Chroming, or Volatile Substance Misuse (VSM), has killed more than a dozen young Australians since 2009, but a coronial inquest has heard the full extent of the "incredibly difficult issue" is not known, and debate continues about how to combat the problem.
A range of experts have given evidence on Thursday at the inquest into the death of 16-year-old Bradley Hope, which is being held in Byron Bay.
The Tweed teenager died after inhaling aerosol deodorant during a sleepover at a friend's house in December 2019.
There is broad agreement about the circumstances surrounding Bradley's death. But his mother Corinne Mair lobbied for an inquest in a bid to "stop another young life like Bradley's being lost".
A court order has been issued to prevent the publication of the specific techniques and products used in chroming, along with discussions about their effects.
The inquest heard VSM could involve a range of "ubiquitous" products that were only linked by the way they were administered.
A stigmatised 'gutter' drug
Sarah MacLean from La Trobe University told the court there seemed to be trends and fashions in chroming.
"Products of choice change and are really location-based," she said.
"Particular products become fashionable at particular times."
But the court heard the use of inhalants was far from glamorous.
"They're seen as a gutter drug — bottom of the barrel," Dr MacLean said.
"There's a lot of shame involved. There's certainly a huge amount of stigma around VSM as you get older."
How common is chroming?
Amy Peacock from the National Drug and Alcohol Research Centre says there are "significant gaps" in the knowledge base surrounding VSM.
"Stigma around use can lead to underreporting," she said.
"Data from surveys often does not capture adolescents [and] those under the age of 14."
One survey that was cited by several experts was the Australian Secondary Student Alcohol and Drug Survey from 2017.
It showed that 13 per cent of almost 20,000 students had used inhalants.
Of those, 43 per cent had chromed once or twice, but 19 per cent had done it 10 times or more in one year.
A similar survey was conducted this year. The results have not been published.
Debate around education
There was a lengthy discussion during the inquest about how to effectively deliver education and harm-minimisation messages about chroming.
The director of Drug and Alcohol Research and Training Australia, Paul Dillon, said it should not be left to teachers.
"This is an incredibly difficult issue to deal with from a classroom perspective," he said.
"The vast majority of teachers don't want to deal with it."
Mr Dillion told the court that teachers who did discuss harm-minimisation strategies risked "finding themselves on the front age of the paper" if their comments were relayed to parents out of context.
He told the court it was also difficult to convince parents and families to tackle the issue.
"Unless it actually affects them directly, they look at it and say, 'My child doesn't do that.'"
It was agreed that one effective measure would be to appeal to the desire of young people to keep their friends safe.
Daniel Madeddu, executive director at the NSW Health Centre for Alcohol and Other Drugs, said a strategy similar to the Stay OK campaign that targeted festival-goers could be used to urge those using inhalants to call triple-zero (000) at the first sign of trouble.
"We have to reassure young people that you are going to get non-judgemental care," he said.
"The basic message is if you see your friends in trouble, call for help."
The inquest continues on Friday.
