Drug related deaths are now at their highest levels since records began in England and Wales. In 2017, there were 56 ecstasy deaths, each new tragedy generating headlines and leading to calls for action, such as the introduction of drug checking in nightclubs and festivals. But others are abusing a different range of substances, a problem that many people think largely disappeared in the 1980s and has been ignored in all the headlines.

Volatile substance abuse (VSA) comprises inhalation of volatile compounds in chemical products – such as glues, paints, spray deodorants and fuels – for their psychoactive effects. These substances are derided as a cheap high and use is stigmatised in comparison to other drugs. But users report that it can be pleasurable, as well as an effective means of self-medicating pain and low mood.

As volatile substances are marked for household or industrial purposes, they are readily available. Misuse is covered by the same laws designed to prevent supply of new psychoactive substances.

The response to VSA in the UK is fragmented and a more coordinated approach to data collection, prevention, treatment and supply reduction is needed. First, we need better data on use and associated harms.

"Not real drugs'

But this is likely to be an underestimate because charities and treatment providers tell us that pathways into treatment are hampered by stigma and therefore users are often unwilling to seek help. There is a perception from some users and providers that these substances are not considered "real drugs" and a lack of routine assessment by treatment workers and healthcare professionals means that a history of VSA is often missed by drug treatment and other health services.

Little is known about how to effectively prevent VSA and treat users. Although there is some tentative evidence to support the use of individual counselling, family therapies and residential activity and engagement programmes, few providers have the skills or resources to offer these solutions.

Industry's key role

The solvents industry has a key role to play in risk reduction. In the UK – and in keeping with cigarette labelling – this has led to the introduction of the SACKI logo (Solvent Abuse Can Kill Instantly) carried on almost all aerosol products. Manufacturers should be encouraged to continue looking for ways to make their products harder to misuse.

These substances are not "glamorous" and their use is not associated with fashionable clubs, festivals or modern cultural movements. Few in the media demand that government "does more" in response to the harm they do. Nevertheless, the health and social harms of VSA are significant.

The relative lack of attention paid to volatile substances and the harm they can cause suggests that society may value the people who use them even less than those who snort cocaine, inject heroin, smoke cannabis, or swallow prescription drugs.