E-Cigs and Drug Use
The use of tobacco products can lead to nicotine addiction and prolonged use can result in lung disease, cancer and cardiovascular disease.1 Electronic cigarettes or e-cigs are perceived safer than traditional tobacco cigarettes and their use is on the rise.2
“In 2012 adolescent ever-use increased to 6.8% and, among high school students, went as high as 10.0%. While the identified common correlate of e-cigarette use was a history of cigarette smoking, a notable proportion of adolescents and young adults who never smoked cigarettes had ever-used e-cigarettes.1”
E-cigarettes are battery operated devices that deliver nicotine via inhaled vapor.3 These devices utilize a mixture of chemicals (refered to as “e-juice”) containing carrier liquids, flavors, and nicotine which is vaporized (aka “to vape”) and inhaled.4 To complicate the debate on the safety of e-cigarettes is the growing trend is utilize them as a delivery device for abusing prescription and illicit drugs. E-cigarettes and vaporizers can deliver some drugs very efficiently (which is not always a good thing). Inhalation allows a direct route for molecules (i.e. nicotine or drugs) from the pulmonary circulation to the arterial circulation allowing these molecules to reach the body and brain very quickly.
“Although they do not produce tobacco smoke, e-cigarettes still contain nicotine and other potentially harmful chemicals. Nicotine is a highly addictive drug, and recent research suggests nicotine exposure may also prime the brain to become addicted to other substances.”-National Institute on Drug Abuse
Very little research has been conducted on the use of e-cigarettes with liquid drug formulations. However, laboratories are beginning to see cases involving these nicotine solutions with e-cigarettes and therefore we must be aware of what individuals are using and selling. Drug forum websites reference the use of these devices with illicit drugs such as synthetic cannabinoids (aka “synthetic weed”, “Spice” or “K2”), “crack” cocaine, heroin/black tar heroin (a mixture of 6-monoacetylmorphine and 3-monoacetylmorphine), and prescription drugs (i.e. fentanyl). Individuals are also reporting that they attempt to dissolve solid-dose drugs such as benzodiazepines (i.e. Xanax, Valium, Klonopin) into the e-cigarette liquids to smoke. Depending on the drug the effectiveness of this method of drug delivery is debatable, but what we do know is the use of oral formulations of drugs by an alternative route such as by intravenous injection can have detrimental effects.5
With little published information on the use of e-cigarettes with drugs it is difficult to determine the risk that is posed to users of these devices. In the interim, the Food and Drug Administration has “issued a proposed rule that would extend the agency’s tobacco authority to cover additional products that meet the legal definition of a tobacco product, such as e-cigarettes”.6
- Sweanor, D. The risks and benefits of long-term use of nicotine replacement therapy products. Food and Drug Administration. Accessed May 1, 2014.
- Chapman, C. and Wu, L. E-cigarette prevalence and correlates of use among adolescents versus adults: A review and comparison. Journal of Psychiatric Research. 2014 Mar 18.
- Sutfin, E., Mccoy, T., Morrell, H., Hoeppner, B., and Wolfson, M. Electronic cigarette use by college students. Drug and Alcohol Dependence. 2013 Aug 1;131(3):214-21
- Schripp, T., Markewitz, D., Uhde, E., and Salthammer, T. Does e-cigarette consumption cause passive vaping? Indoor Air. 2013 Feb;23(1):25-31
- Sundararaghavan S, Suarez WA (2004) Oral Benadryl and Central Venous Catheter Abuse-A Potentially “Lethal Combination”. Pediatric Emergency Care 20(9):604-606
- Food and Drug Administration. Electronic Cigarettes (e-Cigarettes). Accessed May 3, 2014.