A hot topic of the moment is the use of vapes containing something other than the usual e-liquid. In a way, this isn’t anything new: a few years ago hundreds of cases of lung problems (including several deaths) in the US were mostly found to be associated with the use of vapes containing non-standard ingredients. The outbreak was significant enough that a new condition emerged, called “e-cigarette or vaping associated lung injury”, or EVALI for short.
What gradually emerged was that EVALI seemed to result from the use of vapes containing THC, one of the psychoactive chemicals found in cannabis. Other ingredients were also implicated but, more pertinently for the purposes of this blog, it raised awareness that vaping devices could be used as a delivery device for all kinds of substances and not just nicotine, and a black market had emerged for people seeking this out.
It is one thing choosing to take a drug, by whatever route of administration, but quite another when it happens without the individual knowing. And given the increase in the popularity of vaping, perhaps it shouldn’t have been surprisingly – though still concerning – when this summer there were headlines about festival-goers being taken ill after using vapes they’d come across at events.
Where adults go, children often follow, and that has definitely happened with vaping. Awareness has never been as high as it is now, so recent news reports of children collapsing after using vapes believed to have been spiked, feel almost inevitable. Another alarming factor is that under 18s are more likely to source vapes through illegal supply chains in order to subvert age restrictions. While retailers may seem legitimate, if they are not doing age checks a question arises around the diligence with which they conduct other aspects of their business, such as where they source the items they sell… and if they are unregulated, all bets are off in terms of ingredients.
The most common drugs that seem to appear in spiked vapes are THC and Spice. Given that THC is in cannabis, those who vape it might expect a similar experience to smoking weed, but it is likely to be much more unpredictable – and remember that cannabis is an illegal drug in the first place, and therefore subject to huge variabilities. Much like using edible forms of cannabis gives rise to different effects than smoking the drug, so with vaping it can also be very different.
Spice is a whole other world of complexity. It is a synthetic cannabinoid, so there can be an expectation that the effects will be similar to cannabis – on the plus side, relaxed, chatty and giggly, but at the other end of the scale can be panic attacks, vomiting and paranoia – but the reality is that it is much more potent. This means it is very easy to use too much and have an unpleasant experience that involves drowsiness, loss of concentration and coordination, alterations in mood and perception, hallucinations, amnesia and fearfulness which may manifest as aggression.
The effects can also last a long time, and some users report suicidal thoughts, tremors, seizures, and chest pains or even a heart attack due to an increase in heart rate and blood pressure. There is a risk of kidney injury, serotonin syndrome (which can be fatal), exacerbation of underlying mental health conditions, and psychotic episodes. There is also a danger of dependence developing. So someone who naively gets Spice into their system, particularly if they are young, is in real danger.
These vapes sit outside the regulations so won’t be impacted by the proposed Tobacco and Vapes Bill (assuming all the plans come into force), other than retailers being subject to more stringent enforcement. So this is very much about raising awareness that these products are out there, and starting or returning to conversations which may seem like common sense advice but actually are important harm reduction messages: an illegal drug is an unknown quantity, make no assumptions about quality and safety, and think carefully about what you do and the impact it can have.