone do something!’[6]

What do we know about chroming?

One of the difficulties facing workers and researchers is the paucity of reliable information about who abuses volatile substances, under what conditions, where and why. The D&CPC Final Report notes that the accurate measure of drug use, in particular the abuse of volatile substances, is limited by:

• the validity and reliability of population survey results
• the lack of Australian and Victorian qualitative and quantitative data, particularly in relation to use by children and young people
• issues of definition, for example measurement of a ‘dose’ of inhalant.[7]

We know that from data gathered for the 2001 Australian National Drug Strategy Household Survey that about 0.4 percent of Australians aged over 14 years, which is about 70,000 people, had used inhalants in the last twelve months.[8] However, given that most volatile substance use is by 10 to 16 year olds, these figures exclude a significant number of users.

Data gathered for the Australian Secondary Student’s Use of Over-the Counter and Illicit Substances in 1999 survey indicates that 23 to 26 percent of 12 to 14 year olds reported inhalant use in the past year, while only 8 percent of 17 year olds reported doing so.[9] Anecdotal experience suggests that most people who use inhalants do so for a short time and then cease. However, a small group of young people go on to inhale volatile substances problematically. The D&CPC Final Report notes that such a young person is likely to:

come from a low socio-economic background

have a background of adverse life events, such as a history of abuse, or neglect, or trauma, and family difficulties or deterioration

lack involvement in the education system or workforce

be isolated from and lack connection to the wider community

have an antisocial or offending background

be ‘in care’ or involved in the juvenile justice system[10]

The case histories of YSAS clients reinforce the research undertaken by Burdekin,[11] Brown,[12] and Rossiter et al,[13] which found a large percentage of homeless young people used a variety of substances as an attempt to dull their awareness of their own circumstances.

An appropriate framework to address chroming

Common sense dictates that any practitioner in the human services field would direct their energy towards the minimisation of harm of their clients and others in the community. Strategies that attempt to engage young people in a dialogue about their individual circumstances will put the service provider in an excellent position to explore this behaviour with the young person. In particular, a focus on seeking to understand the function of the drug use will enable the young person and worker to jointly develop strategies to diminish the harm.

Any strategy, plan or intervention developed by the worker should occur within existing legislative frameworks and political constraints, and result in a reduction in net harm for the individual as well as the community. Any strategy, plan or intervention should have a health and wellbeing focus rather than a punitive or law enforcement focus.

What is the current situation?

The Drugs, Poisons and Controlled Substances Act 1981 (Vic) has been amended to include legislation dealing with the civil apprehension and detention of persons affected by the inhalation of volatile substances and to allow for the confiscation of paraphernalia. The Drugs, Poisons and Controlled Substances (Volatile Substances) Act 2003 (Vic) is to become operational by 1 July 2004.

A key aspect of the implementation of the legislation will be the development of appropriate operational guidelines for the key stakeholders. In addition, rolling out appropriate training, education and information in a timely manner that focuses on the needs of a definable number of high-risk children and young people will be important.

YSAS has had considerable practical experience in working with young people who use a wide range of licit and illicit drugs problematically, including volatile substances. As an outcome of this experience, YSAS has developed a practice framework for working with these young people that utilises a harm reduction approach, and has as its prime focus the health and wellbeing of the young person.

The harm reduction approach aims to reduce the level of risk and harm associated with drug use by educating people who use drugs to do so as safely as possible, without necessarily reducing or stopping consumption. A common misinterpretation is that a harm reduction approach encourages or condones AOD use, therefore not catering for people seeking to achieve abstinence. On the contrary, the goal of becoming abstinent is one of a range of strategies that a person might employ to reduce harm.[14]

The YSAS practice framework has a number of key underpinnings:

• The motivation for use and the issues underlying the use of the substance needs to be understood by the worker prior to the development of any intervention or strategy.
• Any interventions should do no further harm to the young person, the worker, or the community.
• The focus should be on the harms caused by use and the function of the use rather than simply on the use itself.
• Workers should provide the young person with a range of potential options.
• Workers should ensure that the intervention and treatment goals are appropriate, practical and realizable.
• The young person should be treated with respect and dignity, and encouraged to take responsibility for the informed choices they make.

In relation to ‘chroming’, the following practical steps are followed:

• First, continually monitor the young person’s health and wellbeing, with the goal of ensuring that the client is not at immediate risk.
• Secondly, express concern for the welfare of the young person, making every effort to listen to them and express interest in their plight, and providing them with a clear expression of care and support.
• Thirdly, engage the young person in a meaningful and supportive fashion so that dialogue is able to occur between the young person and the worker about their substance use and the function the drug use performs.
• Fourthly, workers should acknowledge the choices that the young person makes, especially those that are likely to be harmful, and together with them investigate strategies that will reduce or prevent the potential for harm.

A harm reduction approach to the inhalation of volatile substances by young people addresses a range of associated risks and harms, as well as the function that the substance use performs. Workers do this by providing information and entering into dialogue with the young person about:

• Acquisition — committing criminal offences, such as theft, to obtain the substance. Alternatively, the young person may put himself or herself at risk through performing sex work to obtain the funds to purchase the substance.
• Dosage and frequency — how much and how often is the young person inhaling?
• Administration — the use of large plastic bags leading to suffocation, or directly spraying butane into the throat causing it to freeze and leading to asphyxiation.
• Intoxication — the short and long-term effect of chemicals such as butane, propane, toluene and trichlorethylene on the heart, liver and brain.
• Place where the inhalants are used — dangerous sites such as railway station and alongside roads, or inaccessible places where it is difficult to get help or there are no phones available to call an ambulance. Using alone or in an isolated place increases the likelihood of death following asphyxiation or cardiac arrhythmia.
• Behaviour while intoxicated — falls, being hit by trains or motor vehicles, driving while intoxicated, at risk of sexual or physical assault while intoxicated.
• Post-event — further use by the client to stop withdrawal symptoms or postpone the effects of the inhalant wearing off.
• Polydrug use — is the substance used with any others? Are they stimulants, depressants or hallucinogens? Is the use simultaneous or not?
• Setting — what effect does the client expect the substance to have on them?
• Function — to get high, to fit in with a peer group, to deal with past or current trauma

Conclusion

This approach to working with young people who present with problematic substance use issues is appropriate because it is consistent with national and state drug policies that advocate a public health approach to all substance use issues. It also attempts to address in a holistic manner the underlying issues behind substance use. We know that many children and adolescents who use volatile substances indicate that they do so for fun and excitement, as an experiment to see what happens, as a cheap alternative to alcohol and cannabis, and because it is easily obtained through theft or purchase. Others however may use volatile substances to assist them in dealing with current or past traumatic events. A ‘zero tolerance’ or ‘just say no’ approach to young people using substances problematically often acts as an impediment to meaningful dialogue, and is therefore not a good basis for establishing therapeutic interventions that address trauma.

The approach utilised by YSAS respects the user and empowers them to increase opportunities to maximise their health, whatever the circumstances they find themselves in. Therefore, it is an appropriate basis for formulating effective responses for young people who are using both licit and illicit substances, not just inhalants.

The challenge for us will be to encourage the police and other frontline workers to adopt an approach that is health-promoting and harm reducing in the context of the current legislative changes. These changes may well encourage an assertive approach to confiscation and detention of young people that will increase harm to both the young person and the community rather than reduce it.

Focussing merely on a legislative response to the abuse of inhalants is problematic, since the provision of extra police powers will not address the real issues that lie behind volatile substance abuse. Indeed, it may merely serve to create further issues. What will happen if the police do not use their new powers? What further harms will occur to individual young people and the wider community if the new legislation is overzealously used?

We hope that the principles of harm reduction outlined in this paper will be able to inform the operational guidelines developed by the Victorian Government before the legislation is proclaimed.

Rowan Fairbairn is a Senior Policy Officer with YSAS and David Murray is the Executive Officer of YSAS.

[1 ]Sheree Limbrick, Managing Client Substance Misuse (2001); Philip Mendes, ‘Setting a Conservative Policy Agenda: The Victorian Print Media, Young People in Care and Chroming’ (2002) 27(1) Children Australia 10; Moira Rainer, ‘Policy at the End of the Line’, Eureka Street, March 2002, 16.

[2] Limbrick, above n 1, 34-6.

[3] Victorian Drugs and Crime Prevention Committee, Inquiry into the Inhalation of Volatile Substances: Discussion Paper (2002).

[4] Victorian Drugs and Crime Prevention Committee, ‘Harm Minimisation: Principles and Policy Frameworks’, Occasional Paper No 1 (2002) 84.

[5] Nikki Protyniak, ‘Safe Houses for Sniffing’, Herald Sun (Melbourne), 22 January 2002, 1.

[6] Rainer, above n 1, 16.

[7] Victorian Drugs and Crime Prevention Committee, Inquiry into the Inhalation of Volatile Substances: Final Report (2002) 72-85.

[8] Australian Institute of Health and Welfare, 2001 National Drug Strategy Household Survey, Detailed Findings, Drug Statistics Series No 11 (2002) 77.

[9] Commonwealth Department of Health and Aged Care (National Drug Strategy Unit), Australian Secondary Students’ Use of Over-the-Counter and Illicit Substances in 1999, Monograph Series No 46 (2001) 17-18.

[10] Victorian Drugs and Crime Prevention Committee, Final Report, above n 7, 128-148.

[11] Brian Burdekin, Our Homeless Children - Report of the National Inquiry into Homeless Children by the Human Rights and Equal Opportunity Commission (1991).

[12] Hayden Brown, Report on Services Required for Adolescents with Drug-Related Problems (1991).

[13] Ben Rossiter et al, Living Well? Homeless Young People in Melbourne (2003).

[14] Ministerial Council on Drug Strategy, National Drug Strategic Framework 1998 – 1999 to 2002 – 2003: Building Partnerships (1998); Eric Single and Timothy Rohl, The National Drug Strategy: Mapping the Future – An Evaluation of the National Drug Strategy (1997).