'Tick, Tick, BOOM! Recent updates in the use of electronic cigarette technology as an illicit drug delivery system' - A multimodal review of how licit harm reduction devices are being co-opted into potential lethal weapons.

Abstract

The vaporization of illicit drugs can be traced back to ancient times, to snuff boxes with traces of psychedelic drugs in Aztec tombs and opium pipes being found in the remains of many great ancient Chinese societies. The advancement of e-cigarette technology has resulted in a new and novel way to vaporize drugs, and while nicotine vaping remains their primary use, meta-analysis of online forums and statistical analysis indicates this is trend which is increasing in popularity. This paper aims to provide an update on the state of e-cigarettes being used as an illicit drug delivery system, the potential public health consequences of this kind of appropriation and a toxicological assessment of the most popular drugs being vaporised. A systematic review of online dark web marketplaces and online drug forums have formed the basis of this review. It can be concluded that this is a growing area of public health concern and one which should be continued to be monitored closely, particularly with respect to Novel Psychoactive Substances due to their continued and abundant proliferation and lack of research with respect to their toxicological profiles.

Vaping Opioids: Should We Be Worried?

“…Many people impacted by EVALI had accessed contaminated vape products through informal sources (i.e., online) rather than products sold in a store. 13 It may be the case that individuals are also being exposed to opioids unintentionally through buying products from informal sources. This may be of particular concern among youth given they cannot legally purchase vaping products from a vape retailer.…”