Drug use amongst teens in recent years has been changing, according to Dr. Jennie Hendrie, a pediatrician in the Pierce County area.

“I do not think that [teen drug use and vaping] is a huge issue in Pierce County but I think it is becoming an issue,” Hendrie said.

Hendrie’s statement is affirmed by Samantha Yeun, who is the Health Promotions Coordinator II for the Tacoma-Pierce County Health Department PANT (Physical Activity, Nutrition and Tobacco prevention) program.

“The use of alternative tobacco products—e-cigarettes, chew [tobacco], hookah, cigars and candy-flavored tobacco—products are on the rise. Because of the new products attracting young people, they are experimenting and exploring. [Experimenting with alternative tobacco products] is a fad, it is cool and [teens] do not realize that nicotine is addictive. Once you get hooked on it, it is hard to get out,” Yeun said.

Dr. Heather Cooper, a pediatrician in Pierce County explains both the dangers of cigarettes and of the nicotine found in e-cigarettes.

“Cigarettes can cause cancer, which is mostly from burning tobacco. That is where the carcinogens are but nicotine itself is not safe. It can cause heart problems. You can actually die, maybe not from smoking but from a nicotine overdose,” Cooper said. “In a lot of the e-cigarettes, nicotine is so concentrated that, especially in younger kids if [people] get ahold of it they can ingest it or spill it on their skin and have a nicotine overdose.”

According to Yeun, the dangers of nicotine are starting to become more prevalent.

“There are a thousand more calls to the poison control centers regarding kids swallowing or spilling nicotine on themselves,” Yeun said.

Hendrie says she typically warns patients about the impacts that nicotine has with prescriptions.

“I always warn people when I put them on birth control pills that if they are using any kind of tobacco or nicotine products, it could increase their risk for blood clots. [A patient] came in and wanted to be put on birth control. She was extremely addicted to vaping but I told her that birth control plus hormones plus nicotine equals blood clots. Her addiction was more of a social addiction, there is definitely a social component to vaping—she hung out with her friends and smoked e-cigarettes. She could not see how she was going to give it up [to be on birth control pills]” Hendrie said. “I kept telling her, ‘You know, pregnancy plus nicotine is also a risk for blood clots. Whether you get pregnant or take birth control, either way, you have to give up nicotine.’”

Although routine questions about smoking and drugs are asked at appointments, the prevalence of e-cigarettes have sparked recent changes in several pediatrician’s offices.

“We now have a question on our check-in, not only do you smoke but ‘do you use any kind of electronic cigarette?’ We did not even ask before but now it is on our Risk Factor Questionnaire. It has not even been a year but [the issue of e-cigarettes] is on the radar,” Hendrie said.

The issue of e-cigarettes is not the only one coming to doctors’ attention as the reports of marijuana use are becoming more frequent.

“I am not sure if [the increase of teens reporting marijuana use] is just because it is safe to say because it is now legal for adults but I have noticed an increased report of pot use,” Cooper said.

Hendrie has noticed a similar increase in patients regarding marijuana.

“There are a lot more kids who are asking about getting a green card when they come in for their visits, especially kids who have Attention Deficit Disorder. Many of them ask me: ‘What do you think about treating my ADD with marijuana?’” Hendrie said. “[The use of marijuana to treat ADD] is a bad idea because ADD is a lack of motivation and marijuana completely decreases motivation. It seems to be the patients [who are asking for green cards] are already using marijuana for recreational reasons and want a good reason to make it legal.”

Hendrie’s sentiments are echoed by Cooper, who says she is also against the use of marijuana to treat patient’s ADD.

“I do not think medical marijuana is a good treatment for mood issues, attention issues and sleep issues. I do not endorse that. I think that there is a misperception that [using marijuana to treat ADD] helps but I think it hurts in the long run” Cooper said.

Yeun has also seen a change in the thoughts of teens on marijuana use in recent years.

“There is a trend [among] youth [in] thinking that marijuana is less harmful. With the passage of the initiative [that made marijuana legal], teens think that it is safer [to use marijuana] or at least that [using marijuana] is not as bad as we thought it was. [Marijuana] has become normalized in the community,” Yeun said.

However, the fact that the youth consider the drug less of a danger than other drugs does not keep it from causing developmental problems in those who choose to use it.

“[The effects of drug use on teens] are not well known yet but more evidence is being compiled that marijuana, specifically marijuana use in people under the age of about 25, can actually have a significant effect on the developing brain. One really frightening trend is that psychosis and schizophrenia seem to develop much more commonly in people who have used marijuana as teens,” Hendrie said.