Fornits
Treatment Abuse, Behavior Modification, Thought Reform => Straight, Inc. and Derivatives => Topic started by: ` on March 16, 2005, 12:50:00 PM
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[sorry this is long, too busy to edit, can cut later]
Copyright © 1986 J.B. Lippincott Company;
Clinical Pediatrics
Clin Pediatr (Phila) 1986; 25: 308-310
June, 1986
SECTION: TOXICOLOGY
LENGTH: 1444 words
TITLE: Abuse of Isobutyl Nitrite Inhalation (Rush (registered)) by Adolescents
AUTHOR: Richard H. Schwartz, MD, <1> Page Peary, MA <2>
ABSTRACT: Isobutyl nitrite is a volatile liquid sold without a prescription as a "room odorizer" but is widely used as an inhalant to produce feelings of euphoria. Of the 173 13-22-year-olds (mean age, 16 years) clients of a long-term drug treatment facility who completed a questionnaire related to drug use, 74 (43%) admitted to having used isobutyl nitrite at least once, 22 (13%) had used the substance ten or more times, and eight (4%) used the substance 50 or more times. Inhalation of this malodorous substance leads almost universally to dizziness and lightheadedness and usually to severe symptoms of vasodilatation such as "pounding of the heart," blurred vision, and a "warm feeling." The feeling was unpleasant to 44 percent of the users in this study, and most also experienced pulsatile headache. In addition, contact dermatitis and irritation of the tracheobronchial tree and eyes occurred in some users. The primary use of this substance as an euphoric agent warrants consideration of banning its sale altogether.
TEXT:
ISOBUTYL NITRITE, a volatile liquid sold legally without prescription as a "room odorizer," is usually known as "Rush," a trade name. Long popular with homosexual men because of its ability to relax the anal sphincter of the passive partner during anal intercourse and because of its alleged ability to enhance and prolong sexual orgasm, [n1-n3] this volatile aliphatic nitrite also has become very popular with heterosexual adolescents as a means of getting "high." It is estimated that between 1973 and 1978, 12 million bottles of Rush were sold [n4] in discotheques, "head shops," pornography shops, and by mail order ctalogues specializing in drug-related paraphernalia.
The present communication seeks to (1) educate pediatricians, who may not be knowledgeable about this widely abused drug, and (2) report results of a survey of prevalence of use and effects of isobutyl nitrite among adolescent and young adult clients of a drug-treatment facility.
Study Design and Patient Population
Straight Incorporated, Springfield, Virginia, is a unique long-term therapeutic community for chemically dependent adolescents and young adults. The clients are predominantly middle class and white, and the vast majority have a diagnosis of conduct disorder or identity disorder, as well as dependency or abuse of cannabis or alcohol. Most clients at Straight, Inc. have experimented with a vast array of mood-altering drugs. The data in this report were gathered from a 21-item questionnaire about inhalant use answered by clients present at the facility on a single day. The questionnaire was approved by the program director and the professional treatment staff, participation was entirely voluntary, and confidentiality of individual results was assured. The questionnaire was given to individuals attending a large group therapy session, and the young people were informed that the purpose was for medical research only. There were no rewards or consequences based on the decision to participate or not.
Results
We evaluated 173 completed questionnaires received from 126 males and 47 females ranging in age from 13 to 22 years (mean age, 16 years). Clients' drugs of choice were cannabis, alcohol, amphetamines, inhalants, hallucinogens, cocaine, and phencyclidine, in that order. The median age by which clients used drugs monthly was 13.5 years. Seventy-four clients (43%) had inhaled isobutyl nitrite at least once, and 22 (13%) of the 173 clients had used the substance ten or more times (Table 1). The 19 male and 3 female subjects who had abused isobutyl nitrite ten or more times ranged in age from 14 to 19 years, with a mean of 17 years. TABLE 1. Use of Isobutyl Nitrite by 173 Clients at a Drug Treatment Facility
No. Times Used No. Clients %
Never 99 57
1-9 52 30
10-19 6 3
20-49 8 5
50-74 2 1
75-99 -- --
100-199 3 2
200-299 1 1
300-399 1 1
400-499 1 1
Totals 173 101
The 22 clients who inhaled isobutyl nitrite at least ten times had almost all been introduced to the drug by a close friend who had furnished the drug. Frequent users often bought the drug themselves from "head shops" (33%), record stores (17%), pornography shops (11%), or from a mail-order catalogue (6%). The substance was sniffed directly from the bottle (21 clients) or the fumes inhaled from a saturated rag (1 client). Isobutyl nitrite was inhaled in solitude (72%), with close friends (67%), with an older individual (61%), or before heterosexual intercourse (17%). Trade names of isobutyl nitrite products used by the clients were Rush (78%), Locker Room (17%), Bullet (17%), Quick Silver (17%), Thrust (11%), Lightning Bolt (6%), and Hardware (6%).
Dizziness and lightheadedness were almost universal after inhaling isobutyl nitrite, but "heart pounding" (67%), blurred vision (67%), a "warm feeling" (56%), headache (34%), burning in the nose (17%), and nausea (11%) were also reported. Syncope, cough, dyspnea, and a red face were reported by one client each. The "high" obtained from inhaling isobutyl nitrite was described as fair to good by 56 percent and not at all pleasant by 44% of the 73 young people who inhaled the drug at least once.
Discussion
Isobutyl nitrite, a volatile, flammable liquid with an unpleasant smell, is chemically similar to the vasodilator amyl nitrite (street name "poppers"). Both drugs are deliberately inhaled by a significant number of "funseeking" teenagers: in 1984, 10 percent of 17,000 American high school seniors surveyed stated that they had inhaled volatile nitrites at least once. [n5] Marketed under a variety of brand names, often with sexual connotations, vials of isobutyl nitrite bear printed warnings to avoid direct inhalation of the vapors, precisely the use to which this drug is usually put. Indeed, the label of one brand states, "Danger, excessive use may cause euphoria."
The odor of isobutyl nitrite is not pleasant. [n6] The rush of blood to the head felt after inhalation of the vapors of the drug is due to profound vasodilation, lasts only a few minutes, and may be associated with postural hypotension and syncope, as noted in one of our patients. Pulsatile (pounding) headaches, lightheadedness, and blurred vision and pressure in the eyes are also common effects. Spilled isobutyl nitrate can cause nasal and upper lip dermatitis with pronounced yellow crusting, [n7] while prolonged exposure to the fumes can cause irritation of the eyes and of the tracheobronchial tree. [n8] Some methemoglobin-reductase enzyme-deficient susceptible people, after sniffing isobutyl nitrite, develop severe methemoglobinemia, [n9-n11] and at least one infant fatality has been reported secondary to methemoglobinemia, which developed after accidental ingestion of isobutyl nitrite. [n12]
Amyl nitrite, a volatile aliphatic nitrite closely related to isobutyl nitrite, is useful in the treatment of angina pectoris, but in 1969 this drug was restricted to prescription use only because of its increasing abuse by male homosexuals. [n13] Isobutyl nitrite, a licit drug sold openly soon took the place of amyl nitrite in the homosexual community, although some individuals continued to obtain amyl nitrite illegally by stealing capsules from emergency kits used to treat industrial cyanide poisoning. [n14]
The young people in this study had been in treatment at least 2 weeks and an average of 4 months. Being honest and open about their drug problems was an integral part of their recovery from chemical dependence. Conclusions from three published studies support the validity of self-reporting of drug use by adolescents. [n15-n17] Eight of the recovering chemically dependent young people who answered the questionnaire stated that they deliberately inhaled isobutyl nitrite 50-400 times. In most cases the drug was obtained from a close friend who usually purchased the 12 ml bottle for $5 to $6 at a record store or "head shop" in the neighborhood. Users of the drug became intoxicated alone or with a small group of friends. Almost 50 percent of the "users" described their experiences with isobutyl nitrite as unpleasant because of universal symptoms of lightheadedness and dizziness and frequent symptoms of tachycardia, blurred vision, facial flushing, and severe pulsitile headache.
In 1985, New York State restricted the sale of isobutyl nitrite [n18]: Any New York shopkeeper who knowingly sells the volatile nitrite for the purpose of intoxication will be subjected to criminal prosecution.
SUPPLEMENTARY INFORMATION: From the <1> Department of Child Health and Development, George Washington University, Washington, D.C. and <2> Director, Straight Inc., Springfield, Virginia.
Correspondence to: Richard H. Schwartz, MD, Medical Director, Straight Incorporated, 5515 Backlick Road, Springfield, VA 22151.
Reprints not available.
Received for publication November 1985, revised and accepted January 1986.
REFERENCES:
[n1.] Lowry TP. Psychosexual aspects of volatile nitrites. J Psychoactive Drugs 1982;14:77-9.
[n2.] Israelstam S, Lambert S, Oki G. Use of isobutyl nitrite as a recreational drug. Br J Addictions 1978;73:319-20.
[n3.] Lowry TP. Nitrite inhalants for sex -- the quest for the ultimate orgasm. Sex Med Today. July 1980, p. 34.
[n4.] Freezer WJ, Ed. Isobutyl Nitrite and Related Compounds. San Francisco, Pharmex, Ltd., 1978.
[n5.] Johnston L, Bachman J, O'Malley P. Use of licit and illicit drugs for America's high school students 1975-1984. Rockville, MD: National Institute on Drug Abuse, 1985.
[n6.] Horton L. Amyl/butyl nitrite and nitrous oxide. Phoenix, AZ: Do It Now Publications, 1979.
[n7.] Fisher AA, Brancaccio RR, Jelenek JE. Facial dermatitis in men due to inhalation of butyl nitrite. Cutis 1981;27:146, 152-3.
[n8.] Covalla JR, Strimlan CV, Lech JG. Severe tracheobronchitis from inhalation of an isobutyl nitrite preparation. Drug Intell Clin Pharmacy 1981;15:51-2.
[n9.] Horne MK, Waterman MR, Simon LM, et al. Methemoglobinemia from sniffing butyl nitrite. Ann Int Med 1979;91:417-8.
[n10.] Romeril KR, Concannon AJ. Heinz body haemolytic anaemia after sniffing volatile nitrites. Med J Australia 1981;1:302-3.
[n11.] Dixon DS, Reich RE, Santinga BA. Fatal methemoglobinemia resulting from ingestion of isobutyl nitrite, a "room odorizer" widely used for recreational purposes. J Forensic Sci 1981;26:587-93.
[n12.] Nickerson M, Parker JO, Lowry TP, et al. Isobutyl nitrite and related compounds. San Francisco: Pharmex Ltd., 1979.
[n13.] Labataille LM. Amyl nitrite employed in homosexual relations. Med Aspects Hum Sexual 1975;9:122.
[n14.] Cataldie L. Theft of amyl nitrite. JAMA 1983;249:2456.
[n15.] Smart RG, Jarvis GK. Do self report studies of drug use really give dependable results? J Durg Issues 1981;23:83-92.
[n16.] Needle R, McCubbin H, Lorence J, et al. Reliability and validity of adolescent self-reported drug use in a family-based study: a methodological report. Int J Addictions 1983;18:901-12.
[n17.] Benson G, Holmberg MB: Validity of questionnaires in population studies on drug use. Acta Psychiatr Scand 1985;71:9-18.
[n18.] Samuel Grafton, Ed. Butyl nitrite restricted in New York: state consumer agency presses FDH for action. Substance Abuse Report 1985;16:8.
[ This Message was edited by: formerly known as on 2005-03-16 09:53 ]
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National Library of Medicine MEDLINE Database
TITL: Adolescent cocaine abuse. Addictive potential, behavioral and psychiatric effects.
AUTH: Estroff T W; Schwartz R H; Hoffmann N G
ORGA: Harbor Oaks Hospital, Ft. Walton Beach, Florida.
PUB TYPE: Journal Article.
CITE: Clin Pediatr (Phila) 1989 Dec; 28 (12): 550-5
LANG: ENG; English
ABST: Four hundred seventy-nine drug abusing adolescent patients enrolled in seven Straight, Inc. Adolescent Drug-Abuse Treatment Programs in five geographic regions across the United States were studied to determine the severity and patterns of cocaine abuse. Of these, 341 admitted to cocaine use and became part of this survey. Cocaine use was categorized as heavy, intermediate, or light. Areas examined were the addictive spectrum, psychosocial dysfunction, and psychiatric symptoms. Intermediate and heavy users of cocaine abused significantly less marijuana and inhalants than light cocaine abusers. Heavy and intermediate users were more likely to use cocaine intravenously and to use crack. They developed tachyphylaxis more frequently, progressed to weekly use in less than 3 months more frequently, and became preoccupied with obtaining and using cocaine significantly more frequently. They used more sedative hypnotics to calm themselves and engaged in more criminal behavior, such as stealing from parents and stores and passing bad checks. They had more arrests for possession of drugs, stole more cars, sold more drugs, and were more likely to trade sexual favors to obtain the drug. Heavy and intermediate users were significantly more psychiatrically disturbed than light users, becoming more suspicious, nervous, aggressive, and demonstrating increased symptoms of fatigue, sleeplessness, decreased appetite, and increasing cocaine dysphoria. All of these symptoms could be mistaken for psychiatric disorders. This study suggests that cocaine is as addictive in adolescents as in adults; possibly more so. It also causes psychosocial dysfunction and psychiatric symptoms. Further research into cocaine addiction among adolescents is indicated.
MJTR: Adolescent Behavior. Cocaine. Mental Disorders, etiology. Substance-Related Disorders, psychology.
MNTR: Adolescent. Adult. Comparative Study. Female. Humans. Male. Marijuana Abuse, complications. Marijuana Abuse, psychology. Questionnaires. Substance-Related Disorders, complications. United States.
RNUM: 50-36-2 (Cocaine)
GEOT: UNITED STATES
IDEN: ISSN: 0009-9228. JOURNAL-CODE: 0372606. ENTRY-DATE: 19900111. SPECIAL-LIST: AIM IM. JOURNAL-SUBSET: AIM IM.
PMID: 2582695
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National Library of Medicine MEDLINE Database
TITL: Outcome of a unique youth drug abuse program: a follow-up study of clients of Straight, Inc.
AUTH: Friedman A S; Schwartz R; Utada A
ORGA: Philadelphia Psychiatric Center, PA 19131.
PUB TYPE: Journal Article.
CITE: J Subst Abuse Treat 1989; 6 (4): 259-68
LANG: ENG; English
ABST: A unique feature of the 12-hour per day Straight, Inc., program is temporary placement of the client with the family of a client who has progressed further in the program. Eighty-five (85) percent of the clients reported that their drug use was less at follow-up than when they started in the program. Follow-up reports by parents indicated their impression of a statistically significant decrease in the proportion of clients who were still involved in substance use. Statistically significant improvement at follow-up was also reported by the clients on seven of eight other selected outcome criteria (e.g., suicidal thoughts, physical violence, number of arrests, etc.). The majority of the clients reported that they were "satisfied" with the program (70%), that the program "helped" them (74%), and, specifically, that the program helped them with their relationship with their parents (69%).
MJTR: Day Care. Substance-Related Disorders, rehabilitation.
MNTR: Adolescent. Alcoholism, rehabilitation. Female. Follow-Up Studies. Humans. Male. Opioid-Related Disorders, rehabilitation. Research Support, U.S. Gov't, P.H.S.. Social Adjustment. Social Environment. Street Drugs. Substance-Related Disorders, psychology. Virginia.
RNUM: 0 (Street Drugs)
GEOT: UNITED STATES
IDEN: ISSN: 0740-5472. JOURNAL-CODE: 8500909. ENTRY-DATE: 19900112. NIH-GRANT-NUMBER: 64986/PHS. SPECIAL-LIST: IM. JOURNAL-SUBSET: IM.
PMID: 2593209
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NIH-GRANT-NUMBER: 64986/PHS
searching for this...
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Human Subjects Research
http://grants.nih.gov/grants/policy/hs/index.htm (http://grants.nih.gov/grants/policy/hs/index.htm)
http://www.hhs.gov/ohrp/ (http://www.hhs.gov/ohrp/)[ This Message was edited by: formerly known as on 2005-03-16 10:19 ]
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I wonder how many of those kids had never even done the stuff. :tup:
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we should figure out where he is publishing now, and warn them of his history of illegal as well as inaccurate research tactics...[ This Message was edited by: fka on 2005-06-02 05:35 ]
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Richard Schwartz was my pediatrician some years ago. During my physical, my mother complained of some problems we were having at home. He proceeded to screen my urine w/o telling me (which came back negative, I was only 14, I was not using any sort of drugs). He then recommended a place to my mother- Provo Canyon School, where I was sent for a year and a half.
Dr. Schwartz has one of the most terrible, unprofessional bedside manners I have ever seen. At age 13, I had caught mononucleosis at summer camp. The next year, he tried to convince me to receive hepatitis b vaccines, and he loudly proclaimed "I assume you're sexually active!". I was, in fact, not! Really, I was a child. Also that year, I refused to drop my pants and allow him to examine my pubic area, and he stated "You know I could have a nurse come in here and hold you down". That man should not be allowed to work with children. And I believe that some years ago, his office burned down, and lots of his medical records were lost.
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From what I have read this doctor has been sexually inappropriate with a lot of girls. Maybe someone should report him to the proper people and get his license revoked.
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from the VA Board of Medicine: http://www.vahealthprovider.com/results ... 0101020170 (http://www.vahealthprovider.com/results_hon.asp?License_No=0101020170)
Honors and Awards - Optional
Last Updated 6/15/2001
Practitioner Research Award
American Academy of Pediatrics
1990
Adolescent Health: Award for distinguished service by a practicing physician
American Medical Association
1990
20 Years teaching service
Georgetown University School of Medicine
1994
[ This Message was edited by: formerly known as on 2005-03-18 20:27 ]
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How to File a Complaint:
http://www.dhp.virginia.gov/enforcement ... t_home.htm (http://www.dhp.virginia.gov/enforcement/complaint_home.htm)
I posted the awards because of the dates he got them, especially the practitioner research award... will try to find out about the research he was doing.
Does anyone know the dates of Schwartz' tenure at Straight?
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ISOBUTYL NITRITE, a volatile liquid sold legally without prescription as a "room odorizer," is usually known as "Rush," a trade name. Long popular with homosexual men because of its ability to relax the anal sphincter of the passive partner during anal intercourse and because of its alleged ability to enhance and prolong sexual orgasm
ISOBUTYL NITRITE helps children with ADD so they are not sent to an emotional growth boarding school.