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E-cigarettes, Vapes and JUULs - What Teens Should Know

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Information for teens on e-cigarettes, vapes and JUULs, including what they are and health effects.

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What Is Vaping?

Vaping is the inhaling of a vapor created by an electronic cigarette ( e-cigarette) or other vaping device.

How Does Vaping Work?

E-cigarettes (or "vape pens") heat a liquid until it becomes a vapor, which is inhaled. The liquid (e-liquid or "vape juice") can contain nicotine or marijuana distillate or oil. E-cigarettes can be refillable or pre-filled with cartridges containing the e-liquid. The pre-filled e-cigarettes (called "Puff Bars") are designed for one-time use. After taking a certain number of "puffs," the user throws the device away.

What Are the Health Effects of Vaping?

The health risks of vaping include:

addiction: E-cigarettes contain nicotine, a drug that's highly addictive. You don't have to vape every day to get addicted.

anxiety and depression: Nicotine makes anxiety and depression worse. It also affects memory, concentration, self-control, and attention, especially in developing brains.

becoming a smoker: People who vape are more likely to start smoking regular (tobacco) cigarettes and may be more likely to develop other addictions in the future.

impotence: There is some evidence that vaping can cause sexual dysfunction in men.

sleep problems

exposure to cancer-causing chemicals

chronic bronchitis

lung damage that can be life-threatening

Other health effects are possible that we don't yet know about. Vaping hasn't been around that long, so its health risks aren't all known.

Why Should I Quit?

Wanting to be the best, healthiest version of yourself is an important reason to quit vaping. Others include:

Addiction: Addiction in the growing brain may set up pathways for later addiction to other substances.

Brain risks: Nicotine affects your brain development. This can make it harder to learn and concentrate. Some of the brain changes are permanent and can affect your mood and ability to control your impulses as an adult.

Use of other tobacco products: Studies show that vaping makes it more likely that someone will try other tobacco products, like regular cigarettes, cigars, hookahs, and smokeless tobacco.

Toxins (poisons): The vapor made from e-cigarettes is not made of water. The vapor contains harmful chemicals and very fine particles that are inhaled into the lungs and exhaled into the environment.

Sports: You want to do your best in sports, and vaping may lead to lung inflammation (irritation).

Money: Vaping is expensive! The cost of the cartridges over time starts to add up. Instead, you could spend that money on other things you need or enjoy.

To go against tobacco company advertising: Many e-cigarettes are made by the same companies that produce regular cigarettes. Their marketing targets young people by making fun flavors for e-cigarettes and showing young, healthy people vaping. They're trying to make you their next lifetime customer.

How Can I Quit?

Decide why you want to quit and write it down or put it in your phone. Look at the reason(s) when you feel the urge to vape.

Pick a day to stop vaping. Put it on the calendar and tell supportive friends and family that you're quitting on that day.

Get rid of all vaping supplies.

Download tools (such as apps and texting programs) to your phone that can help with cravings and give encouragement while you try to stop vaping. You can try:

Understand withdrawal. Nicotine addiction leads to very strong cravings for nicotine. It can also lead to:

feeling tired, cranky, angry, or depressed

trouble concentrating

trouble sleeping

hunger

restlessness

The signs of withdrawal are strongest in the first few days after stopping. They get better over the following days and weeks.

Get ready for feelings, people, and places that make you want to vape. If possible, avoid places and people that trigger the urge to vape. If you feel the urge to vape, try these things instead:

Chew sugar-free gum or drink water.

Text, call, or hang out with a friend who will support you.

Listen to your favorite playlist.

Go for a walk or jog.

Try yoga or meditation.

Take 10 deep breaths.

Keep your hands busy with a hobby, like drawing or making jewelry.

Go somewhere where smoking/vaping isn't allowed.

When Should I Call the Doctor?

Call your doctor right away if you vape and have:

coughing, shortness of breath, or chest pain

nausea, vomiting, or diarrhea

tiredness, fever, or weight loss

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Vaping: What You Need to Know (for Teens) - Nemours KidsHealth

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E-cigarettes (or “vape pens”) heat a liquid until it becomes a vapor that’s inhaled. Vape juice can contain nicotine or marijuana distillate or oil. Here are the facts on vaping and its many health risks.

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Some people have been led to believe that vaping is completely safe. However, there are significant risks to be aware of - especially for young people.

Exposure to nicotine

Nicotine is a stimulant that makes the nervous system prepare the body for physical and mental activity. It causes breathing to become more rapid and shallow, and increases the heart rate and blood pressure. Nicotine exposure from vaping varies quite a bit depending upon the contents of the e-liquid, the type of device used and how it is used.

Vaping exposes young people to nicotine at a time when the brain is most at risk for addiction. Because the brain continues to develop until early adulthood, roughly age 25-30, use of any addictive substance prior to these years is especially risky. Young people who vape are affected much more than adults by nicotine.

Exposure to toxic chemicals and other harmful ingredients

Vapes contain a number of chemicals, metals and ultrafine particles. These are poisonous when heated to form an aerosol and then inhaled. Because of their chemical ingredients, certain popular flavors - such as cinnamon, vanilla, butter and mint - are especially harmful. Some of the flavoring chemicals are considered safe when eating or drinking. However, once they are heated to produce an aerosol, they form additional harmful compounds that can cause lung damage. There also is evidence that some metals and other components of vapes can seep into the e-liquid and enter the lungs when heated and inhaled, causing mild to severe lung damage.

Nicotine is a highly addictive substance. People who vape can quickly become addicted to the nicotine that is in nearly all vapes. They are also at increased risk of starting to smoke cigarettes or use other addictive substances. If your child stops vaping, even for a short period, they can experience withdrawal symptoms. These include strong cravings, irritability, fatigue, headache, sleeplessness and difficulty concentrating. These symptoms can drive them right back to the nicotine product, even when they want to quit. In fact, many people who are able to stop smoking cigarettes by switching to vaping find it extremely difficult to quit vaping. This is due to the very high doses of nicotine and the ease of vaping.

Cigarette smoking

Teens and young adults who vape are significantly more likely than those who do not vape - about four times as likely - to end up smoking traditional cigarettes.[1] This is true of people who never smoked cigarettes and had no intention of, likelihood of or interest in doing so. Strong and consistent research also shows that vaping is not a safe or reliable way to quit smoking. For many people, vaping can actually make it more difficult to quit smoking.

Multiple tobacco product use

Young people who vape have five times the likelihood of those who do not vape of using tobacco products such as cigarettes, hookahs, cigars or pipes. The majority of people who vape to help them quit smoking end up becoming 'dual users.'[2] This means they are smoking in places and situations where they can do so and vaping in places and situations where smoking is impossible. Dual users, therefore, actually take in more nicotine and other potentially toxic chemicals than people who only vape or only use other tobacco products.

Injuries and poisonings

Vaping devices, especially those with poor quality batteries that have been stored improperly or have been modified by the user, can malfunction or explode. This results in burns and other injuries. Also, if your child is exposed to e-liquids through the mouth, eye or skin contact, they can experience nicotine poisoning, resulting in vomiting, seizures, brain injury or death.

Cardiovascular, respiratory, reproductive, and immunity effects

More and more, nicotine and other chemicals in vapes are being tied to an increasing heart rate and blood pressure and the risk of heart attack and stroke, as well as inflammation, asthma and wheezing. They also can cause inflammatory processes and depress immune function in lungs, and are associated with chronic bronchitis and a reduced ability to fight off bacterial and viral infections.

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Effects of Vaping on Teens | Some have been led to believe that vaping is completely safe, but there are significant risks to be aware of

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Let’s Talk Facts About Substance Abuse and Addiction - Department of Mental Health

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Back to Educational Resources Addiction is a serious illness. Health, finances, relationships and careers can be ruined. The abuse of drugs and alcohol is by far the leading cause of […]

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While there is no one way or guaranteed way to prevent someone from abusing drugs and alcohol, there are things that everyone can do to prevent substance abuse. Here are the top five ways to prevent substance abuse: 1. Understand how substance abuse develops.

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Abstract

Electronic cigarette (e-cigarette) use has recently risen to the forefront of medical discussions across the country. A significant increase in e-cigarette use by adolescents has been observed over the last decade. This article discusses the targeting of adolescents by e-cigarette companies. It looks at how teenagers are uniquely affected by nicotine and at risk for progressing to using combustible cigarettes and marijuana. Lastly, it discusses the role of physicians in combating the spread of e-cigarettes.

Introduction

Every medical student is taught the three basic questions to ask for social history. "Do you drink any alcohol? Do you do any drugs? Do you smoke cigarettes?" While these are three very important questions to help us address potential health hazards with patients, they fail to identify some of the most significant factors in the lives of adolescent patients. Specifically, vaping in adolescents poses a grave risk to patients' health and is a topic that physicians have to confront.

Over the last 20 years, there has been a decrease in the number of teenagers smoking combustible cigarettes. The Youth Risk Behavior Survey demonstrated a decrease in the number of teens trying combustible cigarettes from 70% in 1991 down to 58.4% in 2003 and even further down to 28.9% in 2017.¹ The decrease is largely a response to exhaustive work done by physicians, advocacy groups and lawmakers. Physicians have worked diligently to improve education on the dangers of smoking and fought to pass new regulations to protect patients. The United States is seeing an explosive rise of adolescents' vaping and the renormalization of smoking ( Table 1). Recent national surveys demonstrate a drastic increase in e-cigarette use among high schoolers. An article from the New England Journal of Medicine reported a 10% increase in adolescents using e-cigarettes between 2017 and 2018 alone, which is approximately 1.3 million teenagers.²

Table 1.

Electronic cigarettes are battery-operated devices that use an electric pulse to heat and aerosolize a flavored liquid that typically contains nicotine. They were first introduced to the U.S. in 2007, and they were advertised by the tobacco companies as an adjunct method to help patients quit smoking. This claim never had evidence to support it, as studies comparing the use of electronic cigarettes, placebos, and nicotine patches demonstrated no significant differences in abstinence rates.³ But because e-cigarettes were seen as a treatment option, they were not subjected to the same regulations as combustible cigarettes. It wasn't until 2016 that the Congress passed the Child Nicotine Poisoning Prevention Act, giving the FDA the authority to regulate e-cigarette packaging.¹

Advertising Directed to Teens

Advertising for e-cigarettes has been heavily aimed at adolescents. Everything from the billboards to the packaging to the product itself has been aimed at teens. Ads on social media were widely distributed. From 2014 to 2016, advertising for vaping exploded and one study found that 78% of middle and high school students had been exposed to at least one advertisement.¹ Pods come in fun packaging and the different pods are flavored to be attractive to adolescents, with everything from mint to gummi bear to frosted sugar cookie. This is especially concerning because studies have shown that flavor is one of the most important factors adolescents consider in trying e-cigarettes.⁴ The devices to aerosolize the pods are designed to look like anything from USBs to pens to inhalers. They can be personalized much like a cell phone case and backpacks have special pockets for the mod devices.

Health Risks for Adolescents

This targeted marketing of e-cigarettes is particularly harmful given the significant health risks these products pose to teens. Many people know that nicotine causes lots of problems for the developing brain. However, it is not widely recognized that many e-cigarettes contain higher concentrations of nicotine than combustible cigarettes. JUUL is the most common e-cigarette brand used in the U.S.; it is so popular that teens use JUULing as a verb.¹ JUUL pods contain 5%, or 59mg/ml, of nicotine.⁵ This is approximately equal to the nicotine contained in 20 combustible cigarettes.⁶ To make this more concerning, one study demonstrated that 39% of adolescents did not consider JUULs to be e-cigarettes at all.⁶ Another survey suggested that 63% of adolescents did not know that JUUL pods contained nicotine at all.⁷

Many studies, primarily based on the use of combustible cigarettes, have demonstrated the adverse health effects of nicotine. Adolescent brains are still developing, and nicotine exposure has been linked with cognitive deficits and impairment in memory and executive function. Electronic cigarettes have been connected with increased impulsivity, with one animal study demonstrating that exposure to e-cigarette vapor during times of rapid brain growth (like during adolescence) can cause hyperactivity and impulsive behavior changes.⁴ Another study looking specifically at the teen population found increased risks of physical fighting, attempted suicide, and alcohol/marijuana use when comparing non-users to teens who smoked or vaped.⁸

Nicotine Addiction in Teens

There has also been evidence that suggests e-cigarette use increases an individual's chance of using combustible cigarettes. Adolescents who use e-cigarettes are 3.6 times more likely to report using combustible cigarettes later in life.⁹ Teens have also been shown to be more susceptible to addiction. We know that nicotine addiction often originates in adolescence with studies showing that close to 90% of adult daily smokers started before the age of 18.¹⁰ Thus, e-cigarettes are effectively helping to create a new generation addicted to nicotine.

Gateway to Marijuana Use

Many vaping devices can also be used to inhale cannabinoids. One study demonstrated that teens who use nicotine liquid in e-cigarettes were 3.6 to 4 times more likely to use marijuana in the next two years.¹ Another study demonstrated that 1 in 10 seniors in high school vape cannabis.⁶ This should be extremely distressing to physicians and medical providers because it is known that marijuana is extremely harmful to the development of the adolescent brain and studies have actually shown changes in brain structure. As a result, deficits in attention, learning, and memory associated with cannabis use in adolescents has been reported.¹¹ One study demonstrated that high schoolers who use marijuana were four times more likely to have multiple sexual partners when compared to students who only use tobacco or alcohol.¹² A sizable portion of adolescents who use marijuana report symptoms of paranoia, anxiety and hallucinations.¹³. Adverse effects from marijuana use, including cannabis hyperemesis syndrome have become common among pediatric patients.¹⁴

Flavors and Additives

Beyond the nicotine, the flavoring chemicals and additives present their own danger. Currently there are no federal laws to ensure that the labels on e-cigarettes are accurate. Until August 2018 they did not even have to include the nicotine concentration on labels. Testing has demonstrated different carcinogens in e-cigarettes including aldehydes, metals, and polycyclic aromatic hydrocarbons.⁶ One recent study looking at the different additives found that that vapes containing cinnamaldehyde for cinnamon flavor were associated with impaired mucociliary function in bronchial epithelial cells. Biopsies from chronic vapers demonstrate structural changes in lung tissue.¹

Education

Physicians caring for adolescent patients are quickly realizing the health hazards associated with vaping and are looking for ways to combat the epidemic. First and foremost is education for both the teen and their parents. Teens obtain most of their knowledge on e-cigarettes from social media and their peers. One in three adolescents in the U.S. still consider electronic cigarettes to be less harmful than traditional combustible cigarettes.⁴ It is imperative that teens are given accurate information on e-cigarettes.

Unfortunately, parents often face the same challenges in finding resources for vaping education as their children. They rely on schools to educate both the parent and their child on e-cigarettes, yet studies have shown that most parents receive little communication from their school on the topic.¹⁵ This is an area where physicians can help fill the knowledge gap. One study found that while parents understood that nicotine exposure is detrimental for teens, most did not know that JUUL pods contain nicotine. Less than half of the middle school and high school parents could identify a JUUL mod in a picture.¹⁵ Most parents were concerned about the use of e-cigarettes in teens but only two in five were concerned about use in their own child.¹⁵ Parents who do not feel that their children are at risk are less likely to talk to their children about the risks associated with vaping. It is imperative that physicians encourage parents to discuss vaping with their teens and provide tools to facilitate that discussion.

Advocacy

The other way physicians can help address vaping in adolescents is by participating in advocacy at a local, state or national level. Currently in the state of Missouri, e-cigarettes are not included in the definition of "Tobacco Products" and thus are not subject to the same restrictions as combustible cigarettes. The sale of e-cigarettes to those under 18 years of age is prohibited, just as with tobacco. But the only regulation in place for e-cigarette packaging is that the liquid must be in child-resistant containers. The American Academy of Pediatrics is currently advocating for Missouri to include e-cigarettes in smoke-free laws and to increase the minimum age to purchase electronic cigarettes to 21 years.¹⁶ Organizations like the American Academy of Pediatrics and the American College of Physicians have both released position papers on vaping and offer further ways to join the fight. It is time for physicians to ask their adolescent patients about vaping and to provide education to the child and parents on the dangers of vaping. Physicians have the responsibility to be advocates for their patients working with medical organizations, state and local governments to address the adolescent vaping epidemic.

Footnotes

Contact: salzmang@umkc.edu

References

1. Slekman J. Vaping: It's all a smokescreen. Pediatric Nursing. 2019;45(1):12-15. 35. [Google Scholar]

Articles from Missouri Medicine are provided here courtesy of Missouri State Medical Association

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Electronic cigarette (e-cigarette) use has recently risen to the forefront of medical discussions across the country. A significant increase in e-cigarette use by adolescents has been observed over the last decade. This article discusses the ...

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Overview

In the United States, youth use e-cigarettes, or vapes, more than any other tobacco product.

No tobacco products, including e-cigarettes, are safe, especially for children, teens, and young adults.

Most e-cigarettes contain nicotine, which is highly addictive. Nicotine can harm the parts of an adolescent's brain that control attention, learning, mood, and impulse control.

E-cigarette marketing, the availability of flavored products, social influences, and the effects of nicotine can influence youth to start or continue vaping.

Most middle and high school students who vape want to quit.

Many people have an important role in protecting youth from vaping including parents and caregivers, educators and school administrators, health care providers, and community partners.

States and local communities can implement evidence-based policies, programs, and services to reduce youth vaping.

E-cigarette use among U.S. youth

In 2023, e-cigarettes were the most commonly used tobacco product among middle and high school students in the United States. In 2023:

2.1 million (7.7%) students currently used e-cigarettes. This includes:

550,000 (4.6%) middle school students.

1.56 million (10.0%) high school students.

Among students who had ever used e-cigarettes, 46.7% reported current e-cigarette use.

Among students who currently used e-cigarettes:

1 in 4 (25.2%) used an e-cigarette every day.

1 in 3 (34.7%) used an e-cigarette on at least 20 of the last 30 days.

9 in 10 (89.4%) used flavored e-cigarettes.

Students who currently used e-cigarettes:

Most often used disposable e-cigarettes (60.7%) followed by e-cigarettes with prefilled or refillable pods or cartridges (16.1%).

Most commonly reported using the following brands: Elf Bar, Esco Bars, Vuse, JUUL, and Mr. Fog.

Most middle and high school students who vape want to quit and have tried to quit. In 2020:

63.9% of students who currently used e-cigarettes reported wanting to quit.

67.4% of students who currently used e-cigarettes reported trying to quit in the last year.

Most tobacco use, including vaping, starts and is established during adolescence. There are many factors associated with youth tobacco product use. These include:

Tobacco advertising that targets youth.

Product accessibility.

Availability of flavored products.

Social influences.

Adolescent brain sensitivity to nicotine.

Some groups of middle and high school students use e-cigarettes at a higher percentage than others. For example, in 2023:

More females than males reported current e-cigarette use.

Current use of e-cigarettes varied by race and ethnicity.

Non-Hispanic multiracial students: 20.8%.

Non-Hispanic White students: 18.4%.

Hispanic or Latino students: 18.2%.

Non-Hispanic American Indian and Alaska Native students: 15.4%.

Non-Hispanic Black or African American students: 12.9%.

Many young people who vape also use other tobacco products, including cigarettes and cigars. This is called dual use. In 2020:

About one in three high school students (36.8%) who vaped also used other tobacco products.

One in two middle school students (49.0%) who vaped also used other tobacco products.

E-cigarettes can also be used to deliver other substances, including cannabis. In 2016, nearly one in three (30.6%) of U.S. middle and high school students who had ever used an e-cigarette reported using marijuana in the device.

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Learn how much youth in the United States use e-cigarettes.

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Consequences of youth substance abuse

Young people who persistently abuse substances often experience an array of problems, including academic difficulties, health-related problems (including mental health), poor peer relationships, and involvement with the juvenile justice system. Additionally, there are consequences for family members, the community, and the entire society.

Academics

Declining grades, absenteeism from school and other activities, and increased potential for dropping out of school are problems associated with adolescent substance abuse. Hawkins, Catalano, and Miller (1992) cite research indicating that a low level of commitment to education and higher truancy rates appear to be related to substance use among adolescents. Cognitive and behavioral problems experienced by alcohol- and drug-using youth may interfere with their academic performance and also present obstacles to learning for their classmates (Bureau of Justice Statistics, 1992).

Physical health

Injuries due to accidents (such as car accidents), physical disabilities and diseases, and the effects of possible overdoses are among the health-related consequences of teenage substance abuse. Disproportionate numbers of youth involved with alcohol and other drugs face an increased risk of death through suicide, homicide, accident, and illness.

The Drug Abuse Warning Network (DAWN) study -- in a representative sample of hospitals throughout the United States -- reports trends in people seeking emergency department treatment related to illegal drug use or nonmedical use of legal drugs. Preliminary 1994 estimates indicate drug-related emergency department episodes for youth ages 12 to 17 increased by 17 percent from 1993 to 1994. This increase was greater than for any of the older age groups reported. Significantly, emergency department visits related to marijuana/hashish for youth ages 12 to 17 increased 50 percent between 1993 and 1994 (McCaig, 1995). Ninety-one youth between the ages of 12 and 17 died of drug abuse in 1993 (Office of Applied Studies, 1994).

Transmission of HIV/AIDS primarily occurs through exposure to body fluids of an infected person during sexual contact or through sharing of unsterile drug-injection equipment. Another primary means of transmission is from mothers to infants during pregnancy or the birth process. Many substance-abusing youth engage in behavior that places them at risk of contracting HIV/AIDS or other sexually transmitted diseases. This may include the actual use of psychoactive substances (particularly those that are injected) or behavior resulting from poor judgment and impulse control while experiencing the effects of mood-altering substances. Rates of AIDS diagnoses currently are relatively low among teenagers, compared with most other age groups. However, because the disease has a long latency period before symptoms appear, it is likely that many young adults with AIDS were actually infected with HIV as adolescents.

Although alcohol-related traffic fatalities for youth have declined, young people are still overrepresented in this area. In 1995 alone, more than 2,000 youth (ages 15 to 20) were killed in alcohol-related car crashes (National Highway Traffic Safety Administration, 1997).

These limited examples illustrate the catastrophic health-related consequences of substance abuse among adolescents. Besides personal and family distress, additional healthcare costs and loss of future productivity place burdens on the community.

Mental health

Mental health problems such as depression, developmental lags, apathy, withdrawal, and other psychosocial dysfunctions frequently are linked to substance abuse among adolescents. Substance-abusing youth are at higher risk than nonusers for mental health problems, including depression, conduct problems, personality disorders, suicidal thoughts, attempted suicide, and suicide. Marijuana use, which is prevalent among youth, has been shown to interfere with short-term memory, learning, and psychomotor skills. Motivation and psychosexual/emotional development also may be influenced (Bureau of Justice Statistics, 1992).

Peers

Substance-abusing youth often are alienated from and stigmatized by their peers. Adolescents using alcohol and other drugs also often disengage from school and community activities, depriving their peers and communities of the positive contributions they might otherwise have made.

Families

In addition to personal adversities, the abuse of alcohol and other drugs by youth may result in family crises and jeopardize many aspects of family life, sometimes resulting in family dysfunction. Both siblings and parents are profoundly affected by alcohol- and drug-involved youth (Nowinski, 1990). Substance abuse can drain a family's financial and emotional resources (Bureau of Justice Statistics, 1992).

Social and economic consequences

The social and economic costs related to youth substance abuse are high. They result from the financial losses and distress suffered by alcohol- and drug-related crime victims, increased burdens for the support of adolescents and young adults who are not able to become self-supporting, and greater demands for medical and other treatment services for these youth (Gropper, 1985).

Delinquency

There is an undeniable link between substance abuse and delinquency. Arrest, adjudication, and intervention by the juvenile justice system are eventual consequences for many youth engaged in alcohol and other drug use. It cannot be claimed that substance abuse causes delinquent behavior or delinquency causes alcohol and other drug use. However, the two behaviors are strongly correlated and often bring about school and family problems, involvement with negative peer groups, a lack of neighborhood social controls, and physical or sexual abuse (Hawkins et al., 1987; Wilson and Howell, 1993). Possession and use of alcohol and other drugs are illegal for all youth. Beyond that, however, there is strong evidence of an association between alcohol and other drug use and delinquent behavior of juveniles. Substance abuse is associated with both violent and income-generating crimes by youth. This increases fear among community residents and the demand for juvenile and criminal justice services, thus increasing the burden on these resources. Gangs, drug trafficking, prostitution, and growing numbers of youth homicides are among the social and criminal justice problems often linked to adolescent substance abuse.

The DUF study found the highest association between positive drug tests of male juvenile arrestees and their commission of drug-related crimes (e.g., sales, possession). However, a substantial rate of drug use also was found among youth who committed violent, property, and other crimes (National Institute of Justice, 1996). These data are depicted in figure 5.

Other data support the concern for drug-involved youth in the juvenile justice system. The Survey of Youth in Custody, 1987 (Beck, Kline, and Greenfeld, 1988) found that more than 39 percent of youth under age 18 were under the influence of drugs at the time of their current offense. More than 57 percent reported using a drug in the previous month. In another study of 113 delinquent youth in a State detention facility, 82 percent reported being heavy (daily) users of alcohol and other drugs just prior to admission to the facility, 14 percent were regular users (more than two times weekly), and 4 percent reported occasional use (DeFrancesco, 1996).

A study conducted in 1988 in Washington, D.C., found youth who sold and used drugs were more likely to commit crimes than those who only sold drugs or only used drugs. Heavy drug users were more likely to commit property crimes than nonusers, and youth who trafficked in drugs reported higher rates of crimes against persons. Youth in this sample were most likely to commit burglary or sell drugs while using or seeking to obtain drugs. About one-fourth of the youth also reported attacking another youth to obtain drugs. However, among the youth in this sample, the majority who committed crimes did not do so in connection with drugs (Altschuler and Brounstein, 1991). A breakdown of crimes that youth have committed to obtain drugs follows:

Drug selling: 36 percent.

Serious assault: 24 percent.

Burglary: 24 percent.

Robbery: 19 percent.

The 1996-97 National Parents' Resource Institute for Drug Education (PRIDE) study (1997) found a significant association between crimes committed by adolescents and their use of alcohol and other drugs. Table 1 shows the percentage of 6th through 12th grade students who reported they had used various substances and had been involved in threatening or delinquent activities. The percentage of youth who were involved in these activities and had not used alcohol or other drugs was substantially lower.

For those who work in the juvenile justice system, new data are constantly being reported, but the story is an old one. Juvenile justice professionals encounter daily the distress of youth, their families, and communities resulting from juvenile involvement in substance abuse and delinquent behavior. These professionals also experience the difficulties of trying to work successfully with these young people.

The projects described in the remainder of this Summary developed sound strategies for identifying and intervening with youth who were involved in illicit drug use and who encountered the juvenile justice system. The experiences and lessons learned by these projects can be used by other agencies to replicate or adapt similar programs to meet the needs of the youth they serve.

Drug Identification and Testing in the Juvenile Justice System

May 1998

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Consequences of youth substance abuse Young people who persistently abuse substances often experience an array of problems, including academic difficulties, health-related problems (including mental health), poor peer relationships, and involvement with the juvenile justice system. Additionally, there are consequences for family members, the community, and the entire society.

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Effects of Drug Abuse and Addiction

Drugs are chemicals that affect the body and brain. Different drugs can have different effects. Some effects of drugs include health consequences that are long-lasting and permanent. They can even continue after a person has stopped taking the substance.

There are a few ways a person can take drugs, including injection, inhalation and ingestion. Depending on how the drug is delivered, changes how drugs affect your body. For example, the injection of drugs directly into the bloodstream has an immediate impact, while ingestion has a delayed effect. But all misused drugs affect the brain. They cause large amounts of dopamine, a neurotransmitter that helps regulate our emotions, motivation and feelings of pleasure, to flood the brain and produce a "high." Eventually, drugs can change how the brain works and interfere with a person's ability to make choices, leading to intense cravings and compulsive drug use. Over time, this behavior can turn into a substance dependency, or drug addiction.

Today, more than 7 million people suffer from an illicit drug disorder, and one in four deaths results from illicit drug use. In fact, more deaths, illnesses and disabilities are associated with drug abuse than any other preventable health condition. People suffering from drug and alcohol addiction also have a higher risk of unintentional injuries, accidents and domestic violence incidents.

The good news is: Substance use disorders are treatable.

What is Drug Abuse?

Clinically known as substance use disorder, drug abuse or addiction is caused by the habitual taking of addictive substances. Drugs include alcohol, marijuana, hallucinogens and opioids. Substance use disorder is a disease, causing people to compulsively use drugs despite consequences.

Effects of Drug Abuse

The Effects of Drug Abuse on Health

Substance use disorders are associated with a wide range of short- and long-term health effects. They can vary depending on the type of drug, how much and how often it's taken and the person's general health. Overall, the effects of drug abuse and dependence can be far-reaching. They can impact almost every organ in the human body.
Side effects of drug addiction may include:

A weakened immune system, increasing the risk of illness and infection

Heart conditions ranging from abnormal heart rates to heart attacks and collapsed veins and blood vessel infections from injected drugs

Nausea and abdominal pain, which can also lead to changes in appetite and weight loss

Increased strain on the liver, which puts the person at risk of significant liver damage or liver failure

Seizures, stroke, mental confusion and brain damage

Lung disease

Problems with memory, attention and decision-making, which make daily living more difficult

Global effects of drugs on the body, such as breast development in men and increases in body temperature, which can lead to other health problems

The most severe health consequences of drug abuse is death. Deaths related to synthetic opioids and heroin have seen the sharpest rise. In the past 12 months, 212,000 people aged 12 or older have used heroin for the first time. Every day, more than 90 Americans die after overdosing on opioids.

Effects of Drug Addiction on the Brain

All drugs-nicotine, cocaine, marijuana and others-affect the brain's "reward" circuit, which is part of the limbic system. This area of the brain affects instinct and mood. Drugs target this system, which causes large amounts of dopamine-a brain chemical that helps regulate emotions and feelings of pleasure-to flood the brain. This flood of dopamine is what causes a "high." It's one of the main causes of drug addiction.

Although initial drug use may be voluntary, drugs can alter brain chemistry. This can actually change how the brain performs and interfere with a person's ability to make choices. It can lead to intense cravings and compulsive drug use. Over time, this behavior can turn into a substance dependency or drug and alcohol addiction.

Alcohol can have short- and long-term effects on the brain and disrupts the brain's communication pathways. These can influence mood, behavior and other cognitive function.

Brain damage may also occur through alcohol-induced nutrition deficiencies, alcohol-induced seizures and liver disease. In pregnant women, alcohol exposure can impact the brains of unborn babies, resulting in fetal alcohol spectrum disorders.

It is reported that alcohol-induced brain problems can often be corrected with proper treatment. Abstinence from alcohol for months or years can help partially repair thinking abilities, like memory skills.

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Drug Effects on Behavior

Substance use disorders can lead to multiple behavioral problems, both in the short- and long-term, which can include:

Paranoia

Aggressiveness

Hallucinations

Addiction

Impaired Judgement

Impulsiveness

Loss of Self-Control

These short and long-term health effects of drug abuse have serious consequences, like missed work, punishable offenses, accidents and injuries. In fact, alcohol and drugs are partly to blame in an estimated 80 percent of offenses leading to jail time in the U.S. These incidents include domestic violence, driving while intoxicated and offenses related to damaged property. Legal and illegal drugs excluding alcohol are involved in about 16 percent of motor vehicle crashes. In the past year, almost 12 million people drove under the influence of illicit drugs, and almost 4,000 fatally injured drivers tested positive for drug involvement.

Effects of Drug Abuse on Unborn Babies

Illicit drug use poses risks for pregnant women and their babies. Drugs may contain impurities that can be harmful to an unborn baby. Pregnant women who use drugs may be more likely to harm the fetus with risky behaviors and poor nutrition. Drug use can lead to premature birth or low birth weight. It can also cause the baby to have withdrawal symptoms (sometimes in the form of neonatal abstinence syndrome), birth defects or learning and behavioral problems later in life.

An estimated 14 percent of adults with an illicit substance use disorder reported receiving treatment in the past year. At Gateway, we offer treatment programs for all levels of drug addiction. Give us a call at 877.377.2027 to find out how we can help.
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The Physical & Mental Effects of Drug Abuse | Gateway Foundation

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Drugs are chemicals that affect the body and brain. Different drugs can have different effects. Some effects of drugs include health consequences that are long-lasting and permanent. They can even continue after a person has stopped taking the substance. There are a few ways a person can take drugs, including injection, inhalation and ingestion.

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