Legislature(2003 - 2004)
03/04/2003 03:02 PM HES
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
HCR 8-INHALANTS AND POISONS AWARENESS WEEK Number 1250 CHAIR WILSON announced that the next order of business would be HOUSE CONCURRENT RESOLUTION NO. 8, "Requesting the Governor to declare March 16 - 22, 2003, to be Inhalants and Poisons Awareness Week." Number 1275 REPRESENTATIVE KAPSNER, sponsor of HCR 8, explained the importance of the resolution before the committee, which asks the governor to proclaim Inhalant and Poison Abuse Awareness Week. She told the committee the proclamation would coincide with the national Inhalant and Poisons Awareness Week on March 16-22. Representative Kapsner said she knows many of the members are aware of the serious problem inhalant abuse is for Alaska; however, she believes there is a long way to go in educating Alaska and the nation in understanding the prevalence of inhalant abuse and the resulting damage that can occur. REPRESENTATIVE KAPSNER pointed out that inhalants are not drugs; most of the substances people huff are not contraband. There are over 1,400 commonly used and legal household, office, and classroom products that can be used to get high. Inhalant highs are the result of intensive penetration of toxic chemicals into the brain tissue, where they are capable of causing irreversible damage. She told the committee there is a perception that this may be a rural problem or a Native problem, but it is not. It is a national epidemic. In a 1999 nationwide survey of 8th graders 19.5 percent said they had used inhalants, compared with 22 percent who have tried marijuana and hashish. The use is comparable. REPRESENTATIVE KAPSNER told the committee that in addition to brain, liver, lung, and bone marrow damage, there is evidence that chronic abuse of some inhalants causes chromosomal and fetal damage. Inhalant abuse can occur in children as young as four, five, or six years old, if they are huffing with their older brothers and sisters. Inhalant abuse is very common in adolescent years, and it is often recognized as a gateway to abuse of other illicit substances. Seventy percent of one group of substance abusers who were in treatment indicated they started with inhalants. Seventy percent said they would go back to inhalants if alcohol was not available. Many treatment facilities employees use gas tank locks for their automobiles, because so many people in treatment go out looking for a high and go to their gas tanks. REPRESENTATIVE KAPSNER explained that because the chemicals and inhalants enter the lungs in such high concentrations, they have a higher toxic profile than other types of drug abuse. It actually takes four to six weeks to detoxify inhalant abusers just so they can start treatment. REPRESENTATIVE KAPSNER said she hopes awareness of the signs of use become widely known. Some of the common signs include paint or stains on the body, clothing, rags, or bags; missing abuseable substances from the home; spots or sores around the mouth; red or runny eyes or nose; a chemical breath or odor, and a dazed, drunk, or dizzy appearance. Other signs which may accompany abuse are nausea, loss of appetite, anxiety, excitability, irritability, relentlessness, unexplained moodiness, slurred or disoriented speech, and outbursts or anger. Number 1530 REPRESENTATIVE GATTO asked what a common profile of an inhalant abuser would be. REPRESENTATIVE KAPSNER replied that there are no typical profiles for inhalant abusers. She said sniffers and huffers are represented by both sexes; they are urban and rural; and they come from all socioeconomic groups throughout the country and Alaska. She told the committee inhalant abusers range in age from elementary and middle-school age children to adults. REPRESENTATIVE GATTO agreed that adults use inhalants - smoking, for instance. He noted that perfumes are also a form of inhalant. Number 1566 CHAIR WILSON said as a nurse, she has worked in the emergency room when an individual has come in who has been involved in a chemical spill. She said in a case when victims have inhaled fumes, they may appear fine initially, hospital staff watch the victims closely because the damage to the lungs may appear later when they may start experiencing breathing problems. Chair Wilson asked if inhalant abusers experience the same type of symptoms. Number 1599 REPRESENTATIVE KAPSNER said she believes with accidental inhalants there may be a delay before the effects would appear; however, with huffing the response is much quicker. There is an instant high, which is the reason why some people prefer inhalants to contraband drugs. The inhalant goes through the lungs, and is an instant high. In talking with village public safety officers [VPSO], [she has found] they are very concerned about inhalant abuse. One reason is that it is not illegal and it is not even a violation of state law to huff. Another reason is that inhalants dull the pain receptors. She told the committee VPSOs are only equipped with a billy club, and even if they are only trying to subdue the victim or inhalant abuser, such a person is almost unstoppable because his/her pain receptors are not working. Number 1672 REPRESENTATIVE KAPSNER told the committee that with this limited amount of knowledge, most Alaskans do not know enough about inhalants and the seriousness of its abuse. She said her primary concern is for the young people who abuse inhalants, not knowing there can be irreversible brain damage, bone marrow damage, and lung damage. She said young children are setting themselves up to have developmentally disabled children, and the cost to the state is really quite exorbitant when people become retarded from the abuse. The symptoms are a lot like Fetal Alcohol Syndrome [FAS]. One of the major differences that she has heard from Jim Henkelman [Statewide Outreach Coordinator, Tundra Swan Treatment Program, Yukon-Kuskokwim Health Corporation] is that FAS children do not have a long-term memory and do have a lot of childhood memories. Most people who are inhalant abusers say that they lost their memory after they started huffing. They have the long-term memory; they just do not have the short-term memory. Representative Kapsner told the committee Jim Henkelman, who is the state's expert on inhalant abuse, would like to give the committee a presentation on this subject. Representative Kapsner said she would like to see this resolution pass and hopes the governor proclaims March 16 through the 22 as Inhalants and Poisons Awareness Week. Number 1741 REPRESENTATIVE KAPSNER noted that some statistics that were provided to the committee in a brochure say that children five years and under account for the majority - 53 percent - of the exposures to poison. The graph of substances involved like cleaning supplies in household exposures shows 125 cases in people over 20 years old. Representative Kapsner said this does not appear to be accidental poisoning. It looks more as though huffing was involved. Number 1754 REPRESENTATIVE CISSNA commented that Representative Kapsner's statement about the pain receptors made her realize what might have happened with a foster daughter. She told the committee as a teen, her foster daughter was exchanging a jar of gasoline and huffing with a cousin who was burned badly when the cousin took a drag on a cigarette, it fell into the jar, and it flamed up, melting one side of her face. Representative Cissna said she believes impairment of the girl's pain receptors contributed to this tragic event. In a normal situation an individual would drop the jar, but if a person were huffing he/she would have lost that instant reaction. She asked if there is any record of these kinds of accidents, and if so, how many there are. REPRESENTATIVE KAPSNER said Jim Henkelman might know the answer. REPRESENTATIVE CISSNA said inhalant abuse and the effects on kids is much more extraordinary than alcohol. It is far worse than can be imagined. REPRESENTATIVE KAPSNER agreed and said it is a silent epidemic and is claiming the lives of a lot of people nationwide. REPRESENTATIVE GATTO said that the more volatile a substance is, the more valuable it is to someone that is an inhalant abuser. If the substance is volatile then it becomes a gas very easily, and is flammable and very hazardous. Representative Gatto pointed out that once it gets into the lungs it is transported quickly to an individual's heart and then to the brain. It takes only seconds to have an impact on individual's brain - anesthetizing it. He said inhaling alcohol is also pretty instantaneous, not ethyl alcohol that is normally ingested, but wood alcohol. Representative Gatto said it is an enormously horrible thing to do to anything that is alive. He expressed concern for a method of changing abusers' behaviors, and said he believes this resolution is a start. REPRESENTATIVE KAPSNER noted that there is a zero fiscal note on the resolution. She shared one more point with the committee, that inhalants are the fourth most abused substances [following alcohol, tobacco, and marijuana] among high school students. Number 1952 ZOANN MURPHY, Health and Social Services Planner, Community Health and Emergency Medical Services Section, Division of Public Health, Department of Health and Social Services, testified in support of HCR 8. She told the committee her duties include injury prevention and she would like to speak about the poison prevention portion of the resolution. Ms. Murphy [holding up a highlighter pen] told the committee this would be very valuable to a teen who wanted to huff. All the other substances the committee spoke about are dangerous, but so is a highlighter and it can be picked up for $.99. She told the committee she puts together the annual report for poison control for the State of Alaska. Poisoning is the tenth leading cause of injury death and the eighth leading cause of non-fatal hospitalized injuries to Alaskan children ages 0-19 from 1994 through 1998 [the most current statistics available]. Ms. Murphy told the committee the national fatal poisoning rate for the years 1994 through 1999 is 6.5 for 100,000. Alaska has a very small population with a very large problem. She urged the committee to pass HCR 8. Ms. Murphy provided the committee with background information on the injury surveillance and prevention program. Number 2092 REPRESENTATIVE SEATON asked about the map on Alaska for the rate per 100,000 [population] by region from 1994 through 1999 and asked if the rate was a total for all five years or an average yearly rate. MS. MURPHY responded that it is for the entire time period from 1994 through 1999. REPRESENTATIVE SEATON responded that if these rates are for a five-year period and if the committee wanted to look at it per year, then, for example, the total for the "Interior (Rural)" - which is 51.31, divided by 5, gives a rate of 10 per year. MS. MURPHY said she does have a chart that shows approximately nine children under the age of four are injured severely enough to be hospitalized [statistics from trauma registry data]. She told the committee the statistics are dated and the department is still working on the 2000 and 2001 data. REPRESENTATIVE SEATON asked if the comparison with the United States that she provided was based on an annual rate. MS. MURPHY replied that it was also a five-year rate. REPRESENTATIVE CISSNA asked if there is any substantial research done on this subject. She asked where the department gets most of the information on kinds of incidents and prevention efforts. Number 2148 MS. MURPHY replied that the information comes from a variety of sources. The report provided to the committee was put together by the Oregon Poison Center [an organization the state is collaborating with]. She told the committee her rate information came from the Alaska Trauma Registry which is a registry that lists all hospitalized patients and fatality information, which is provided by the Alaska Bureau of Vital Statistics. REPRESENTATIVE CISSNA asked if there is any effort in Alaska to look for funding sources to do extensive research on this subject. She said when Alaska finds it is the leader in the nation in some indicator, it is important to find solutions and export that knowledge. MS. MURPHY responded that the department is in the process of doing that under a federal HRSA [Health Resources and Services Administration] grant. In fact, this is how the poison center collaboration effort came about. She said currently education has focused on getting the word out on the 1-800 number, but expressed hope that the next round of federal grant funding will allow the department to expand that into more community outreach. Ms. Murphy said she is currently attending as many health fairs as possible to get the word out. REPRESENTATIVE KAPSNER said she believes the numbers are very low. She asked how the department is characterizing fatal and nonfatal poisonings in Alaska. She told Ms. Murphy that it seems artificially low to find only 20 people in her region having a fatal or non-fatal poisoning during a five-year period. Number 2243 MS. MURPHY replied the number is a rate per 100,000, not a number of individuals. REPRESENTATIVE KAPSNER said the figure still seems very low. MS. MURPHY said the numbers vary from year to year. REPRESENTATIVE KAPSNER asked if poisonings would including people who die of inhalant abuse. MS. MURPHY replied that it would include inhalant deaths, but most of the poisonings that are reported to the poisoning center do not include inhalants, because generally by the time the victim has gotten to the hospital the condition is classified as a poisoning. She said that could change, but it would require going back over the numbers. REPRESENTATIVE KAPSNER said a number of years ago, five or six people died in one of the villages because the person who was running the water treatment facility put too much fluoride in the water. Would that be classified as a poisoning? MS. MURPHY replied that it would be classified as a poisoning. REPRESENTATIVE SEATON said he does not think the statistics relate to the problem the Kenai Peninsula is experiencing. This rate of 28.43 per 100,000 people for five years would reflect less than one person per year. He said if it was just his district it might be plausible; however, there are three districts on the Kenai Peninsula. Representative Seaton said he does not believe these statistics reflect the issue of recreational huffing. He said he believes Ms. Murphy's report is dealing with a different problem. Number 2358 REPRESENTATIVE CISSNA moved to report HCR 8 out of committee with individual recommendations and a zero fiscal note. There being no objection, HCR 8 was reported from the House Health, Education and Social Services Committee.