ANCHORAGE -- At grocery stores in many Alaska villages, hair spray is kept behind the counter, out of reach of those who might use its noxious fumes as a cheap and easy way to get high.
It is recognition that in rural communities, where liquor is banned, hair spray, gasoline, cleaning fluids and other common chemicals pose an even greater threat than alcohol.
Inhalants can cause severe, permanent brain damage and even death. But because they are so easy to obtain -- even by young children -- inhalant abuse has been a subject that some parents and educators have avoided.
''People say you'll create a problem if you talk about it,'' said Sandra Mironov, behavioral health administrator for the Yukon-Kuskokwim Health Corp. ''We've hidden a lot of things through the years by not talking about them -- child abuse, sexual abuse, alcoholism. You just didn't talk about them.''
But talking about the problem can save lives, said Mironov, an organizer of the health corporation's third annual inhalant abuse awareness and prevention conference, which begins Wednesday in Bethel.
The three-day conference will bring together specialists to speak on prevention and treatment and offer individual counseling to inhalant abusers and their families.
''We will have a lot of speakers who will be talking about their own experiences with inhalant abuse and where they are with their own healing,'' Mironov said.
A 1998 survey by the YKHC found that, during 1996 and 1997, 161 Alaskans sought treatment for inhalant abuse at drug and alcohol treatment programs. During the same period, the survey found that 46 people with a history of inhalant abuse died.
Last September the Yukon River village of Emmonak mourned the loss of a 16-year-old girl who died after a night of huffing gasoline fumes.
Alaska children who use inhalants typically begin at age 8, with some starting as young as 5. About 20 percent of Alaska students in grades 7 and 8 have used an inhalant at least once, according to statistics compiled by the state Department of Health and Social Services. That's double the national rate.
Inhalant abuse creates a unique set of problems that drug and alcohol treatment centers are generally unable to deal with effectively, said Harvey Weiss, director of the National Inhalant Prevention Coalition and one of the speakers at the Bethel conference.
''A lot of treatment centers won't accept a huffer for a number of reasons,'' said Weiss.
An inhalant addict often needs at least 30 days in detox before therapeutic treatment can begin, but most insurance companies won't pay for more than 30 days at an in-patient facility, Weiss said. In addition, many substance abuse centers don't have the resources to deal with the neurological damage caused by inhalant abuse.
And among substance abusers, there is a stigma to using inhalants.
''Crack, heroin and cocaine users -- they would ostracize the huffer,'' Weiss said. ''There's just a perception that you've got to be really low to be a huffer.''
Max Mitchell, a career counselor who works with students in a dozen southwest Alaska villages, says inhalant abuse is seen as shameful among students -- even among those who do it. And the reluctance to admit to using inhalants can make it difficult to gauge the extent of the problem.
''There's a lack of social status. Everybody will tell you if they smoke pot. That gives you status,'' said Mitchell. ''Using inhalants means you don't have the peer connections to get pot.''
Getting treatment in Alaska should get easier.
YKHC has been awarded a $3.5 million federal grant to build a residential inhalant abuse treatment and detoxification center in Bethel. Mironov hopes the center will open next year.
Paula Albert, 16, of Bethel said it was feelings of worthlessness and despair that led her to abuse inhalants, huffing perfume and hair spray to get a ''dizzy, fuzzy'' feeling.
''When the good feeling went away, I wanted more,'' said Albert, who now speaks to groups about the dangers of inhalants and will address the conference on Thursday.
Instead of making her feel better, inhalants led to a deeper depression. Albert says she became more forgetful and eventually dropped out of school.
A frightening incident helped her to stop. One day, while inhaling perfume in her bedroom she felt a deep pain in her lungs and feared she might die.
''It felt as if they were being squeezed really hard,'' Albert said. With the encouragement of a friend, she eventually gave up inhalants and returned to school.
Because inhalants can quickly cause permanent damage, experts say prevention is the most effective way to deal with the problem.
''We can't emphasize enough the importance of providing alternative activities for the kids,'' Mironov said. ''We need people volunteering to help so that kids have other choices than getting into trouble.''
The alternative is costly.
A 1993 study by the Indian Health Service in Alaska found that a 19-year-old person with a chronic history of inhalant abuse and significant brain or organ damage will cost society $1.4 million over their lifetime for treatment, medical care, social services, law enforcement and the courts.
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