Sheila Walker, CADC II, SAP                                               

                                 Substance Abuse Counseling                                                                                                                       916-517-1683





In the past few years there has been a dramatic increase in the use of electronic cigarettes (e-cigarettes). What are e-cigarettes?  Are they safe for the smoker and those exposed to the smoke? 
“Electronic cigarettes (also called e-cigarettes or electronic nicotine delivery systems) are battery-operated devices designed to deliver nicotine with flavorings and other chemicals to users in vapor instead of smoke. They can be manufactured to resemble traditional tobacco cigarettes, cigars or pipes, or even everyday items like pens or USB memory sticks; newer devices, such as those with fillable tanks, may look different. More than 250 different e-cigarette brands are currently on the market.
While e-cigarettes are often promoted as safer alternatives to traditional cigarettes, which deliver nicotine by burning tobacco, little is actually known yet about the health risks of using these devices.

Most e-cigarettes consist of three different components, including:

A cartridge, which holds a liquid solution containing varying amounts of nicotine, flavorings, and other chemicals
A heating device (vaporizer)
A power source (usually a battery)

In many e-cigarettes, puffing activates the battery-powered heating device, which vaporizes the liquid in the cartridge. The resulting aerosol or vapor is then inhaled (called "vaping").”

 “The American Lung Association is concerned about the potential health consequences of electronic cigarettes (e-cigarettes), as well as the unproven claims that they can be used to help smokers quit. Presently there is no government oversight of these products.

Early studies show that e-cigarettes contain nicotine and other harmful chemicals, including carcinogens.

A 2014 study showed wide ranging nicotine levels in e-cigarettes and substantial variability between listed and actual nicotine levels in these products. In 2009, the FDA conducted lab tests and found detectable levels of toxic cancer-causing chemicals, including an ingredient used in antifreeze, in two leading brands of e-cigarettes and 18 various cartridges. A 2014 study found that e-cigarettes with a higher voltage level have higher amounts of formaldehyde, a carcinogen.

Also unknown is what the potential harm may be to people exposed to secondhand emissions from e-cigarettes. Two initial studies have found formaldehyde, benzene and tobacco-specific nitrosamines (all carcinogens) coming from those secondhand emissions.

Studies are showing a dramatic increase in usage of e-cigarettes, especially among youth. For the first time ever, a national study released in December 2014 found e-cigarette use among teens exceeds traditional cigarette smoking. The study also found that e-cigarette use among 8th and 10th graders was double that of traditional cigarette smoking. CDC studies have also shown e-cigarette use among high school students increased by 61 percent from 2012 to 2013.”

An article in Hill Physicians Magazine gives some important information regarding teens and e-cigarette use.  It states that although there has been a steady 20 year decline in the rates of teens using cigarettes, teen use of e-cigarettes has tripled since 2011.  It also reports that:  “The liquid nicotine found in e-cigarette cartridges is a neurotoxin that can cause nausea, vomiting and serious side effects.  It can be absorbed through the skin when the liquid is handled or spilled.   According to the American Association of Poison Control Centers, the number of liquid nicotine-related calls rose 219% between 2012 and 2013.  Often it is the younger children in the household, not the user, who become poisoned through skin contact or by ingesting the flavored liquid.”

Because there are no government regulations or oversight, there is a lack of consistency in the various products on the market. More research is needed to know the short-term and long-term affects this will have on the body and brain.



Over the past few years in my private practice I have had a sharp increase in the number of clients who abuse heroin.  The clients I have seen are typically young adults who have been raised in middle/upper class home.  Most of them started out abusing prescription pain medications such as Vicodin and Norco.  Due to an increase of tolerance this then led to the use of Oxycodone and eventually heroin.  These are young adults you would never guess use heroin!

Continued drug use results in an increase of tolerance to the drug.  Meaning it takes more and more of the drug to create the same affect.  Therefore, the user seeks a more potent drug such as Oxycodone.  Oxycodone is more difficult to obtain due to new government guidelines which in turn results in an increase in the cost of the drug on the street.  When the cost becomes prohibitive, the user may turn to heroin.  It is less expensive and at times easier to find.

My experience in my practice was echoed in a recent article published in The Wall Street Journal on August 8, 2013.

"Heroin use in the U.S. is soaring, especially in rural areas, amid ample supply and a shift away from  costlier prescription narcotics that are becoming tougher to acquire.  The number of people who say they have used heroin in the past year jumped 53.5% to  620,000 between 2002 to 2011, according to the Substance Abuse and  Mental Health Services Administration.  There were 3,094 overdose deaths in 2010, a 55% increase from 2000, according to the federal Centers for Disease Control and Prevention.  The heroin scourge has been driven largely  by a law-enforcement crackdown on illicit use of prescription painkillers such as oxycodone and drug-company reformulations that make the pills harder to crush and snort, drug officials say.  That has pushed those who were addicted to the pills to turn to heroin, which is cheaper and more plentiful."  (

Some of the clients I have counseled in the past few years did not have a history of drug use but became addicted to pain medications they were prescribed for a legitimate pain issue.  Then they started taking more than prescribed because they discovered they liked the effects.  They ended up in counseling because of the problems it created in their life.  Even if this never results in heroin use, it is a serious problem that needs to be addressed with professional counseling.

If you or someone you love abuses prescription medications or heroin please contact me.  There is hope and help is available.

What is: Wax, Earwax or Dabs:

The latest thing in the use of marijuana is "wax", also known as earwax or dabs.  Wax is the hash oil extracted from marijuana that has a yellow-brown appearance and looks like earwax.  It is ingested by inhaling the vapors or "vaping".  This is an odorless way to use marijuana which appeals to some people especially adolescents and young adults who do not want to get caught using marijuana.

The method of making wax is extremely dangerous.  It involves using butane to extract the oil.  Butane is highly flammable and there has been an increase in cases of people being severely burned as a result of the butane causing an explosion from making it at home.

According to the Sacramento Bee on February 9, 2014:

"In Northern California, the UC Davis Health System's burn unit treated 27 victims last year with similar injuries, and six have come in during the last few weeks.  Officials suspect that the overall numbers are much higher because victims don't disclose the illicit causes of their injuries."


"The explosions are a growing side effect of California's unregulated medical marijuana industry.  The act of manufacturing butane hash is a criminal offense, but pot supply stores can legally sell the butane canisters, dispensaries can sell the hash and anyone with a doctor's recommendation can buy marijuana and "vape" it.  In other words, there is a legal, lucrative market for a product that is illegal to make".

"The dangerous component is the use of butane gas, which is a very explosive type of gas if it has an ignition source," said Assistant Chief Niko King, of the Sacramento Fire Department. "As soon as that ignition source hits, it results in a very violent flash explosion."

Another alarming fact is the potency of the wax.  Smoked marijuana can be 20-30% THC (the ingredient that causes the high), while the potency of wax can be 70-90% THC.  This is a much more powerful drug!  Wax users are reporting experiencing side effects that they have not experienced from smoking marijuana.  Some of the side effects include psychosis and hallucinations.  Some of which have led to psychiatric hospitalizations.

This is a trend that needs close observation.  What will the long term and short term effects be?  I hope this helped to educate you on the latest trend in getting the most intense high possible.