Legislature(2003 - 2004)

03/04/2003 03:02 PM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= 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.                                                                                        

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