5 days ago
More than just a bad habit: How Kpods affect youths' physical and mental health, Lifestyle News
Small, discreet and easily attainable — vapes continue to be used among youths in Singapore despite being illegal.
And behind the sweet-scented smokes and fruity flavours of these devices, a public health concern is rapidly growing as instances of people, particularly youths, smoking a particular type of vape called Kpods continue to surface in public.
But what exactly are Kpods — and how are they different from traditional vapes and cigarettes?
According to an article by the Singapore Heart Foundation (SHF), Kpods are vape cartridges filled with synthetic drugs such as cannabinoids, ketamine, methamphetamine and medical sedatives, and because these substances are mixed in unregulated combinations, users never really know what they are putting in their body. Are youths more vulnerable?
Singapore saw indications that young people here were using Kpods in April, after a 13-year-old girl was caught behaving erratically and vaping outside the State Courts.
With more reports of youths behaving erratically in public and racking up debts after using Kpods, it leads to the question — why are teenagers and young adults so much more vulnerable to the temptations of this vice?
Speaking with AsiaOne, Dr Lambert Low, senior consultant for the National Addictions Management Service (NAMS) and chief of department of addiction medicine at the Institute of Mental Health (IMH), explained that it could be due to several reasons, including the "sensation of novelty" due to the variety of flavours and sleek design, as well as peer and social media influence.
"The mixing of vapes with pharmaceutical drugs entices youths to experiment, not knowing the harms they risk," he added.
One of the main substances of concern in Kpods is etomidate.
For those who aren't familiar, etomidate — which is currently classified as a regulated poison under the Poisons Act in Singapore — is commonly used as an anaesthetic to induce sedation for surgery.
On July 30, Coordinating Minister for National Security & Minister for Home Affairs K Shanmugam announced that the Ministry of Home Affairs will be classifying the drug as a Class C drug. Health implications of using Kpods
While etomidate is often used in surgical procedures, it doesn't mean that it's safe for inhalation.
When it's used in professional medical settings, it's a "strictly-controlled dose-dependent relationship", and given by a trained anaesthetist who knows the body's response and side effects of the poison, therefore they're able to prevent them from developing, Dr Steve Yang, respiratory physician from Mount Elizabeth Hospital, told AsiaOne.
But in Kpods, the concentration of etomidate is often unknown and unregulated — and it's also inhaled directly rather than injected like in medical settings.
According to Dr Yang, when the poison is inhaled, the onset of action (length of time it takes for a medicine to take effect) is "totally unpredictable" but "definitely rapid and uncontrolled".
"When it's inhaled, you don't know the side effects, you continue inhaling uncontrolled, the concentration is unknown, the absorption is unknown, that's when it becomes dangerous," the physician explained.
According to SHF's website, many of the other synthetic drugs found in Kpods can also damage cardiovascular health.
Ketamine and etomidate can lead to increased heart rate and raised blood pressure, cause memory loss and even breathing problems.
Methamphetamine, which is a powerful stimulant, can lead to serious issues like heart failure, stroke and mental health problems, while synthetic cannabinoids can overstimulate the nervous system — causing heart palpitations, chest pain, high blood pressure and abnormal heart rhythms.
In some cases, they may also trigger potentially fatal consequences like heart attacks or sudden cardiac arrest, according to SHF.
Repeated long-term use of the drug-laced vape may lead to issues like scarring of the heart muscle, long-term irregular heart rhythms, early-onset heart disease and a heightened risk of heart attacks.
Dr Yang echoes this, stating that the uncontrolled substances in Kpods including etomidate can cause serious health consequences such as: Increased heart rate
Raised blood pressure
Heart failure
Stroke
Heart palpitations
Chest pain
Irregular heart rhythm
Heart attack
Sudden cardiac death
In terms of lung health, some immediate health effects of Kpods include: coughing, breathlessness, wheezing and asthmatic attacks.
Kpods, being a type of vape, can also induce EVALI (E-cigarette or vaping product use-associated lung injury), explained Dr Yang, stating that Vitamin E is also often added into these devices, which triggers an inflammatory response in the lungs, causing the user to develop lung inflammation.
"They can't even breathe, and people have died from it. So with Kpods and whatever chemicals they put inside these Kpods which you do not know, those can cause damage to your lungs and that might lead to permanent damage," said the physician, warning that "even with treatment, you might not recover" because the "lungs have been permanently scarred".
The substances used in Kpods are also known to cause kidney damage.
With chronic use, especially for youths, Kpods can also lead to irreversible long-term damage to the organs as their developing organs are more susceptible.
"For kids, because they are still young, they believe that they can take all these insults to their system over time, but what happens is that they still have developing organs, developing brain tissue, as well as heart," Dr Yang stated, explaining that once an issue develops, they would have to "live with the long-term effects" of all the organ damage caused by etomidate.
A significant problem of etomidate, highlighted Dr Yang, is a suppression of stress hormone (cortisol) release.
According to the physician, the use of etomidate can cause "a bit of adrenal suppression". This means that you won't release as much cortisol as you need when you're in a situation of stress.
"So when there are stress situations like infection, we need to have all these cortisol to raise our blood pressure, raise our heart rate as a counter to these stressful situations. If you lack this response, what happens is that your blood pressure drops, and your heart rate cannot compensate when you need to," he said, explaining that this then sends the person into something called "significant shock", a critical condition caused by a sudden drop in blood flow throughout the body.
"This can increase mortality rate when you are in a stressful situation," Dr Yang continued, citing stressful workplace situations, infections and losing fluids due to blood loss as examples.
IMH's Dr Low seconds this, saying that Kpods is "not merely an addiction issue" and can cause "serious health impact" such as adrenal insufficiency. Long-term use of Kpods
And what happens if you don't quit?
Speaking on the continued use of Kpods into possibly adulthood, Dr Yang said: "You're basically perpetuating the damage to your organs."
The physician also explained that with the chronic use of Kpods, a higher dose would be required to receive the "same kick", and with that comes higher doses of all the illegal drugs in the vape, which can cause increased risk of damage to organs.
On top of causing the damage to the heart, lungs, brain, kidneys and gastrointestinal health, it can also distress the nervous system, causing tremors and repeated seizures.
"These will actually in the long-term impact your function in society as you grow older," said the physician. Mental health impact
Beyond being detrimental to physical health, using Kpods can also take a toll on the mental health of young users.
"If you develop psychiatric issues, you develop things like social withdrawal, behavioural changes that will affect performances in school or workplace, and that will be a problem as you grow into adulthood, because societies are now fast-moving. People who stay ahead are likely to remain ahead. And if you start off at a disadvantage [due to Kpods], then the disadvantage will build up and basically escalate over time, and you end up being left behind," cautioned Dr Yang.
But how would Kpods affect mental health in youths?
Dr Low highlighted that brain development in youths "continue well into the mid-20s".
"During this process, any form of drug abuse can harm their brain development and mental health, or even predispose them to developing an addiction," he explained, nothing however that the specific risks of etomidate exposure on adolescent brains require further research.
"Research literature also showed that some individuals might experience psychiatric symptoms such as aggression and agitation, rapid shifts in mood and even suicidal ideation," the senior consultant warned.
While the hypothesis that Kpod usage can lead to further abuse of other drugs has not been scientifically tested, Dr Low stated: "From a clinical perspective, there is a possibility that early substance experimentation may predispose individuals to other drug abuse."
Dr Yang also explained that when inhaled, the illegal substances used in Kpods "enter the blood brain barrier" and go "straight into the brain", which can cause paranoia, hallucinations and anxiety. Signs of using Kpods
To help those struggling with Kpods manage their addiction, it's important to be able to identify some signs that indicate that someone might be using it.
According to Dr Low, some telltale signs include: Appearing unsteady or sleepy
Issues with motor coordination
Changes in sleeping patterns (sleeping too much or too little)
Changes in eating habits
Often requests or demands for money from parents
Hiding in rooms
Avoiding family functions or interactions with friends or becoming increasingly isolated from friends and family
Drop in school or work performance
Becoming easily agitated when being checked on
Losing interest in their favourite or regular activities
He also added that individuals who are actively intoxicated on Kpods typically experience symptoms such as drowsiness, confusion, weakness, dizziness and falls. Some individuals may also develop involuntary muscular movements, such as myoclonus (sudden and brief involuntary muscle twitches or spasms).
Explained Dr Low: "Research literature also showed that some individuals might experience psychiatric symptoms such as aggression and agitation, rapid shifts in moods and even suicidal ideation." How to encourage quitting properly
While experts say that identifying the early warning signs of addiction and encouraging youths to quit Kpods is crucial and pressing, it's also important to approach the topic properly to ensure that those at-risk are receptive to receiving help.
And while there isn't a specific treatment for Kpod addiction as of now, Dr Low suggests that counselling is useful.
"We build a relationship with the individual, work on their motivation using motivational interviewing and try to encourage and work with them to stop using," he explained, stating that this includes identifying what's fuelling their use, identifying their triggers and cravings, addressing underlying mental health issues, looking at relationship issues with family and partners, and looking at dysfunctional coping mechanisms and replacing the unhealthy ones.
He also stated that some individuals may also have other behavioural issues that need to be addressed "whether it's social, relationship or psychological", and psychiatric medication may also be required if the individual develops or suffers from co-morbid (other simultaneously existing) psychiatric disorders like depression and anxiety.
As for what can be done at home, Dr Low advised that parents can play a vital role by creating a safe space for their children to share openly about their struggles.
"Take time to understand the underlying factors driving their behaviour, whether it's academic pressure, social influences or emotional difficulties," advised Dr Low.
According to the senior consultant, some "essential support strategies" include: Maintaining consistent, honest dialogues that build trust
Validating their feelings while being clear about the risks of vaping
Guiding them towards professional help and counselling services when needed
Focusing on their inherent strengths and abilities to make positive changes
Fostering an environment that supports their recovery journey
For the ones providing support, Dr Low also emphasised that "it's equally important to maintain their own wellbeing by connecting with support networks and seeking guidance when needed."
For those trying to quit or to support someone in quitting substances including Kpods, there are resources available such as the National Mindline at 1771 (24 hours) or 6669-1771 (WhatsApp).
The Health Promotion Board also has an I Quit Programme to support those trying to quit smoking and vaping by calling the QuitLine on 1800-438-2000. The sign-up form and more information can be found on HealthHub's website.
SINGAPORE HELPLINES Samaritans of Singapore: 1800-221-4444
Singapore Association for Mental Health: 1800-283-7019
Care Corner Counselling Centre (Mandarin): 1800-353-5800
Institute of Mental Health's Mental Health Helpline: 6389-2222
Silver Ribbon: 6386-1928
Shan You Counselling Centre (Mandarin): 6741-0078
Fei Yue's Online Counselling Service:
Tinkle Friend (for primary school children): 1800-2744-788
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