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How Teenage Vaping Puts Structure in Place for Heroin and Cocaine Addiction

U.S. News & World Report logo U.S. News & World Report 6/13/2018 Indra Cidambi, M.D.

Teen girl tries e-cigarette with her friend: Smoking among teens has decreased – because teens are vaping nicotine instead. © (Getty Images) Smoking among teens has decreased – because teens are vaping nicotine instead. The rapid adoption of e-cigarettes has been driven, at least in part, by a huge jump in the potency of e-liquids.

Cigarette smoking among teenagers is on the wane. While data show smoking among teenagers has dropped over the past few years, it's not all good news. Teenagers are vaping nicotine instead. One in 8 – or 12 percent of – teenagers in New Jersey have tried e-cigarettes and/or hookah at least once. When cigarette smoking and nicotine vaping are added together, nicotine use may actually have increased. The rapid adoption of e-cigarettes has been driven, at least in part, by the huge jump in the potency of e-liquids (both nicotine and marijuana) used in vapes. Nicotine and marijuana act on the brain in ways similar to other substances of abuse and prime the brain for addiction to other potent drugs down the road.

Exponential Jump in E-Liquid Potency

Part of the reason for the adoption of e-cigarettes by teenagers is the exponential jump in the potency of e-liquids (nicotine and marijuana) used in vapes. E-liquid products like JUUL contain nearly 50 milligrams of nicotine per milliliter of liquid, whereas a cigarette has about 12 milligrams of nicotine. THC content in liquid concentrates, used in vapes, can range between 50 and 90 percent, as compared to 20 percent in marijuana. Vaping high-concentration marijuana can deliver a more intense high, but it can also lead to addiction.

Vaping Lays the Foundation for Addiction

Many people think smoking an e-cigarette is not nearly as bad as smoking a real one, but they're not completely correct. Although vaping eliminates fumes from paper and associated chemicals, a big concern is that nicotine is very addictive (it releases dopamine, like other drugs).

"Vaping" has already progressed from nicotine to marijuana, and concentration of nicotine and THC (per milliliter of liquid) has increased dramatically. Like more potent drugs, nicotine and marijuana stimulate the release of more dopamine in the brain, the "feel good" neurotransmitter. Chronic use of these substances will cause the brain to reduce the natural release of dopamine and an increasing amount of these substances will be needed in order to get the same "dopamine-release" response from the brain. This change in the reward pathways in the brain leads to addiction.

This increases the likelihood that these users will eventually "graduate" to more potent substances in order to quench their cravings or obtain a high. A study showed that 25 percent of teenagers who use e-cigarettes progressed to smoking pot, compared to 12.5 percent of teenagers who did not use e-cigarettes. 

Heroin and Cocaine Could Be Next

Users of heroin have been "vaping" it for a long time. However, they have used high heat (placing the heroin in a metal foil and using a lighter to heat it) in order to "vape" the heroin. Inhaling vapors is preferred, as it reaches the brain almost as fast as injecting the drug. Luckily, as of now, heroin and cocaine in their most common crystal form cannot be used in vaping devices, as the tight crystal structures in heroin and cocaine bind molecules strongly, making them "un-vapable" in the low heat that the vaping devices produce. However, it is predictable that drug cartels will make heroin and cocaine "vapable" down the road by mixing them with weak alkalis to create freebases that could be used in vaping devices. Anecdotal evidence suggests flakka, a synthetic drug, is already being vaped.

Action Needed Right Now to Restrict Access to Vaping Devices

The vaping trend has gone largely unchallenged until recently, but a concerted, coordinated response is called for in order to curb the use of e-cigarettes among teenagers. The state of New Jersey, for example, raised the minimum age to buy tobacco products to 21 years in 2017, and some municipalities have required e-cigarette vendors to be licensed.

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Copyright 2017 U.S. News & World Report

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