Teen Vape Addiction: What Parents Need to Know About THC Use They May Not Notice, with Dr. Deepa Camenga

350 Vape Addiction: The THC Use You May Not Even Notice, with Dr. Deepa Camenga

[00:00:00] Many of those kids want to stop for their parents. The question is, do they want to stop for themselves, right? They’re aware, like their parents are involved. So something about that probably, you know, plays into why they think they’re addicted because many of them really care for their parents, et cetera, et cetera, but they, they cannot stop
Welcome to Hope Stream, the podcast for parents of teens and young adults struggling with substance use and mental health. I’m Brenda Zane. I’ve walked this path with my own child’s addiction and high-risk lifestyle. Each week, we help you gain clarity, learn new skills, and most importantly, find real hope in what might feel helpless.
You are not helpless, and you’re not alone anymore. Find more resources at hopestreamcommunity.org. Hey, friend. How excited are 

[00:01:00] you for today’s episode? I tracked down the foremost physician that I could find to weigh in on all things vaping and young people. It’s kind of funny because in my past career, I wasn’t ever required to really do, like, blind outreach or cold calling to people. I was always working with a group of clients that we already had relationships with.
Now, running a podcast, I find myself having to get out of my comfort zone and reach out to people who, at times, can feel very intimidating. That was the case when I decided I needed to reach out to Dr. Deepa Camenga, who just happens to be, I don’t know, a pediatrician who specializes in adolescent addiction and addiction medicine, and also is a known authority on vaping Good news was when I reached out, she was more than 

[00:02:00] kind and gracious and welcoming and agreed to do the podcast. So you please do your deep breathing while I tee up what I know is going to be a wildly popular and much shared episode. I reached out to Dr. Camenga because there is so much chatter and conversation and worry in our community about vaping, especially with the adolescent group, but also with the young adults who have been at it for a couple of years and are finding it really, really hard to stop.
Dr. Deepa Camenga is an associate professor of emergency medicine, section of research at Yale. She is a physician scientist who’s board certified in pediatrics and addiction medicine with expertise in adolescent addiction. She is also the associate director for pediatric programs for the Yale Program in Addiction Medicine. In this role, she is one of very few clinicians that 

[00:03:00] prescribes medication treatment for adolescents with opioid use disorder. She also leads an innovative addiction medicine teleconsult service for local school-based health centers. In 2017, Dr. Camenga was elected to serve on a national American Academy of Pediatrics committee on substance use and prevention.
She was tasked with protecting and improving the health and wellbeing of children and adolescents throughout the country. Dr. Camenga completed her medical education residency training at the University of Rochester, New York, and completed a fellowship in health services research through the Robert Wood Johnson Foundation Clinical Scholars Program at Yale.
So yeah, she’s a smartie. I know all of that is impressive, but I think what is even more impressive is that Dr. Camenga is also parenting teenagers herself, so she 100% gets it As you can 

[00:04:00] imagine, I had a million and 12 questions, including what actually is in the vape devices that young people are using, whether we should think about vaping as one element of harm reduction if your child is also using more dangerous substances, what some of the symptoms of THC addiction look like, and importantly, what are some of the routes for helping young people reduce and eventually stop vaping.
Also, you’ll want to head to the show notes, because you can find a download there that we created where we’re sharing photos of what these vaping devices look like, because I’m telling you what, they can be pretty incognito, just so you know what you’re looking for. I don’t wanna delay this any further, so please single focus or single task as you listen to this critical conversation that I sat down for with Dr.
Deepa Camenga, Associate Professor of Emergency Medicine, adolescent addiction 

[00:05:00] specialist, and real-life mom of teens. Enjoy. Welcome, Dr. Camenga. I’m so excited to have you here. I tracked you down because I was looking for somebody who was qualified to talk about the topic of vaping, but specifically with adolescents and young adults, because for parents, I think it’s different. So welcome, and thank you for giving us some of your time.
Thank you for inviting me. I think that the vaping thing is so hard. I didn’t have this issue when my son was struggling because it was, like, 11 years ago, and I don’t know the timeline. Like, I don’t know the history of vaping like you probably do, but it just wasn’t something that we were dealing with.
And so I really feel for the parents today who are dealing with vaping. It is super confusing and scary. But just to 

[00:06:00] start out, so you’re board certified in addiction medicine, but really focus on adolescents and young adults. Yes. That’s right. What drove you to that audience? Like, what was the deal there?
Well, I’m a pediatrician, and early on I realized I love talking to teens and listening to teens. It’s a wonderful part of life because they’re learning and growing. And there’s also, it takes like, a village to help a child be healthy. So I also enjoy working with families, schools, communities as well, to support teens.
The thing that’s different than with younger kids is that teens have to be part of what you’re doing every step of the way. So I first became interested long time ago in talking to teens about tobacco use. Specifically at that time, which was, like, 25 years ago, it was cigarette smoking. 

[00:07:00] Right. But even then, I soon realized that many teens who use one substance use multiple ones. And so I needed a set of skills to be able to talk about all substances with teens, because most of them who are trying multiple things. And as time went on, the vaping epidemic started, and that’s a big part of my practice now, talking to teens about vaping, whether it be nicotine or cannabis, and helping them make decisions and have healthy coping skills so hopefully they can eventually stop and reduce harm from those substances.
Yeah. When you think of sort of a 50,000-foot view of your practice, ’cause you’re feet in the fire. Like, you’re seeing it every day. What are you seeing today, and maybe how does that look different than it did 25 years ago, both 

[00:08:00] with, like, tobacco and all that, but just kind of in general with parents? Like, what’s going on? So I think the unique thing about vapes is they’re just so easy to use and discreet in places where it wasn’t so easy to use or smoke before, so specifically school. In middle school starting, even younger than that, most likely most students will see somebody in their school vaping or know of somebody who’s vaping.
majority of students are seeing it. It’s all over, and it’s very difficult for schools, ’cause they’re so tiny, discreet, odorless, to know that students are using it. So I always say the conversations have to start pretty early, before middle school, because that will be something that is present in the environment of most schools. Yeah. I’m seeing a lot of onset of trying vaping in 

[00:09:00] middle school and high school. The thing that’s different about vapes than cigarettes is that they have such a high concentration of nicotine, and very quickly kids who are predisposed perhaps to developing addictions due to a variety of things, if they have access to them, they can accelerate their use pretty quickly.
And the one thing I’ve noticed just talking to teens, some of them say, “Yeah, I’m definitely addicted.” When it was cigarette smoking, I think it’s because they couldn’t in the 2000s smoke indoors, and they couldn’t just frequently, constantly smoke. So I didn’t hear that. They could have had a nicotine use disorder or tobacco use disorder, but they weren’t saying it. Kids feel the loss of control that they’re having with nicotine vapes, and actually they themselves are saying, like, 

[00:10:00] these are the most addictive things that they’re feeling. Wow. Now, with cannabis, there are some who are feeling addicted, but a thing that I’ve noticed is there’s a lot of self-medication going on, and very much intentional self-medication.
Kids are coping with a lot of things, and they view vapes as a way to do that. And just like nicotine vapes, they’re just always, they’re around. They’re easy to get. And often, especially when people are just starting, they don’t exactly know what’s in the vape. It could be nicotine. It could be cannabis. So many teens are using both.
They’re not intentionally using both. It’s just they use what’s around Yeah. They’re probably, and this is what I think is fascinating, is kids are starting with the vaping. It’s not like they’re starting with cigarettes- No … and then move to vaping- No … which is what the 

[00:11:00] industry said, right? Yeah. Like, “Oh, we’re gonna give people Correct … something to move off of cigarettes. Yeah. But they’re starting with it for exactly what you said; it’s odorless for the most part. I think there’s that weird sweet- Yeah, yeah … kind of smell. Yeah. Yeah. But if you don’t know, you don’t know. Yeah. So, and yeah, like you said, with it being so small, and I just recently came back from Europe, and it was almost like the vape was an accessory along with the phone.
Like, young girls would have a pink phone case and a pink- Oh, yeah … vape. Yep. Right? And in some cases, it even had like a little, almost like a little charm hanging from it or something. Mm-hmm. I was like, “Oh my gosh.” Yeah. This is not a cigarette replacement. No. This is like- And it’s a very stylized product- And it-
like you just mentioned. Yes. There’s the variety of colors- Yes … and looks. One of the biggest driving forces is flavors, and- Right … yeah. And my patients, teens, 

[00:12:00] young adults report to me that’s a real source of enjoyment, is the flavors with the nicotine. Yeah. Well, if it tasted like tar, I’m sure they wouldn’t be- Exactly, or like cigarette smoke
hitting it all day. Yeah. Those are very… They’re candy, and fruit, and have a lot of names which are quite appealing, I think. Yes, exactly. And there- And the packaging … thousands of, to select from as well. Yeah. Yeah. So when you think about kind of your typical vape that a kid’s gonna pick up maybe at a gas station, what’s actually– Do we even know what’s actually in it?
Like, is that regulated, or- So there are- … is it kind of a wild card? … some electronic cigarettes that the FDA have regulated, but these are not the products that teens are using, because they don’t, in general, have all these 

[00:13:00] flavors, high nicotine concentrations, bedazzling on the packaging, things like that. Yeah. Bedazzled. Yeah. Bedazzled vape. Yes, exactly. So the things teens are using are not regulated, because it is illegal to have sale or marketing of the FDA-regulated products to people under the age of 21. I’ve never seen in my practice any teen using an FDA authorized product. Like they’re using- Right
other non-regulated products. So as a result, we know most likely there is nicotine in there. We don’t know for any one vape what else could be in there. Which is terrifying, right? Yeah. Because- It could be metals, it could be anything. And that’s maybe six years ago now, in the cannabis vapes, there was a contaminant of 

[00:14:00] vitamin E that was associated with the big EVALI outbreak that happened in 2019, 2020, where young people were experiencing severe lung injuries from inhaling that contaminant We have no way of knowing if something like that could happen again because these are not regulated products.
Right. Gosh, that’s so scary. I, I wanna go back to where you said that some young people are coming in and saying, “Yeah, I am addicted to this.” What is it that’s making them say that? Like, what are they experiencing that they’re willing to finally get to a point where they could say, “Yeah, I’m actually addicted”?
Yeah. They’re continuously using all day, and they feel withdrawal when they can’t stop. And they are saying they’re addicted. They’re not saying necessarily they wanna stop, you know? That’s a diff- Right … that’s a difference. True, 

[00:15:00] there’s a difference there. There’s a difference. Yes. But it’s just the amount that they’re using, the amount that they’re all day, frequently throughout the day, and then just inability to stop. And many of those kids want to stop for their parents. The question is, do they want to stop for themselves, right? And there’s- Right … they’re aware, like their parents are involved. So something about that probably plays into why they think they’re addicted because many of them really, they care for their parents, et cetera, et cetera, but they cannot stop, and their parents are, like, very concerned and open with them about it.
But- Yeah, and obviously- … stopping yourself is a very complex, as you know, with addictions, it’s a complex thing. Part of it has to be for yourself, right? Totally. And I think it’s great that the parents are having the conversations. I imagine there’s also a set of parents who are not having the conversation- Mm-hmm who are sort 

[00:16:00] of like, you know, laying down the law, like, “This is not gonna happen.” They don’t have that understanding- Yes … that this could be addictive. Yeah. And I don’t think any of the kids are going into it like, “Oh, I’m gonna go and get addicted- Nope … to THC through this vape.” They have no clue that that could happen.
Yes. What ages are you seeing, like, toward the younger end of kiddos coming into your practice with this? Oh, around 11, 12, so like sixth grade- Oh my gosh … depending on the school environment, when middle school starts. Wow. Do you think COVID, or like what role do you think COVID might have played with some of the kids who are now, like you just said, 11, 12, 13.
Maybe they were seven, six. I can’t do math in my head. Six, when you were younger. Yeah. And just, I guess, in general, as far as you talked about how these kids are coping with a lot, and they don’t necessarily have 

[00:17:00] the coping skills. Do you think there is a role that COVID played in that, that parents might not be necessarily taking into consideration with all of this?
We know with COVID that because kids, when they were not in school or socializing as often, or probably because a lot of parents were working in home, so there was a lot more monitoring happening or an awareness of what the kids were doing, rates of vaping and all substance use like really went down, and have remained down.
I think for those, the current middle school students who started, they were young. We know that they were exposed to different education in elementary school than those who were older. And we also know that during that time, many of them experienced distress, and there’s a lot of… And it just continued. So there some 

[00:18:00] small group of middle school students are experiencing some psychological distress. Maybe it’s related to what happened when they were younger in COVID or anything else. And it’s, vaping really helps relieve that for young kids or older kids. But even the youngest kids can articulate that it helps with anxiety, it helps with coping with traumas or stressors that they’re experiencing within their families or communities or things like that.
They’re very much able to articulate it, even at a young age. I think COVID had something to do with it, that most of the data shows that COVID was associated with decreasing rates overall in the population. But it doesn’t mean we’re still not seeing kids who are vaping and initiating vaping at quite young ages.
It’s still happening. Hey, can I tell you about something that might be 

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[00:20:00] and I’ll see you there. Okay, let’s get back to the show Yeah. And I wonder if they think maybe, because I think there has been a lot of messaging around fentanyl and opioids, and I wonder if younger kids maybe in the 13 to 15 to 16 range feel like this is a safer option. Do you hear that? Like, do they think, “Well, at least I’m not taking pills,” right? Or, “At least I’m getting drunk.”
Yeah. Like, is that a factor at all? Sometimes that’s their perception, yes. Sometimes I do hear that. I’m still surprised the younger ones, there is still some lack of awareness with fentanyl and their risks. Definitely more awareness in younger teens than there was five years ago or seven years ago, but there still is. They don’t know what it is. I do try to provide that general health 

[00:21:00] education to any child who’s using substances, because you never know Yeah. But yeah, they do view it as that, and they also view it as just like probably every other substance, something they’re not gonna use there for many years to come.
Yeah. Yeah. Yeah. It’s that kind of perfect storm of undeveloped brain, a- teenage, just all the angst that comes with that, and the cool factor- Yep … and the accessibility of the vape is, and I hear this from parents where their kiddos have talked to them and just said, “Well, when everybody’s standing around in a circle after school and they’re passing it around, I don’t know how to say no.”
Exactly. Like, and everybody’s pushing, like, “Just hit it, just hit it,” and they’re like, uh, even if they don’t want to, it’s like, how do I say no? It’s just this little thing. It’s not a big deal. Yeah. And I can imagine that pressure’s really stressful for a teenager. Yes. You know? 

[00:22:00] Exactly. And not all teens, but there is a component of some of the younger ones have been socially excluded previously.
Mm. And this is true of all substances. It does provide a social group that, for some kids, was not having like a group who they knew they could be with, was not something they had. Mm. And all, that’s a normal part of development. Teenagers want to have a social group. So for some of them, it helps facilitate having friends.
And- Mm, for sure … because they’re, what, for whatever reason, socially excluded from other peer groups. And so that’s a hard thing they struggle with, ’cause they’re leaving their friends and have been socially perhaps excluded or rejected from other groups. So it’s not natural for a teen to be alone. Right. So that’s also something they’re 

[00:23:00] juggling with once they start using more often, is that they don’t have other friends. So what are… Even if they- Yeah … want to stop, even what are they to do? A lot of what we work with is trying to Work on skills to kind of say that very openly, “I’m quitting for this reason or not.”
And it’s a difficult skill. For sure. I’m wondering a little bit about, I’ve talked to some moms whose kids are athletes- Mm-hmm … and also began vaping, and they’re having symptoms like they can’t run as much or as fast- Yep … as they used to. They might have some like black stuff when they cough. Yeah. What are some of the signs that a parent could watch for if their kids are having some of these symptoms- Yes that maybe there’s like more going on than they know about? Yeah. So I think athletes do repeatedly, in my practice, report, not all, but some do report 

[00:24:00] a sensation of decreased endurance while running, and that’s actually a motivator for them, especially for those who are quite involved with athletics, to figure out how to stop.
And that sensation I’ve heard especially with people using cannabis vapes. But it- Mm-hmm … with nicotine as well. I haven’t seen it where somebody has like really decelerated or their performance has decreased like so impressively. It’s really, it’s subtle, and you would have to say, hear the kid saying they feel more out of breath- Right than they did. Or it’s just, “I can’t run as far,” or whatever it is. Yeah. I think the things to watch for though are the vapes themselves, ’cause there aren’t like some extreme signs that are very easy to point out. But the 

[00:25:00] devices themselves, the delivery systems themselves, should not be in the child’s environment, and that is something to keep an eye out for, knowing what they look like, and also knowing how to have conversations that are not perhaps confrontational.
Be ready to have calmer conversations if you come across it. That is something all parents should be prepared to do, and I think they should be prepared before middle school for this because that’s when it’s just so easy. It’s so, so easy to get. It is so crazy that we’re talking about having those conversations in, like, elementary school for a middle school situation.
One thing that I know my listeners are just waiting for me to ask you is, okay, but my kid is also experimenting with pills. They’re doing some, like, MDMA or LSD or, like, some of the party drugs, and I know they’re drinking and they’re 

[00:26:00] vaping. Like, where does this fit on the hierarchy of you have got to stop this? Like, is… Would we wanna eliminate some, try to eliminate some of the other things first and then work on vaping, or how does… You know what I mean? Like, they’re going, “Which is the most evil?” I guess is- Yeah … probably one of the things that they’re thinking about. Well, you know, unfortunately with the drug supply and fentanyl being so prevalent, it is scary.
And there are kids, adults, who say that they’re using cannabis and it’s contaminated. There aren’t official reports per se of that, but patients or people tell us this. Yeah. So it’s a tough thing. I think it is a goal to not use substances, but it’s also not a goal to condone one 

[00:27:00] over the other, because we know- Right especially with cannabis and the developing brain, the continued use of that after stopping using opioids is associated with return to opioid use. It’s complex, probably why that’s true. Yeah. And also, if they’re around one substance, they’re around multiple substances. Mm-hmm. Yeah. And that is tough as well.
uh, when a person’s trying to enter recovery. So you talk about it in that sort of way, with an ultimate goal. And if you actually talk to kids who are entering recovery, they do report goals of wanting to stop that. Most of them, not all. Eventually. Yeah. You know. Yeah. Yeah, because what we hear a lot is, “My kid went to treatment.” Yeah. Finally. Like, right. Yeah. Finally got him into treatment. Yeah. They 

[00:28:00] were there for 30 days, did fabulous, came home. Now you’re back with the same stressors, the same peers- Yes … the same everything, and they’re not gonna do pills, they’re not gonna drink, but they are going to vape. And they might start vaping, having never vaped before, after they get back from treatment.
And they say, “Mom, you can’t take away my nicotine,” or, “You can’t take away my vape because this is the only thing keeping me from going back to all of those other things.” And the parents are just torn because it’s like, “Ah, like this is so wrong.” And also, what if it really is helping them? What are your thoughts on…
I have thoughts on that, but what are your thoughts on that? That’s a tricky, that’s a tricky situation. I always empathize greatly with parents in that situation. Mm-hmm. I think it is fair that in your home you 

[00:29:00] have your rules, especially when there are other children or whomever. Yeah. Even your parents- Uh-huh living with you in the home. Yeah. Yes. And that is part of what you’re hopefully learning as your child goes into recovery, what the healthy boundaries are around it. I think it is reasonable if you don’t want it to be done around your children, other children, siblings, et cetera, et cetera. That is a reasonable thing.
I think that’s also a sign that- They’re entering recovery, but still not with optimized perhaps supports. Because that- Yeah … in the grand scheme of life, that is not the only thing that is preventing them from returning to use most likely. Right. But it does facilitate social connection, and it takes time to make a new social… And 

[00:30:00] sometimes it’s really not even possible depending on the community and situations that your child is living in. And there’s a lot that they’d probably have to give up if they stopped, and it takes time to find those new environments and peers and things like that. It’s really, really, really tough And then having them connected to people who are expressly there to help use motivational techniques, et cetera, to motivate them to quit.
There are treatments for- Yeah … people who are not ready to quit to help them be ready to quit. But it doesn’t mean that they’re still not accessing those services. Yeah. I agree. That can be an indicator that maybe that 30-day treatment program wasn’t quite enough- Exactly … and we need more supports around this kiddo. Because I don’t think 

[00:31:00] that, you know, we talk a lot about recovery capital and all the things that we can surround a young person with to prevent them from going back to a return to use, and I don’t think vaping should be in the category of recovery- Exactly … capital. Oh, I’m gonna steal that. Thank you, Brenda.
Yes. It just doesn’t fit there. So I, and it, and our kids are so good at selling us. Yeah. They are just brilliant- Yeah … masters of selling us an idea. Yeah. I always told my son when he was struggling, I’m like, “Buddy, when you get through this, you had better go and be a lawyer, because you could convince anybody of anything.” And so they do the sales job, and we’re so terrified of them going back to- Yeah … what we consider to be the more dangerous drugs, and legitimately probably are. I would put fentanyl in a more immediately- Yeah … dangerous category- Yeah … than a, a THC vape- Yeah … pen, potentially. And so it’s just that tug. But yeah, I think 

[00:32:00] that there’s other recovery capital that we need to put around them before considering a vape pen in that category.
You mentioned treatment. What does treatment look like for, let’s say you’ve got a kiddo in your office and they’re like, “I actually am addicted, and I do wanna quit. Like, I really do wanna quit.” What does that look like? What’s your next move? Well, for nicotine we do have some medications we can offer to help with cravings, because nicotine concentrations are so high in vapes.
Kids try to stop, but feel awful. So we do try to help them with that. And there are medications we can offer, along with behavioral treatments. Cannabis, unfortunately, our treatment options are a little more limited. We do use behavioral treatments as well, kind of behavioral therapy, 

[00:33:00] motivational enhancement therapy, et cetera. A therapist can do that with, with the child to help reduce and hopefully have them stop as well. I always, especially with both cases also Always recommend that the mental health monitoring increase because we do expect, since it, as I mentioned, like the correlation with mental health, self-medication for mental health symptoms that perhaps while trying to stop these mental health symptoms may increase in intensity, which means- Right
there might need to be adjustment of treatment plans or medications or therapies around their mental health. But that should be expected. That’s not a sign that something is wrong or something’s not working. So I always try to explain that in the beginning. We may need to have some more frequent monitoring in the mental health as 

[00:34:00] they’re stopping changes in medication doses. This isn’t that something bad is happening, it’s that you’re taking away something that was hiding or masking the underlying symptoms. That is so good. I hope everybody, like, rewind and listen to that again, because I’m pretty sure a lot of parents are thinking, “Well, they’re quitting. Everything should just be getting better.”
Exactly. Yeah. And so thank you for calling that out, because yes, when you rip the Band-Aid off and there’s no Band-Aid there anymore, that wound is going to hurt. Yeah. And so providing extra support. Do you think there’s… Let’s say a parent has tried that, and I’m thinking of a couple kiddos I know who have tried multiple times to stop on their own.
They’re unable to do it. They’re so uncomfortable. The withdrawal symptoms are so uncomfortable. They’re irritable. They can’t hang out with their friends because all of their friends- Yeah … vape. Is inpatient 

[00:35:00] treatment something that you would consider for- Sure … a THC- Yes … like a vape, THC vape- Yes addiction? Yes. Oh, yes. There, there- Okay … are many people who are- Yeah … teens in treatment with that, and it’s, the cannabis use is really affecting their life, like you said. You know, it’s affecting their ability- Yes … to function in school, sports, friends, and- Yeah … importantly, their mental health. Yeah. And so a big part of the treatment for inpatient treatment with cannabis is getting a good diagnosis of the underlying mental health symptoms and optimizing that as well, as well as helping them with the withdrawal that comes with it.
Yeah. Is there… Like, I know when people are coming off of opioids, there’s medications. Is that true of THC as well, or is it kind of like you just- So, yep … like, fight it out? So as an addiction medicine specialist, there, in the field, we do have things we use. I will say- 

[00:36:00] Mm … these are not FDA-approved uses. As I tell my parents, these are off-label symptomatic treatments. It should be a good discussion between you and your- Yeah … clinician, and an informed discussion. Yeah. But for cannabis withdrawal, we tend to treat the anxiety symptoms a- as well the sleep disturbance, which can be very- Yeah … distressing and make it hard for people to stop. And then there is an internal distress that people will feel, so there’s a lot of emotional support as well, oh, and that has to be put into place for the person, especially within the first two weeks.
Yeah. With nicotine, there might be headache, and we have NRT, nicotine replacement therapy. And headaches and stuff you can treat with Tylenol, and it’s a little different. But there are 

[00:37:00] symptomatic treatments that we can offer if someone’s feeling really awful withdrawal symptoms. Yeah, I’ve heard that the withdrawal symptoms are pretty terrible for both the parents and the kid Yeah ’cause they’re so- Yeah … un-fun to be with Mm-hmm … when that happens. What about the pouches, like the Zyn pouches? What is the kind of medical consensus on that? Yeah. Because a lot of kids are also starting with those. Yeah. Yes. So maybe they’re not starting with a vape. Yes. Give us the download. Yeah. So they haven’t been on the market as long as vapes.
Irregardless, this is my opinion, they are an on, what we call an on-ramp, just like vapes, alcohol. Any of these things are on-ramps to other substance use. Yeah. And there’s nothing like, especially for a child who’s not using anything else, there’s nothing like just using it. Same things apply. People who use 

[00:38:00] one type of substance use other types of substances. They do have levels of nicotine. We do not know safe levels in teens. And if your teen has whatever that vulnerability is to develop an addiction, whether it be biological or just ’cause it’s just everywhere in their environment, they’ve experienced bullying, there’s a variety of things. For them, there is a risk that it’ll lead to trying other things Yeah.
It’s such a… I feel like parents are just being bombarded with so many- I know … things. And to try and sort through that of, obviously none of it’s safe, and I don’t think… It’s not like we’re here trying to convince parents that any of this is bad. I think we know it’s all kinds of bad, but we’re just trying to help suss out this is what this is, this is what that is, and what our kids might be going through and experiencing. Because I truly believe 

[00:39:00] a lot of it is, comes down to the social aspect of it, and they get themselves in deeper than they think they’re going to, faster than they think they’re going to. Mm-hmm. And if they haven’t been having these open conversations with their parents about substances or about their mental health, I could imagine, I’m just thinking of myself at, like, 15, it would have been hugely awkward for me to go to my parents and say, like, “Oh, hey, by the way, I’ve been doing this thing over here that you don’t know about, and I think I can’t stop doing it.”
Yeah. “And it’s making me feel…” Like, that’s a lot to expect a young person to- Oh, yes, if it hasn’t been happening all the way. Yeah. Yeah. These conversations have to start early and tiny, about tiny things, you know? Yeah. And whatever the tiny thing is, listening with openness and curiosity and not judgment, and 

[00:40:00] caring and empathy. Yeah. So when the big things come, they feel that trust as well, and it’s hard as a parent- Yeah … because it’s a gut wrench. It’s a gut wrench. Oh. Oh, absolutely. It’s like, you feel this- I just want- … nauseous, the feet come out, the floor come out from under you. Oof. And you’re like, “I have to remain calm. I have to not escalate.”
Yes. It’s a lot. It’s truly a lot, whatever the situation is. If your child’s drinking and comes home, driving and drinking and comes home, it’s a lot. Yes. So perhaps it- I’m sure you- … shouldn’t happen right when you see it, because you’ll need some time to get yourself together. Right. We talk a lot about the pause button.
Like- Yeah … I think of that big Office, I think there was, like, a simple button for one of the Office- Yeah … stores. Like, I think of the pause, but just, like, press the pause button. You don’t have to address it in the moment. It’s 

[00:41:00] actually, I don’t think, even gonna be as effective if you address- Yeah … it in the moment, because everybody’s heated. One of you may be under the influence. And that was a question I wanted to ask you, if you’re seeing, because so many adults are vaping now- Mm … what do you do when you’ve got the parents who maybe they have legitimately gone from cigarettes to, like, “Oh, now I’m vaping,” because I don’t know if that’s safer or not.
You could tell me. What about when the parents are vaping? The kid’s like, “Well, my dad vapes.” Is that something you see? I do. And actually, interestingly, I think parents are a little more empowered to talk about cigarette smoking and how bad it is with their kids, ’cause a lot of kids say, “Oh, I would never do that.”
My dad tells me he’s addicted, tells me this person died in the family from smoking, and he’s trying to stop. So I see it less 

[00:42:00] than I do with cannabis. That’s where I see a lot of- Hmm … more of the modeling and the difference in conversation. The kids are not reporting that their parents are talking to them about it in the same way as they are tobacco Meaning that there, you know, this is the risks.
There are risks. And there’s a lot of reasons for that because cannabis, the legalization and public perception around it. But irregardless, children are children and these products are not meant for them. They’re really just not meant for them. You know? Yeah. When your brain is still doing the brain thing and containing just the entrance of that level of substances, and I think that’s the concern that I hear from parents with the vapes is just the concentration that is going into that vulnerable brain is so concerning.

[00:43:00] I wonder if you have any talking points that you have found to resonate with young people about this, because we can tell them, “Oh, this is gonna be super dangerous and you’re gonna have all these health impacts in 10 years,” and they’re gonna be like, “Yeah, whatever.” They can’t fathom 10 years. Is there anything that you’ve found that does make them at least pause for a second and think- Yeah
about this? So with cannabis, it’s really the connection. It’s acknowledging that it helps in the short term with mental health, and it does relieve symptoms of distress in the short term. That’s why people use it sometimes. Yeah. But we know in the long term, it makes things worse in terms of mental health, especially as teens are aging, especially ’cause of their developing brain. So just not saying it’s bad for your mental health, acknowledging 

[00:44:00] that in, in the short term there is some relief of pain and whatnot, emotional pain. But in the long term, we do know that it is associated with worse mental health. And parents, there’s emerging data showing it’s associated, it’s not causal, but associated.
We don’t know what causes everything. Associated with increased suicidal ideation. So really, over time, mental health symptoms can get more serious with continued use. So having the kids be aware of that. The other thing is psychosis, paranoia, panic attacks. These are all things, and for some kids that does resonate with them, and if you ask, they’ve actually seen their peers experiencing some of these acute psychiatric symptoms with 

[00:45:00] vaping cannabis or using cannabis. Another thing that I talk to, it depends on the person, we talked about the athlete and what motivates them. The other thing some kids notice is their short-term memory being bad, or– and- Hmm … do know there’s good evidence it affects short-term or working memory and learning, and that’s pretty much what they’re trying to do in this stage of life, whether it be to get a job, learn a new job, new trade, or more education.
It does affect that. Those are some of the things that kids will listen to and think about, and sort of I ask them to notice whether they’ve noticed any of these things- Mm … with themselves. And the last thing I talk about with them is this like morning nausea, because we do know there are more 

[00:46:00] cases of this syndrome called cannabinoid hyperemesis syndrome in young people, and that is associated with cannabis use, and it causes a severe episodic vomiting and abdominal pain event.
Some people have to be hospitalized, receive fluids, electrolytes need to be fixed. It can be very serious. It’s very distressing. There are some gastrointestinal side effects, and they’re not fun, that can happen as well with cannabis use. And a lot of times when I bring it up, they’re like, “Oh yeah, I know this person that happened to.
I know this person it happened to.” You know? So those are some of the things we talk about. And then a lot of what we talk about is really the underlying reason they’re using and alternative ways to address that Yeah. Well, 

[00:47:00] all of those symptoms sound not fun, and I like how you’re tying the conversation to their future and their success in the future, because I think that is something that sometimes we overlook in thinking that our kids don’t think about that, but I think they really do.
And so to connect, “Do you think that this could get in the way of you going to that college,” or, “Do you think this could get in the way of you becoming a veterinarian?” Or whatever it is. Mm-hmm. That seems to be something they can attach their brain to more so than, “Well, you could have lung cancer when you’re 70.”
Exactly. Exactly. Right. Yep. Yeah, yeah. Oh, my goodness. Well, I know I need to let you go. If you could give words to a parent who maybe just found a vape, and I am gonna put in the show notes a download that you can grab that will… I’m gonna put pictures of some of the more- Oh … unobvious vape products- Yeah
so that parents can see, because it’s kinda like you don’t know 

[00:48:00] what you’re looking for, because a lot of them do look like just like a pen or a stylus or something. So I will put that in the show notes. But let’s say a parent did find a vape in their kid’s backpack today, and you could say one thing to them, what would you say?
I think stop, breathe. Just stop. Approach your child in a quieter moment, you know, when they are not juggling 10 things, running. A private moment, and just be like, “I found this. I’m curious about this. Tell me more about it.” Very open. And of course, you’re gonna hear, “My friend. I’m holding it for my friend,” and all.
Yeah. Yeah, that’s the usual thing. “It’s not mine.” And then just be very open about it. “I’m concerned,” you know. “Even if your friend’s using it, we know that it’s around you, so 

[00:49:00] what are your choices? How are you handling this?” And starting there with compassion, curiosity, and seeking help when it’s hard to have those conversations as well.
Those are times where you can talk to your friends. Even I, who are raising teenagers, when situations arise, call my friends. I’m like, “So how do you think I should bring this up?” Other moms who are similarly, who are aware of these issues. Yes. Or your sisters or brothers, whoever it is you talk to, because raising children- Yeah
is just so challenging. But I think addressing it and not ignoring it is something that, that has to happen. And your kids love you. It may be a moment of distress, but- We fight for them, right? That’s what we do. Yeah. Absolutely. We love them to death, and we have to do some 

[00:50:00] hard things to keep them safe and moving in the right direction.
So, well, I can’t thank you enough for your time. We will put links in the show notes. If you happen to live in Connecticut, maybe you could be, you know- Yeah … get connected- Yeah … with Dr. Camenga. And then we will, again, put the download of the vape devices so you can see that, and just appreciate your time so much.
Thank you. All right. Thank you very much.
Okay, my friend, I am so glad that you are here with me today. Do you want the resources from this episode? If you do, head to hopestreamcommunity.org, click Podcast, and you will find this episode, along with 300 or so others, and every link that we mention. And if you haven’t tried it yet, we offer a free two-week trial of our online community for moms, The Stream.
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[00:51:00] hopestreamcommunity.org/try, and we can get you set up with a free two-week membership. And if this is your first time here, or if this whole approach feels new and uncomfortable, that is normal. You can grab a free e-book I wrote called Worried Sick. It will help you start seeing new ways to respond to your child and find new ways to approach this whole situation that feels very confusing.
You can find that at hopestreamcommunity.org/worried. You, my friend, are an elite-level parent. You are doing an incredible job. You do things most parents never have to do, and I am so honored to be walking this path with you. Take ridiculously good care of yourself, and I will meet you right back here next 

[00:52:00] week.