Vaping of e-cigarettes remains very popular among teenagers. Across the country, about 20% of high school seniors report that they are currently vaping. We do not know how this compares to what is happening in our community. Yet I see many kids in our community vaping, and wonder if they are aware of the health consequences.

As a parent and as a psychologist, my biggest worry is that kids who vape will develop nicotine addiction, more formally called tobacco use disorder.  Nicotine is extracted from tobacco, and is the active ingredient in most vapes. It is a stimulant that increases heart rate and blood pressure. Kids like vapes because nicotine improves alertness, focus, and memory. The problem is that over a very short period of time, nicotine can cause depression, reduce alertness and focus, and impair memory and learning. Many kids who start vaping report how difficult it is to make it through the school day or take a test.

It goes without saying that the COVID pandemic has increased levels of anxiety for many people. The whole thing can be very traumatic. Some have contracted the virus, while others have family or friends who have been seriously ill or have died. With the lockdowns have come lost jobs, diminished savings, family conflict, and substance abuse. The daily news announcements about infection rates, variant strains, changing guidelines, and death counts can be overwhelming.

On December 18, at our Chayeinu event, we had the privilege to hear Rabbi Yaakov Horowitz speak with parents in our community on having an ongoing dialogue with their children about alcohol and drug use. During the talk, he shared a story about a conversation he had with a policeman who had responded to an overdose in the Jewish community. While the Rabbi expressed some surprise that the opioid crisis was now taking Jewish lives, the policeman reminded him that there is no good reason for Jews to be immune, because substance use and abuse is a human problem.

The Sunday Baltimore Sun (December 1) ran a front-page article on progress made toward enacting recreational marijuana legalization in Maryland for adults. (Medical marijuana was legalized in 2014.) The article begins by acknowledging that the likelihood of legalizing recreational marijuana use for adults “is growing dim for 2020,” with the bipartisan work group still in “investigative mode.” The article goes on to explain that state lawmakers are looking into a variety of issues: 1) setting tax rates, 2) identifying marijuana-influenced driving, and 3) expunging old convictions (presumably of cannabis possession).

These are no doubt important issues, though it is interesting that nowhere on this list is the concern that marijuana legalization will increase marijuana-related problems. As we have noted before [see www.wherewhatwhen.com/authors/view/michael-kidorf] marijuana is not a benign drug. While occasional marijuana use poses only minor risks, chronic marijuana use is associated with a number of well-documented health concerns. Among these concerns are the development of cannabis use disorder, cognitive and memory difficulties, psychological and physical problems, diminished educational and employment achievements, and more motor vehicle accidents. Teenagers and adults with ADHD, psychiatric conditions, or a history of trauma are particularly vulnerable to experiencing these problems.

The national focus on the opioid crisis unfortunately obscures the fact that the use of cigarettes is the leading preventable cause of mortality, accounting for about 480,000 deaths annually, and about 30 percent of all cancer deaths. Despite an over-50-year-long government campaign against cigarettes, smoking continues to hold many people in its addictive grip as well as draw new victims. Indeed, It is particularly worrisome to watch adolescents smoke either traditional (combustible) cigarettes or JUULs, knowing that smoking early in life is not only a strong predictor of smoking as an adult, but also greatly increases the likelihood of using other drugs. Adults who continue to smoke cigarettes will likely face a host of medical complications and increase the risk of transmitting the smoking habit to their children.

We frequently hear that America is experiencing an opioid crisis, an opioid epidemic, or even a public health emergency. These terms generally refer to the sharp increase in opioid-related overdose deaths over the past five years. As most people know, opioids are a class of analgesic drugs that provide pain relief and euphoria. These drugs include commonly prescribed painkillers (Codeine, Percocet, Vicodin), heroin, and synthetic variations (Fentanyl). Last year, about 70,000 Americans died from a drug overdose, and about two thirds of these cases involved the use of opioids (often mixed with other drugs or alcohol). The rate of opioid-related overdose deaths in 2017 was six times higher than what was observed in 1999. In Maryland, about 2,000 deaths over the past year were attributed to opioids.