The Rise in Opioid and Electronic Cigarette Abuse

Substance abuse is an epidemic that is on the rise throughout the world. It is a tragic trend, a battle against one's own brain chemistry, and it does not appear to be ending anytime soon. Instead of dying from viral disease, today's young adults are overdosing on drugs that they initially used to make their lives better. The difficulty of ending this epidemic lies in the fact that the disease is in the brain of the addict themselves. Through extensive research, scientists around the world are working to identify the drugs that are the largest threat. Identifying the most threatening drugs will assist in directing research to find an eventual solution. The most harmful drugs of abuse that are rising in popularity within American society are opioids as well as the contents within electronic cigarettes.

To begin, opioid abuse is a devastating issue that is impacting many and taking lives. According to the Center for Disease Control and Prevention, an estimated 2.1 million Americans were abusing opioids in 2016.  Additionally, the rate of opioid-related overdoses in 2017 is six times larger than the rate in 1999, coming to the average of 130 fatalities a day in the United States (Data Overview, 2018). The rate of opioid abuse is increasing exponentially and it does not seem to be ending any time soon, despite the efforts of healthcare workers and politicians. It is a true epidemic. 

Opioids impact physical and mental health in many different facets; all of which point to this drug being one of the most harmful drugs of abuse. Firstly, opioid abuse rewires the brain by hijacking its natural opioid system. When a user regularly floods their brain with opioids, the brain responds by synthesizing additional receptors, thus creating a system of addiction and tolerance. The user then will have to continuously increase their dose of opioids to achieve the same effect, as the brain is compensating on a biological level. The threat of these neurological changes is that it makes quitting incredibly difficult as the brain begins to expect a regular influx of opioids from the user (Darq & Kieffer, 2018). Currently millions of Americans are amidst this process, rewiring their brains to need opioids to maintain their own neurological homeostasis. Many of these individuals will become trapped within their addiction and eventually overdose as their brains continue to demand more and more opioids. Aside from the neurological risks of opioid abuse, the literature suggests that opioids may alter the endocrine and cardiovascular systems as well (Ali, Raphael, Khan, Labib & Duarte, 2016; Rawel & Pate, 2018). In general, opioids are incredibly dangerous drugs that are impacting millions of lives within the United States.   

While opioids have a higher fatality rate than nicotine products, it is not possible to discuss rising trends in substance abuse without bringing to attention electronic cigarette usage among today’s youth.  Electronic cigarettes, or “e-cigs,” are so common that they are almost normal. One cannot be on a college campus long before seeing puffs of vaporized smoke or “vape” fill the air. It is not a surprise that electronic cigarettes are the next big thing on campuses as companies, such as Juul, have been specifically marketing their products towards youth. In a 2019 study, 21.7 % of the 4,800 undergraduate students surveyed had reported smoking electronic cigarettes at some point in their lifetime (Hefner, Sollazzo, Mullaney, Coker & Sofuoglu, 2019). This result shows that electronic cigarettes are incredibly common yet society knows very little about they are doing to the bodies and minds of users. Initially, electronic cigarettes were considered the “safer” alternative to normal cigarettes. This is a common mentality as electronic cigarettes do not contain the tobacco or tar that are in “old-fashioned” cigarettes (Gottschalk, Fraga, HIrschfield & Zuckerman, 2019). Tobacco is known to increase the risk of various forms of cancer including cancer of the stomach, liver, kidney and esophagus (Vineis et al, 2004). Tobacco users also have an increased rate of cardiovascular diseases such as coronary heart disease and stroke (Mainali, Pant, Rodriquez & Deshmukh, 2015). While the deadly consequences of tobacco may not apply to electronic cigarettes, electronic cigarette users may not be avoiding as many health problems as they think.

 As the literature on electronic cigarettes has increased, it is becoming clear that this substance of abuse is far from harmless.  Firstly, it is important to note that electronic cigarettes do have nicotine, and while they may not be as addictive as traditional cigarettes they do have addictive properties (Liu, Wasserman, Kong & Folds, 2017). Even though electronic cigarettes do not have tobacco, they do have other chemicals that elicit harm on the body. For example, one of the many flavoring chemicals used in electronic cigarettes is diacetyl. Diacetyl is a chemical important to cytoskeleton and cilia development within the bronchial epithelial cells of the lungs. Those using electronic cigarettes have been found to have less cilia, thus hurting the functioning of their lungs and leading to possible respiratory problems (Park et al, 2019).  In addition, a recent meta-analysis found that electronic cigarettes may have a negative impact on cardiovascular functioning  (Kennedy, van Schalkwyk, McKee, M., & Pisinger, 2019).  Overall, electronic cigarettes have the potential to be incredibly harmful on the body, specifically within the lungs and heart.

It is important to note that the totality of the impact electronic cigarettes will have on society is still unknown. While they seem like a safe alternative to traditional cigarettes, it is impossible for scientists to know the entirety of the side effects as they are just now rising in popularity. Many of the side-effects of tobacco cigarettes did not become apparent until much later in the user’s life; this may hold true for electronic cigarettes as well. Electronic cigarettes have the potential to be very harmful and may deeply hurt the health of society in the years to come.

In conclusion, substance abuse is a major problem that is plaguing the United States and leading to the deaths of its citizens.  While there are many substances contributing to this problem, opioids and electronic cigarettes are playing an exceptionally large role due to their rising popularity. Even though they are very different substances, opioids and electronic cigarettes are damaging the health of millions of people at an increasing rate. It is important for scientists and politicians alike to focus their attention on these substances to improve understanding of their mechanisms and effects. Overall, opioids and electronic cigarettes are incredibly harmful drugs and greater research is needed to determine how to stop their cycle of destruction.

References:

• Ali, K., Raphael, J., Khan, S., Labib, M., & Duarte, R. (2016). The effects of opioids on the endocrine system: an overview. Postgraduate medical journal, 92(1093), 677-681.
• Darcq, E., & Kieffer, B. L. (2018). Opioid receptors: drivers to addiction?. Nature Reviews Neuroscience, 19(8), 499-514.
• Data Overview. (2018, December 19). Retrieved from https://www.cdc.gov/drugoverdose/data /index.html.
• Gottschalk, L., Fraga, J.-A., Hirschfield, J., & Zuckerman, D. (2019, November 25). Is Vaping Safer than Smoking Cigarettes? Retrieved December 10, 2019, from http://www.cent er4researc h.org/vaping-safer-smoking-cigarettes-2/
• Hefner, K. R., Sollazzo, A., Mullaney, S., Coker, K. L., & Sofuoglu, M. (2019). E-cigarettes, alcohol use, and mental health: Use and perceptions of e-cigarettes among college students, by alcohol use and mental health status. Addictive behaviors, 91, 12-20.
• Kennedy, C. D., van Schalkwyk, M. C., McKee, M., & Pisinger, C. (2019). The cardiovascular effects of electronic cigarettes: A systematic review of experimental studies. Preventive medicine, 105770.
• Mainali, P., Pant, S., Rodriguez, A. P., Deshmukh, A., & Mehta, J. L. (2015). Tobacco and cardiovascular health. Cardiovascular toxicology, 15(2), 107-116.
• Liu, G., Wasserman, E., Kong, L., & Foulds, J. (2017). A comparison of nicotine dependence among exclusive E-cigarette and cigarette users in the PATH study. Preventive medicine, 104, 86-91.
• Park, H. R., O’Sullivan, M., Vallarino, J., Shumyatcher, M., Himes, B. E., Park, J. A., ... & Lu, Q. (2019). Transcriptomic response of primary human airway epithelial cells to flavoring chemicals in electronic cigarettes. Scientific reports, 9(1), 1400.
• Rawal, H., & Patel, B. M. (2018). Opioids in Cardiovascular Disease: Therapeutic Options. Journal of cardiovascular pharmacology and therapeutics, 23(4), 279-291.
• Vineis, P., Alavanja, M., Buffler, P., Fontham, E., Franceschi, S., Gao, Y. T., ... & Sitas, F. (2004). Tobacco and cancer: recent epidemiological evidence. Journal of the National Cancer Institute, 96(2), 99-106.