inhalant abuse: An overlooked problem

A 14 year old schoolboy was brought to de-addiction clinic with complaints of inhaling typewriter correction fluid, lying to escape punishment, truancy from school, bullying younger brother, stealing money, running-away from home and declining academic performance. He would find time for huffing typewriter fluid after school when his parents were at work. His parents worked as sweepers and belonged the first evidence of any description of consciousness has come from none other than the Indian sacred texts of Vedas, which have vividly described the consciousness as a field phenomena. The words “Aatma” and “Chetna” had definitely the same meanings as the word consciousness that we have today.

with complaints of inhaling typewriter correction fluid, lying to escape punishment, truancy from school, bullying younger brother, stealing money, running-away from home and declining academic performance. He would find time for huffing typewriter fluid after school when his parents were at work. His parents worked as sweepers and belonged the first evidence of any description of consciousness has come from none other than the Indian sacred texts of Vedas, which have vividly described the consciousness as a field phenomena. The words "Aatma" and "Chetna" had definitely the same meanings as the word consciousness that we have today. Now I turn to a more important question. Why have these concepts not received adequate attention in the modern scientific literature of consciousness? Is it because these are all philosophical or completely abstract? I think not. Rather this represents the absence of the effort to develop a scientific stance towards these states, which is further limited when we see its Indian contributions, which I have mentioned earlier. [2] However, the past decade has evidenced the orientation of scientists across the world for understanding these concepts.
My inquisitiveness lead me to many such Yogic cults with the intention of unraveling their experiences and understandings of consciousness. I found the concepts of two of the Yogic cults specifically interesting in this respect, which are "Kriya Yoga" founded by "Swami Yoganada" and "Vihangam Yoga" founded by Swami "Sadafaldeoji Maharaj". The following is just a brief overview of what I collected from the vast literature presented in these and other Indian texts.
Consciousness is a non-material entity: To start with, the followers of meditation clearly state that the entity of consciousness is nonmaterial in the most subtle (Sookshma) sense.

Consciousness and attention are different but correlated:
Surprisingly, a matter of recent discussion [4] was clarified long back when Consciousness (Chetna) was differentiated from Attention (Dhyana) since the time these words were coined. [3] It is still conceptualized such in Indian Yogic practices. [4] Yogic meditation is a way of understanding consciousness: The practitioners of mediation speak of several instances when they passed through such states where they could perceive consciousness in a complete form. The firm statements of Vihangam Yogis defining Yoga as the "Science of consciousness" seems to be the result of personal experiences of passing through such states.
There are several states of consciousness: Against the current understanding of only normal and altered states of consciousness, Vihangama Yoga followers believe that there are 6 states of consciousness-Sthul awastha, Sukshma awastha, Karana awastha, Mahakarana awastha, Kaivalya awastha and Hamsa awastha. [5] These are the purer states of awareness wherein the consciousness extends beyond body and other limitations that we know of at physical planes. I have appealed else where to explore these states for having objective knowledge rather than discarding such states. [6] Recently we conducted both qualitative study and 192-channel EEG study on the Vihangam Yoga meditation states, from which we found that the meditation is a unique state of peaceful alertness as supported by both subjective statements and objective observation Through this letter, I am appealing all the inquisitive minds who are in search of consciousness to orient themselves towards these and similar yogic practices. I have received feedback comments from various researchers from different fields of study. If all of them make a collaborative approach towards this topic, the study of consciousness which is an integral part of the Indian heritage, can receive a multidimensional exploration and probably will lead us to the hidden and finer aspects of consciousness.
to lower Socio-economic status. His father was alcohol dependent and patient had witnessed him taking alcohol and fighting with his mother in drunken state on several occasions. The locality in which they resided had many children using inhalants and some were patient's friends.
He was managed conservatively. He was psycho-educated about harmful effects of his behaviour. Parents were explained about behavioural reinforcement techniques and impact of role models on child behaviour. His father was enrolled in de-addiction clinic. For last three months, both patient and his father are maintaining abstinence and are on regular follow up. There is marked improvement in home atmosphere and bonding among family members.
In another case, Psychiatric consultation was sought for a 12 year old boy admitted in Orthopaedic Ward of associated Hospital. Patient was brought there in unconscious state after fall from a running train and both his legs and all fingers of right hand had to be amputated. On gaining consciousness on third day, patient was able to give his details.
The boy was a student of seventh standard and resided in a suburb of Delhi. Six months back, he came in contact with a neighbourhood child who used to inhale an adhesive used to fix punctured tyres. He started using the substance.  [1] This was an 18 month trial which showed most patients in each treatment group that is olanzapine or quetiapine or risperidone or ziprasidone or perphenazine ,discontinued the assigned treatment because of lack of effect or intolerability. In 2006, Jones et al, [2] published the famous UK CUtLASS study which showed that the second generation antipsychotics had no clear advantage over first generation antipsychotics and thus shook the basic pillar of NICE guidelines for treatment of first onset schizophrenia.Both the trials were multicentred, pragmatic,double blinded RCTs and hence their findings need serious consideration.
In the CUtLASS study the QoL was measured only for a period of 1 year which is too less a time to assess QoL longitudinally. In CUtLASS, the first and second generation antipsychotic arms showed less than expected participants which was 64 and71 in each respectively ,with a power of 75%. It was originally estimated at the beginning of the study that at least 110 participants would be required in each arm to get a power of 80%.
In the CUtLASS study many psychiatrists chose sulpiride in the first generation arm which has a very similar (though this is controversial) side effect profile to second generation antpsychotics. Also clinically we know that we are seeing far less cases of tardive dyskinesia than before. It is not clear however whether it is because of the use of second generation antipsychotics now or because high dose of typicals that were used in the past. But at the same time these studies point to the hypothesis that psychiatrists as community have been influenced by a systematic campaign from pharmaceutical companies which has greatly increased the cost of treatment in schizophrenia, when the same park was residence of hundreds of persons of different age groups who abuse a variety of substances. He met with the accident after he fell out of the train in intoxicated state. His parents were illiterate and his father was an unskilled labourer. They belonged to lower socioeconomic status. Patient was managed conservatively and a rehabilitation plan was discussed with his parents.
These cases highlight that Inhalant abuse is a unique problem, as these substances are easily available, cheap and are not regulated by laws. The above cases highlight that it is more of a social problem stemming from poverty, parental neglect, poor role modelling, soft laws, changing societal norms; and thriving on child labour and beggary. The cases revealed the rampant use of such substances, although the reported cases are few; which implies that the problem is being overlooked. There is need of further research in this area.