Vaping sees more youth treated for hallucinations, collapsed lungs

Government hospitals are seeing a growing number of cases related to teenage vaping, raising new concerns about the e-cigarettes which are now readily available due to a legal loophole to control the habit among minors.

Although there are no official figures, hospital sources who spoke to MalaysiaNow said there has been an increase in cases of hallucinations and collapsed lungs (pneumothorax) among young vapers.

One doctor in a southern state reported that a patient under the age of 20 had hallucinations after starting to vape.

According to him, the patient had consumed a new vape flavour in the first week that his friend had introduced him to.

"He came to the hospital for treatment because he could no longer distinguish between reality and fantasy. He sees people's faces on lampposts, he imagines his deceased father when he meets people.

"He sees objects that he does not know exist," he told MalaysiaNow.

The patient is believed to have been admitted to a psychiatric ward for psychosis, a type of mental disorder.

However, the health department had difficulty identifying the flavours used as there are no regulations for vaping.

"But we are sure it's mushroom," he said, referring to the "magic mushroom" vape flavour, which is extracted from a type of mushroom and contains psilocybin, a very strong hallucinogen.

Recently, it was reported that a Form 4 student in Terengganu was hospitalised after suffering a seizure and losing consciousness, presumably after inhaling vape containing "magic mushroom".

The tobacco and vaping industry benefited from the Anwar Ibrahim-led government's decision not to implement the generational end game (GEG), a law that bans the sale of cigarettes and vapes to those born from 2007 onwards in order to achieve a smoke-free generation by 2040.

The controversial decision by then health minister Dr Zaliha Mustafa in July last year to exclude liquid and gel nicotine from the Poisons List only further complicated efforts to eradicate smoking by legalising the open sale of vape products to the public.

A Klang Valley doctor said cases of hallucinations due to complications caused by vaping are on the rise.

He said a patient would behave aggressively and needed to be sedated.

"There were 15-year-old patients who tried smoking. But since vaping has come along, they are being replaced by those who try vaping. Then they try different flavours, including mushroom. They become addicted and the dose increases when they reach a certain tolerance threshold, so that the normal dose no longer has any effect," the doctor said, adding that he has observed an increase in health complications from vaping since the middle of last year.

The doctor, who wishes to remain anonymous, said it is difficult to control the dosage of nicotine or other banned substances in vape flavours as they are not regulated.

This victimises young people who would not care about the ingredients of vape flavours.

He added that it is also difficult for the health ministry to detect the presence of these new illicit drugs through conventional urine tests.

"If the person has a mental health problem, any drug that is in the vape will aggravate their mental state and cause him to become mentally ill," he said.

"Even if there is no mental illness, a person's brain will be severely impaired and susceptible to mental illness," he added.

Teenagers at risk

Dr Hijaz Ridzwan, assistant professor of psychiatry at the International Islamic University, said magic mushrooms contain banned substances such as LSD or PCP, which cause delusions and hallucinations.

"In the last three to five years, we have seen how easy it is for minors to start vaping. In addition, more and more synthetic drugs such as cannabis and methamphetamine are being sold in the form of vapes," he said.

Other complications include respiratory problems, bacterial infections and pneumonia.

According to Hijaz, these health problems can affect vapers regardless of their age.

Dr Rozanizam Zakaria from Sultan Ahmad Shah Medical Centre in Kuantan said teenagers are more at risk because their brains are still developing.

"There are cases where teenagers who have no history of health problems or mental illness suddenly show abnormal behavioural changes, including aggression towards family members.

"Investigation shows no evidence of physical health problems until we find out that they have used illicit substances in the past. Then we would know that the teenagers in question have used vapes containing mushroom-based substances, which they bought online," he added.

He explained that the risk of developing psychosis is higher in people with a family history of mental illnesses such as schizophrenia and bipolar disorder.

He said that while psychosis recovers once the effects of the substance wear off, there are cases of long-term effects on mental health.

MalaysiaNow has also been informed of rising number of young people on the East Coast being admitted to emergency rooms for pulmonary complications.

Patients often have a tube inserted into their chest to remove fluid from their lungs.

"If the fluid is cloudy or brownish in colour, we would ask the patient if they are a smoker or vaper"

It's common practice for hospitals to prioritise other patients who need more urgent care before attending to patients who use vape.

He said Kelantan had started collecting data from health clinics and government hospitals to assess the impact of vaping on teenagers.

Another problem, however, is the fact that some parents condone their children vaping.

One hospital worker reported a teenage patient who admitted that he had never been reprimanded by his parents for vaping.

On the contrary, he said he swapped vape liquids with his father at home.

"We are already burdened with problems of inadequate staff and medication supplies, and now we have to deal with society's attitude which refuses to accept the dangers of smoking and vaping," he added.

According to another medical source, doctors and pharmacists often complain about ministers and officials in Putrajaya for their indifference to vaping-related problems.

It said Malaysia faces a massive health crisis if no efforts are made to restrict or regulate the sale of nicotine vape.

"If the excuse is to collect taxes and generate revenue for the country, just wait, in the end the money will be used to buy pneumothorax tubes," the source added.