Vaping cocaine sounds like a bad idea, but a pair of European researchers want to make it a reality, and it could help people who struggle with addiction.
In a paper published in the journal Drug Science, Policy and Law, a toxicologist and an addiction research professor came up with a novel idea for a drug. The authors say that a device like this could help people find treatment when and if they need it, and that it could reduce the harms of smoking cocaine. The design is similar to a normal e-cigarette, except that the battery, atomizer, and e-liquid are not nicotine or cocaine.
Vaping certain drugs is popular and is seen as a less dangerous activity than inhaling smoke. The powerful drug MDMA, also known as ecstasy, and cocaine have been co-opted to use the vaporizer technology. Steinmetz isn't claiming to have invented the idea of a cocaine e-cigarette, but he has done the work to make it a reality. The question is how much it will help, and whether people will use it to help with their addiction.
Steinmetz tells Discover that he is not the first person to think about this. If it helps half of the people, then it's worth it.
Crack and powder cocaine.
Cocaine can be refined into a powder that is snorted. cocaine can be smoked thanks to a lower boiling point. This variation gets its name from the sound it makes when heated. Crack and powder are the same drug, but that hasn't always reflected in legal distinctions, as communities of color are often the brunt of these laws.
The high from cocaine powder versus crack cocaine is different because the route of administration is different. If someone is addicted to crack, they may use it many times in a day.
Steinmetz says that the most harmful thing about stimulants is that people continuously use them. The heated particles can cause damage to the lungs, which is something a vaporizer would address. It may keep people alive in other ways.
Steinmetz says that you can decrease the risk of overdose. Steinmetz believes that his concept would help people who shun the healthcare system find treatment when they are ready because it would be a prescription model. It has been shown that forcing people into rehab is not effective.
Steinmetz believes that the biggest benefit of a cocaine e-cigarette would be that it would remove the risks of prohibition. There are no back-alley deals or substances with unknown chemicals anymore. Steinmetz says that when weighing legalization and decriminalization, scholars always neglect how much harm prohibition causes.
Is it possible to make illegal drugs safer?
The cocaine e-cig is an example of a concept called safe supply, which suggests substituting black market drugs with a pure version of the same substance, prescribed by a doctor, can reduce the risk of overdose and death. In Europe and North America, there is a safe supply of opioids.
Doctors in the U.K., Switzerland, Canada and Germany are able to prescribe heroin so that users don't seek an illegal version that could be contaminated with other drugs. The data shows that heroin-assisted treatment can reduce drug use, increase graduation into treatment and reduce mortality.
Mark Tyndall, a public health professor at the University of British Columbia, has been running a safe supply program in the city for the last two years using vending machines. He prescribes Dilaudid to about 70 patients, with plans to expand the program. Participants can pick up drugs several times a day using the machines.
The results have been promising so far. Several patients have graduated from the program, while others have stopped using drugs entirely.
Tyndall says that it's a drop in the bucket as far as need goes. Between March 2020 and March 2021, there were more than 1,500 deaths from overdoses in B.C. We think we're making progress, but it's not enough.
E-Cigs for drugs.
Tyndall has been thinking about an e-cigarette that is similar to the cocaine pen. Around 40% of B.C.'s opiate users smoke heroin or Fentanyl, according to Tyndall. Smoking opioids is riskier than injecting them, but e-cigarettes could make it less harmful.
In some countries, it is possible for doctors to prescribe a cocaine e-cigarette for problematic s tate use. Safe supply is not a very popular idea. Steinmetz says that there are only 10 practices in the entire country.
The high rate of prescription opioids that led to the first wave of the overdose crisis was argued to be the cause by some experts. Tyndall and his colleagues argue that we are in the fourth wave of the public health emergency, fueled by synthetic opioids like isotonitazene. We need different strategies for safe supply in the form of cocaine vaporizers, supervised consumption sites, or the like.
Global health experts argue that prohibition is not effective in the treatment of addiction. Tyndall says that people stop using drugs when they find something better. We don't offer people much better and we keep punishing them.
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