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(partae - vaping)

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Abstract – Background: E-cigarettes are battery-operated devices that heat a liquid and deliver an aerosolized product to the user. Pulmonary illnesses related to e-cigarette use have been reported, but no large series has been described. In July 2019, the Wisconsin Department of Health Services and the Illinois Department of Public Health received reports of lung injury associated with the use of e-cigarettes (also called vaping) and launched a coordinated public health investigation.

Methods: We defined case patients as persons who reported use of e-cigarette devices and related products in the 90 days before symptom onset and had pulmonary infiltrates on imaging and whose illnesses were not attributed to other causes. Medical record abstraction and case patient interviews were conducted with the use of standardized tools.

Results: There were 98 case patients, 79% of whom were male; the median age of the patients was 21 years. The majority of patients presented with respiratory symptoms (97%), gastrointestinal symptoms (77%), and constitutional symptoms (100%). All case patients had bilateral infiltrates on chest imaging. A total of 95% of the patients were hospitalized, 26% underwent intubation and mechanical ventilation, and two deaths were reported. A total of 89% of the patients reported having used tetrahydrocannabinol products in e-cigarette devices, although a wide variety of products and devices was reported. Syndromic surveillance data from Illinois showed that the mean monthly rate of visits related to severe respiratory illness in June through August of 2019 was twice the rate that was observed in the same months in 2018.

Conclusions: Case patients presented with similar clinical characteristics. Although the definitive substance or substances contributing to injury have not been determined, this initial cluster of illnesses represents an emerging clinical syndrome or syndromes. Additional work is needed to characterize the pathophysiology and to identify the definitive causes.

Electronic cigarettes, or e-cigarettes, include a diverse group of battery-powered devices that allow users to inhale aerosolized substances.1 E-cigarette aerosol generally contains fewer toxic chemicals than conventional cigarette smoke.2 However, e-cigarette aerosol is not harmless; it can expose users to substances known to have adverse health effects, including ultra-fine particles, heavy metals, volatile organic compounds, and other harmful ingredients.2,3 E-cigarettes are commonly used to inhale nicotine but can also be used to deliver substances such as tetrahydrocannabinol (THC), cannabidiol (CBD), and butane hash oils (also known as dabs).4 E-cigarettes entered the U.S. marketplace around 2007 and since 2014 have been the most commonly used tobacco product among youths in the United States.1 During the 2017–2018 period, the prevalence of current use of e-cigarettes (also called vaping) increased from 11.7% to 20.8% among U.S. high school students.5 In contrast, 3.2% of U.S. adults reported current e-cigarette use in 2018.6

Published case reports have detailed a range of severe pulmonary illnesses among persons who have reported use of nicotine or cannabis extracts in e-cigarettes.7-13 No previous case series, however, has described large clusters of temporally related pulmonary illnesses linked to the use of e-cigarette products (e.g., devices, liquids, refillable pods, and cartridges).                     

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From August 2019 to date, over 2,700 patients have been reported with e-cigarette, or vaping, associated lung injury (EVALI) in all the states of the US.

Study - Severe Lung Injury Associated With Use of e-Cigarette, or Vaping, Products—California, 2019. Image Credit: Shannon Laura / Shutterstock

The study results

The investigators found that among 160 patients with EVALI of whom approximately 60% were male, with a median age of 27 years, about half received intensive care, and a little less than a third had to be put on mechanical ventilation. Four of them died in hospital.

Of the 160 patients, 86 were subject to interview. Among this group, 83% said they vaped products containing tetrahydrocannabinol (THC), which is the psychoactive component of cannabis. 43% had vaped products containing cannabidiol (CBD), another principal constituent of the same plant. 47% had vaped products containing nicotine.


The authors emphasize, “These findings underscore the importance for all clinicians, including outpatient health care providers, to consider EVALI in patients with a history of vaping who present with typical findings of infection, as well as monitor their clinical course and respiratory status closely for decompensation, in accordance with CDC guidance.”...depression, and anxiety are the most common illnesses found in patients with EVALI in California, which could indicate that such patients vape at higher rates or that such patients are at higher risk of EVALI.

Again, vitamin E or vitamin E acetate proved to be present in most products containing THC.

The study concludes, “The California Department of Public Health recommends that individuals refrain from using any vaping or e-cigarette products, particularly THC-containing products from informal sources, while this investigation is ongoing.”

Journal reference: Heinzerling A, Armatas C, Karmarkar E, et al. Severe Lung Injury Associated With Use of e-Cigarette, or Vaping, Products—California, 2019. JAMA Intern Med. Published online March 06, 2020. doi:10.1001/jamainternmed.2020.0664

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“Compared to many, my childhood was a cakewalk. Because your childhood beat you around and left you in pain doesn’t mean that you’ll continue the cycle. Let your hurt be the source of your greatest compassion, the deepest love and understanding. You can do anything. 

Walk through it, don’t numb or hide.

It’s been twenty-eight years since I stopped drugs and dedicated myself to a spiritual path, but those hard drugs I did, the heroin, cocaine, and meth, they hurt me bad, it took a long time to really recovery from ‘em. I hope for you that you don’t waste your energy there. 

Even the Weed. Man, I was way too damn young for that Shit, it made growing up a more difficult challenge that it needed to be. For years and years, I made the mistake of trying to run away, before I learned to surrender, accept my pain as a blessing, trust in the love, and let it change me.”

Acid for the Children,  ‘Flea’ – Bassist and co-founder Red Hot Chilli Peppers

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The youth vaping epidemic is of longer duration. Current use of e-cigarette, or vaping, products increased by 900% among U.S. middle and high school students between 2011 and 2015, declined in 2016, and then increased again between 2017 and 2018, erasing previous progress.2 In 2019, more than 5.2 million young people in the United States reported current use, including 27.5% of high school students and 10.5% of middle school students.2Both these epidemics predominantly affect young people and probably have multiple causes. Moreover, it’s likely that the widespread use of e-cigarettes, including products that facilitate THC use, has created an environment that has fueled the EVALI epidemic.

The EVALI and youth vaping epidemics warrant immediate and decisive action to protect public health. The use of vaping products among young people is unsafe, regardless of whether they contain nicotine or THC. Both marijuana use and nicotine use can harm brain development through young adulthood; starting to use these substances at a younger age also increases the risk of tobacco and cannabis use disorders later in life.1,3 The risks posed by these products are further compounded by the emergence of EVALI.

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REGULATE THIS INSANITY! It is not a conflation to say all illicit drug use can lead to this outcome, especially in a culture that seeks only pleasure, or only avoidance of any discomfort! 

 Murderous rampages, superhuman strength, and a high more potent than crystal meth: As deadly drug claims its first British victim, RICHARD PENDLEBURY investigates the insanity of taking flakka


Camille Balla will next appear at the Palm Beach courthouse, Florida, at the end of March. 

If her case goes to trial, the evidence is likely to unsettle even the most stout-hearted juror. And that is some understatement.

In March 2018, police were called to Balla’s home in Royal Palm Beach. There, they found the 32-year-old covered in blood, with large cuts to her fingers and palms. In the property’s garage they came across her mother Francisca, lying dead in a pool of blood.

  • Factory worker Andrea Horvathova, 23, died after taking flakka with a cocktail of other illegal substances in the UK 
  • Camille Balla, 32, allegedly smoked a flakka-laced marijuana joint before killing her mother at their home in Royal Palm Beach, Florida

Her eyes had been gouged out, seemingly by some of the shards of broken glass which lay around her...apparently by her own daughter.

Francisca’s eyeballs had been placed on a cardboard box a few yards from her corpse. While officers were contemplating this horror, Balla reportedly veered between icy calm and shrieking hysteria. When formally arrested she allegedly began to chant, ‘I’m a murderer’!

Later she is said to have told police that before she killed her mother she had been smoking marijuana, which she believed had been laced with the designer drug flakka.

This will have surprised no one in the Sunshine State, because in the last half dozen years Florida has been hit by a flakka epidemic. It has manifested itself in dozens of overdose deaths and suicides, as well as a number of disturbing public incidents

Flakka gets its street name from the Spanish slang phrase la Flaca. This loosely translates as ‘a slim attractive woman’. But there is nothing beautiful about the effects of the drug or the circumstances of those who abuse it. They are often poor, if not desperate, individuals.

In the UK a hit of flakka can be purchased for as little as £2.30 — and it is said to be more potent and addictive than crystal meth.

Alpha-pyrrolidinovalerophenone is flakka’s scientific name, or more simply alpha-PVP. It is a synthetic version of the natural chemical cathinone, the active ingredient in khat leaves that are chewed for their stimulating effects in the Horn of Africa and the Arabian Peninsula.

But other side-effects are grim, even deadly. Flakka can cause paranoia, delusions, hallucinations, aggression and psychotic behaviour, leading some abusers to think they have superhuman powers, such as flying or prodigious strength.

Sweating and dilated pupils are common indicators. Heart attacks and strokes are a risk under its influence. First-time users are said to take three to four days to return to a normal state of mind. Repeat users can take more than two weeks to be restored to equilibrium.

In 2017, Derren Morrison was sentenced to life imprisonment for beating to death Louise Clinton on her 83rd birthday. He told police he believed the grandmother, a total stranger, was a blood-covered demon who had been trying to kill him. He had been smoking flakka before the assault, he said.

Last year, another alleged flakka user gouged out his own eyes and attempted to chop off his penis. The 35-year-old medical student from Brazil had been depressed after splitting from his girlfriend.

Flakka use by people with existing mental health issues can have explosive consequences. But such is the drug’s reputation for inducing spectacular psychosis that it has been blamed for shocking crimes without solid proof of a connection.

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