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31
Straight, Inc. and Derivatives / Raps
« on: April 11, 2005, 09:29:00 PM »
This was written by someone else, I don't know who. I really hope they don't mind if I post it here, if they do I can take it down. Read at your own risk.

Some more about rap structure and the process of rap's :

Types of Raps
Past/Present/Future- This was the most common of the therapeutic
raps. There would be a basic theme or concept. For instance, staff
might come in to the front of the group and ask someone to relate
about a time in their past when they failed to do what they had said
they would do. Everyone would start to motivate, a noisy proposition,
and staff would call on a oldcomer to set a good tone for the rap.
Then staff would relate a little to what they said,and then a couple
more oldcomers. Eventually once the idea was established
staff would start calling on newcomers. People who did not relate with
specific personal and heartfelt information would be confronted.
Staff would call on someone else in the group to carry out the
confrontation. Staff would lead the group into relating about the
present. This might provide them a window to ask a person who had
failed in a commitment the prior day-just why did it happened ? This
kind of planned confrontation was daily. The Rap would end on
positive note, with staff leading the group to discuss
goals or dreams about fulfilling commitments in the future.

Confrontation- The "volcano" was a favorite confrontation rap. There
were many similar concepts. The basic idea is to get one or two
people to describe exploding, or the things that a volcano does, then
start to call on the people targeted for confrontation. These were
people who were anything short of 100% compliant and enthusiastic
about the program. These raps often led to extensive verbal assault
and physical battery. Confrontation raps were almost always with a
couple of Sr. Staff or higher in the room, or possibly leading the
group. They might also participate from the back of the
group.

Review- There were only a couple of review raps as I remember it. One
was rules rap, a daily recitation of the entire litany of rules
including memorization of all the names and positions on the chain of
command. The other common review rap was after the open meetings on
Friday and Monday nights.

Off The Wall- If the group was in a good place we would at times be
treated to an off the wall rap. This might include breaking up into
groups and working on role playing projects.

Core Idea- This rap was "grown from a core statement or central
thought".Avoiding chronological development staff would lead the
group in the process of taking "the pearl" and add layer after layer
of insight and perception to it before the rap draws to a close.

Work Groups- Splitting into triads or larger groups to allow each
small group work as a team to build a project or skit. This is more
of a technique than a kind of rap as it can be integrated in many rap-
types.

Instructional- Some review raps are instructional, often morning rap
is instructional, the point of the rap is to educate. Virtually all
basics raps were instructional. RSC or RSA raps were instructional.
Kind of self-explanatory.

Introduction- Staff could choose to do their own introduction to the
group as the basis for a rap. They could answer questions about their
own lives and pasts as a way to build trust with the group.

Basics- A basics rap was about the seven steps and the other *tools*
of change that the program offered. They avoided confrontation and
personal issues. Staff would keep the pace fast and the relating
brief. However, it should be noted that any rap about "honesty" could
start off as basics and end up confrontational. It was the staff
members call, it could change directions in the time it took for a
fifth phaser to hand in a Chain of Command report.

Love Rap- Generally every night rap was some variety of love rap.
Confrontation was avoided; focus was on changes of the day, setting
goals and other positive concepts. Misbehavers were often carried out
to the intake rooms for these positive raps. Love raps were mushy
tear filled events where people who had been carving in their own
arms all day would stand up and cry from the stress. These
emotionally battered children would promise to change the following
day and start the whole process over again in the morning.
Daily Rap Structure Basics-The object is warming up the group &
getting them to start thinking about the steps again. Focus them, get
them started motivating, do an early assessment for the mood of the
group. Label trouble points and correct seating arrangements. Rap
solely focused on basics of the program. Avoid confrontation or
personal issues.

Morning Rap- A quick paced shallow rap about the past habits ties and
friends. A fast paced process of demonizing anything that was part of
the clients life prior to the program. Clothing, foods, behaviors,
thoughts and every other aspect of the "past" was demeaned
repeatedly. Morning rap was to set the mood for the day - compulsive
confession. On open meeting days this slot was filled with Homes Rap.

Guys & Girls Rap- Much more personal rap, with one staff member
typically of the same gender as the group. These raps involved
intense pressure to discuss sexual topics. Confession of the most
horrific sexual thoughts was encouraged. Guys talked about their
natural random homo-erotic thoughts as if they were demons that were
part of the druggie world coming to drag them into relapse. Girls
talked about how they were sluts in their pasts and confessed to
having sluttish desires towards the guys in the group, again,
as part of the drug problem. Guys talked about being "losers" in their
pasts, and "losers" in their current school/work environments outside
the program.. These raps were often highly confrontational, and
regularly degraded into physical violence for both sexes.

Exercise Rap- Staff Trainees typically led this rap, though at times
it was a fifth or fourth phaser. The exercises were always performed
with no warm up or cool down process. We were always on a hard floor.
We often did exercises that were really damaging to our bodies. The
worst were the forced leg lifts, often mixed with aggressive verbal
assault and physical battery. I remember people jogging in place
barefoot, or in otherwise poor footwear for such high-impact
exercise. I have li ttle doubt that this practice caused
physical damage to many of clients. If you think about it for a
minute,prisons can't do this to people, and schools have to have a
licensed instructor, and even then it has to be voluntary. This was
daily forced exercise without regard for the potential damage. The
objective was simple-get the group worked up before confrontation rap
of the day.

Afternoon Rap- The most confrontational rap slot of the day. This was
oftena period of two solid hours of loud aggressive verbal assaults
along with physical battery. Afternoon rap was a sweaty inferno in
the Georgia summer.These raps would attract senior staff and the
group staff supervisor. These were people who were highly skilled at
verbal assault and manipulation.Afternoon rap was the tear down point
of the day for the newcomers. They were faced with the waves of
oldcomers arriving from school and work,flaunting their freedom.
These so called examples would then spend the late afternoon and
evening hours relating to the group, confronting newcomers and
doing the grunt work of operating the program. Newcomers were brought
to understand over time that if they simply confessed to being a drug
addict,and learned to believe it, they too could be a part of this
elite group & free from the hell of being a newcomer. On open meeting
days this slot was filled with Executive Rap.

Night Rap- Almost always a love rap of some sort, the idea was to send
everyone home thinking about themselves and how lucky they were to be
alive and in straight. Night rap often included turning the lights
down low, staff members telling their own stories, lots of tears,
slow songs etc. Bring the kids down from being abused each night
before you send them home.What is a Rap ? For my own part a rap was a
period of two hours or longer, in a group of 100-300 people, getting
motivated and if called upon, standing up and trying to relate to the
rap topic in a way that would win me group approval. Once I got into
staff training I learned more about how the raps were structured
and what their purposes were as I have written above, but that still
does not seem to answer the question, what is a rap ?

It is nearly impossible to explain the level of emotional pressure
developed within the group. A rap was always focused on addiction and
recovery, even an off the wall rap would end with a serious note
about addiction and the risk of ending up dead or in jail. Raps are
about the entire group changing,not just individuals. An individual
revelation in a rap can be therapeutic or traumatic for everyone in
the room. Raps were a chance for staff and upper phasers to use
information they had about newcomers against them, with
the goal of changing these peoples minds.

Raps are very structured group conversations. Staff would pick and
choose who they called on in group based on knowledge of how that
person will relate to a rap topic. Trusted higher phasers, especially
fourth and fifth phasers were exected to set the example of relating
in a manner that obtained group approval. Group approval was only
offered for people who had come to accept themselves as insane, and
in need of God. The deceptive and generic term higher powers is often
put forth as a denial of the religious nature of the program. It is
merely smoke and mirrors. Newcomers are coerced through intense group
pressures into relating in the same way. Relating in anyway that is
off the topic or focus of the rap will result in prompt
verbal assault and potentially physical battery. The process of
confession and conformity was central to the program and raps were
planned to elicit as many confessions as possible from group
memebers. The ultimate goal was to elicit complete self disclosure,
the sharing of ones innermost thoughts,darkest ideas and deepest
fears. Revelation of these normally hidden but natural human emotions
and fears in such a traumatic and stressful manner left the kid in a
state best described as an emotional sponge. If you truly
want to find out how this feels, go to work tommorrow, stand up in the
middle of the cubicle farm, and profess loudly and tearfully your most
deeply hidden secret or fear, that one thing that you would really
rather no one ever knew - like having sex with a relative, touching
your dogs genitals when you were 8 years old etc. Everyone has them,
we all grew up on the same planet. Try it, see if you like it. To get
the full effect be sure there are at least 100 people around, and get
them all to yell "we love you" at you when you are done. Complete the
process by sitting down and flailing your arms and upper body around
wildly for the next 12 hours without speaking again all day. Please
let me know how it goes via E-mail.


Kids, don't try this at home and all standard disclaimers for this
kind of example apply Raps were the only way that a newcomer was
allowed to communicate for twelve hours a day. A newcomer who did not
get motivated would not be called on and could go the entire day
without being permitted to speak. A newcomer who spoke out in group,
without the permission of the staff, would quickly be battered, at
the hands of those around them, If the surrounding clients were
not agressive enough in enforcement, a staff member would incite them
to physically assault a newcomer who was not motivating and relating
appropiately in a rap. Someone would put their hand over the
newcomers mouth and try to gag the person. If there was any
resistance to this battery, the newcomer would then be further
battered, restrained, and perhaps thrown to the ground and sat upon-
all for the act of speaking. There was no avenue of recourse for the
newcomer. Most often in a few weeks or months the same
newcomer would be apologizing for "forcing the group to restrain me
for my own good, to protect me from my twisted drug habit of speaking
out without permission", or some such programmed lingo-drivel.

Raps were the core control feature, raps were the entire day, even
dinner and lunch were referred to as raps. During meals we would be
objects of ridicule if we did not put our food down to get motivated
to speak each time we had the chance. Raps were constant, they were
woven together with the Straight Inc. songs, they never seemed to
end. There was no "recess".



Rap Topics and Outlines I can Remember
The Cliche Rap - A particular Sr. Staff member did a really smoking
cliche rap that stands out in early 1984. The idea was to get people
into relating in really cliche based statements, leading the group
into the use of cliches by relating as a Sr. Staff in a pat short
shallow way. As the group gets into the cliches and people use more
and more of them, then you ask them what is a cliche ? then start
asking some problem oldcomers to explain cliches in their programs
etc...it turns into a raucous confrontational game, you see as people
talk in cliches trying to deny that they are doing so, Staff would
call on someone who is frantically trying to get the chance
to confront the first person. This second individual is waving their
hand in the air attempting to manipulate the staff in any way
possible to be the one to confront, and when called on starts to use
a new set of cliches to confront with, so the staff gets to call
them down with a third phaser standing up , and so on till you get
four or five people all standing. The last one up has to be the first
to finish, and ach one in turn has to eat their words and be publicly
humiliated and humbled.

32
Tacitus' Realm / NDRI: The Center for Therapeutic Community Research
« on: April 11, 2005, 08:28:00 PM »
who are these people? i did a search for journal articles on therapeutic communities, and the names on this website published a bunch of them.

http://www.ndri.org/ctrs/ctcr/ctcrpubs.html

33
Straight, Inc. and Derivatives / Want to Get Together, People?
« on: April 09, 2005, 10:46:00 PM »
Hey folks, I know a lot of us would like to put together our efforts to get some stuff done. What was that thing you used to say about a herd of cats, Antigen? Nevertheless, some folks are working on stuff behind the scenes. pm me if you want to network. this does not mean i'm in charge, i'm not!   :smile:

34
Copyright 1983 The Washington Post  
The Washington Post
January 29, 1983, Saturday, Final Edition
SECTION: Metro; B7

LENGTH: 272 words

HEADLINE: Judge Dismisses Lawsuit Against Drug Program

BYLINE: By Leah Y. Latimer, Washington Post Staff Writer

BODY:
A Fairfax County man's class-action suit requesting $750,000 for each of the participants in Straight Inc. , a national drug rehabilitation program with a Fairfax branch, was rejected yesterday by a federal judge who said the man's charges of brainwashing and harassment were an individual matter.

U.S. District Court Judge Albert V. Bryan Jr. said there was insufficient evidence to prove that the suit, filed in Alexandria last month by Fred Collins, 20, represented the wishes of more than 3,000 program participants cited in the suit. Bryan said Collins could, however, proceed with an individual suit against the program.

The ruling followed a last-minute attempt by Collins' attorney to limit the persons included in the suit to participants in the Fairfax program. "It doesn't make any difference, class or no class" action, attorney Philip Hirschkop said yesterday, "as long as we can go forward."

Ronald Goldfarb, a D.C. lawyer representing the Florida-based drug rehabilitation program, called Collins a "rebel without a constituency" and contended that "90 percent of the case was thrown out" as a result of the ruling.

Collins had charged that he was held captive in Florida by Straight counselors for 5 1/2 months last year. His suit alleged that the firm's methods included regular mental and physical abuse such as solitary confinement and lack of food.

Bryan also denied a motion by Collins to release the names of program participants. Earlier, a group of parents and participants in the Straight program presented affidavits denying Collins' charges and saying they did not want to be in the lawsuit.

35
You got my email address. If you hate this forum, quit coming around here. Don't tell me to get to work and then come here and waste time yourself.

36
Feed Your Head / The God of Small Things
« on: March 25, 2005, 03:19:00 AM »
_The God of Small Things_ by Arundhati Roy

ISBN: 0060977493
Format: Paperback, 336pp
Pub. Date: April 1998
Publisher: HarperCollins Publishers


one of the best books i ever read. it's not about god, it's about love and the caste system in India.[ This Message was edited by: formerly known as on 2005-03-25 00:21 ]

37
Feed Your Head / SYNANON: The Tunnel Back by Lewis Yablonsky
« on: March 24, 2005, 12:16:00 PM »
found a copy at a used bookstore. need it for a couple months, then i can pass it on. read at your own risk, it seems so far to be pro-Synanon...

38
Straight, Inc. and Derivatives / We were medical research subjects
« on: March 22, 2005, 09:08:00 AM »
thestraights.com/people/medical-doctors/medical-research.htm
 
http://fornits.com/wwf/viewtopic.php?to ... forum=7&10

Does anyone remember any research projects firsthand?

39
Straight, Inc. and Derivatives / What happened
« on: March 18, 2005, 01:35:00 AM »
I still really don't understand, I really don't get what happened to me in Straight. I mean, what did they do to turn me into a Straightling. Did they do something that made me literally psychotic, or was I before and that made me extremely weak in there? Did previous abuse and neglect make it harder for me to see what was so wrong there? Has anyone else experienced paranoia to the extent that they would rather be homeless than live in an "exposed" place? I would like to figure this out because i seem consistently able to screw my life up and never get anywhere and also because i know this question is fairly central to everything i mean the way i have experienced my life and the way i conceive of myself. i mean, if i have a mental or emotional problem, or whatever, and you know, i think that feeling like you don't (or can't) exist is kind of a mental problem, then what happened, or was I always like this and Straight just made everything more painful. if someone reads my post and sees themself in them and the crashing and you found a way out of that it might help me.

40
Paul Newman (Newman's Own) contributed a significant amount of money to Straight, Inc., according to a news article (see post below for full text) from 1992. I'm looking for a list of his current charities. Maybe we could take our story to him and ask for funds for our side of the cause now.





[ This Message was edited by: formerly known as on 2005-03-18 19:05 ]

41
[note type in bold regarding unreported suicide attempts]

Times Publishing Company  
St. Petersburg Times (Florida)

 View Related Topics

July 31, 1991, Wednesday, City Edition

SECTION: NATIONAL; Pg. 1A

LENGTH: 873 words

HEADLINE: States take hard look at Straight

BYLINE: DAVID BARSTOW

BODY:
 In Massachusetts, authorities say a youth is punched in the face by a staff member of Straight Inc., the controversial drug treatment program based in St. Petersburg.
 
 In Virginia, a 13-year-old Straight client is molested by a 19-year-old client, but the incident is never reported to state officials.
 
 In California, state officials refuse to license Straight, citing evidence of "unusual punishment, infliction of pain and humiliation."
 
 These are troubled times for Straight, which in happier days won praise from Nancy Reagan and President Bush as one of the nation's best drug treatment programs for adolescents.
 
 Under intense criticism from state regulators, Straight pulled out of California last year and Virginia this week. In March, Straight's treatment program in Texas was placed on probation by a major accreditation commission. Last month, Massachusetts regulators refused to renew Straight's foster care license, which could make it difficult for Straight to continue business there because the program requires clients to live with "host families" while undergoing treatment.
 
 "We had very severe concerns about what was going on there," said Betty McClure of Massachusetts' state Office for Children. She cited the case of a child with scoliosis curvature of the spine who was forced to sit on a floor for 10 hours and was physically restrained by other children.
 
 Straight officials deny the allegations of mistreatment.
 
 "We don't abuse kids," said Joy Margolis, Straight's spokeswoman in St. Petersburg. "If we abused kids do you think parents would want to have their kids here?"
 
   Margolis said two-thirds of the children who complete Straight's long-term therapy remain drug-free for at least two years.
 
   "We do a lot of good," she said. "We save lives. We reunite families."
 
   Straight currently operates treatment programs in five states Texas, Michigan, Florida, Georgia and Massachusetts. Straight officials claim to have treated more than 50,000 family members since the drug treatment program was established in 1976.
 
   Straight offers an intense five-phase program in which clients must adhere to strict rules: No living at home. No TV. No school. Limited contact with anyone outside the program. Gradually, as progress is made, the restrictions are relaxed and teen-agers are l l returned to families and schools.
 
    Over time, Straight has refined and revised many of its more controversial methods, Margolis said. Now only trained counselors are allowed to restrain clients who become violent. "Oldcomers" no longer lead "newcomers" around by their belts. They link arms instead. "It's a bonding technique," Margolis explained.
 
   One state where regulators are pleased with Straight's recent performance is Florida. Straight has programs in Orlando and St. Petersburg.
 
   In 1989, the state Department of Health and Rehabilitative Services (HRS) threatened to yank Straight's license unless it fixed several problems. For example, HRS officials were concerned by accounts that clients were allowed to restrain other clients.
 
   Straight corrected the problems, HRS officials say.
 
   "They're in good standing with our department here," said Bob Holm, HRS' substance abuse coordinator for Pinellas County. "They've done well."
 
   Officials in other states tell different stories.
 
   Jacqueline M. Ennis supervises licensing for Virginia's Department of Mental Health, Mental Retardation and Substance Abuse Services. She said that in July 1990 Straight officials signed a consent agreement promising to correct several problems. But when Virginia officials inspected Straight six months later, they found 76 violations, she said.
 
   Some violations were minor, such as paper work errors, she said. Others were potentially life threatening. Several children attempted suicide while staying with host families, but the attempts were not reported and the children were not treated, Ennis said. And Virginia officials learned that a Straight client had molested a younger client from news reports.
 
   Ennis also criticized Straight for persisting with "dehumanizing" treatment techniques. Some teen-age clients were forced to reveal their sexual fantasies during group sessions, she said. Others were subjected to what she called "spit therapy," where children would spit on each other to reduce their egos.
 
   Straight spokeswoman Margolis said Virginia officials overreacted to "unsubstantiated claims" made by disgruntled clients. She said Straight complied with all Virginia regulations and had been lauded by state officials for making improvement.
 
   So Virginia's decision in January not to renew Straight's license was a surprise, Margolis said. Rather than fight Virginia regulators, Straight officials decided this week to move the program about 30 miles north, to Columbia, Md.
 
   Ennis said Maryland regulators have been warned. "I think the folks in Maryland know what they're getting," she said.


LOAD-DATE: November 12, 1992

42
Copyright 1992 The Atlanta Constitution  
The Atlanta Journal and Constitution

March 6, 1992, Friday

SECTION: STATE NEWS; Section D; Page 1

LENGTH: 216 words

HEADLINE: Center administrator denies clients' allegations

BYLINE: By Diane Loupe STAFF WRITERregulations; investigations; facilities; abuse; public; hospitals

BODY:
C. Suzanne Hardman-Broder, administrator of Straight Inc., denied that clients were abused or mistreated and claimed that the state regulators did not discuss such allegations with her.

Straight Inc., which has been operating in Marietta for almost 11 years, is part of a Florida-based chain of adolescent drug-treatment facilities that has come under fire in other states. Officials in California, Virginia and Florida have investigated complaints of abuse, in some instances closing facilities.

Clients at the Marietta facility alleged they were:

Called a "slut," "tramp" and a "hell-raiser" in front of a group.

Denied access to water, medical care and sleep.

Physically restrained and not permitted to leave even if they were an adult.

Other problems detailed by the regulators included:

The facility couldn't prove their psychiatrist evaluated a client who swallowed a bottle of cough medicine and some whiskey, and slashed his arm.

One counselor had only a general equivalency diploma; three others had only bachelor's degrees with majors in psychology.

Ms. Hardman-Broder said the allegations "concerned' her but noted, "I also have worked with dysfunctional people who tend to say things when they want to prove a case that may be exaggerated or taken out of context."

LOAD-DATE: March 7, 1992

43
Straight, Inc. and Derivatives / Step Inc.? never heard of it before
« on: March 16, 2005, 02:10:00 PM »
Times Publishing Company  
St. Petersburg Times (Florida)

May 27, 1993, Thursday, City Edition

SECTION: COMMUNITY TIMES; Pg. 1

DISTRIBUTION: COMMUNITY TIMES

LENGTH: 596 words

HEADLINE: 'I had a second chance'

BYLINE: LISA CUNNINGHAM

DATELINE: TAMPA

BODY:
 The drinking started for Grant Nations when he was about 10 years old. He  said he was trying to gain acceptance from his peers.

"Then after that, I liked it," Nations said.

Eventually, he was drinking, smoking marijuana, sniffing inhalants and  abusing over-the-counter medicines.

So his parents checked him into the Step Inc. program for alcoholics. He  was just 14.

"I didn't want to go," Nations said. It was eight months into the  program, which operates similar to the Straight Inc. program, that he finally  realized he had a problem.

Now, Nations talks to teenagers about his experience.

The Kiwanis Club of Tampa gave Nations, a Chamberlain High School senior,  its 11th annual youth leadership award Wednesday. More than 100 club members  and their guests attended the luncheon at the Riverside Hotel in downtown  Tampa.

Nations was chosen because of his "strong commitment to leading other  young people in the right direction, exhibited by his active volunteer work"  in Tampa, said Kiwanis member Bob Lewis.

Nations' guidance counselor, Sandra Schmidt, nominated him for the award.  "Grant made some wise choices" when he chose his friends at Chamberlain, she  said.

His parents, Glen and Susan Nations, also came to the luncheon. Grant  thanked them for their role in changing his life.

"I really had no earthly idea that what I'd been through was going to  affect so many people," Nations told the group. "I used to be a follower. I  used to envy the people who could lead."

He has spoken about his addiction at events sponsored by the Fellowship of  Christian Athletes. He also has talked at Students Against Driving Drunk  assemblies at his school and at Buchanan Junior High School.

The Step program is "very tough," Nations said. Counselors are all  graduates of the program. Sessions are 12 hours long each day.

"Until you prove yourself, you're not even allowed to go to school," he  said. "All your privileges are taken away" and gradually given back. If  someone is caught drinking or using drugs, privileges are again revoked.

Nations spent 19 months in the program. The last six months were a  follow-up period. It was similar to prison because "you can't get away," he  said.

He was taken completely off drugs, which "wasn't so bad," Nations said.  "You had only yourself, and you had to deal with what was coming."

After his treatment, Nations played football and baseball at Chamberlain.  In 1991-92, he was named the school's Male Athlete of the Year.

He earned a 4.0 grade-point average and joined many student organizations,  including the National Honor Society, Student Council, the Science Academic  Society and the Fellowship of Christian Athletes.

Nations will attend Baylor University this fall. He will major in business  administration.

Peer pressure is "not that big a deal after all," Nations said. "I  haven't drank in 3 1/2 years, and no one has ridiculed me. You don't have to  drink to be popular.

"I had a second chance. They (the kids he talks to) may not have a second  chance."

The club also recognized Curtis Frazier for his work with Tampa youth in  the YMCA/Tampa Housing Authority sports program. Frazier served time in prison  in 1988.

After his release, Frazier became a counselor for Young Life Urban  Ministries. In 1991, he rescued three children from a burning house in West  Tampa.

Frazier now counsels children on how to stay away from a life of crime.

Frazier was given a $ 100 savings bond, and Nations was awarded a $ 250  check.

GRAPHIC: BLACK AND WHITE PHOTO; Grant Nations, a Chamberlain High School senior, received the Kiwanis Club of Tampa's annual youth leadership award.

LOAD-DATE: May 27, 1993

44
[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.

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