Manufacturer of e-liquid laced with methamphetamine arrested in Indonesia

After the EVALI wave caused by e-liquids with cannabis and vitamin E in 2019, the seizure in Jakarta of a stock of e-liquid containing methamphetamines once again raises the question of the diversion of electronic cigarettes and their products.

A 22-year-old man was arrested in Jakarta for selling vials of e-liquid containing methamphetamine online.[1]. In the home he had rented, 385 vials of this e-liquid were seized, for a total of 16 liters, as well as a homemade laboratory. This man had clandestinely imported the equipment and products from Iran, and had stopped in Hong Kong before reaching Indonesia.

Misuse of electronic cigarettes

A synthetic drug widespread in Asia, methamphetamines are derived from amphetamines and their effect is longer lasting and more intense.[2]. Referred to as "yabaa", "crystal", "ice" or "meth", they are found in particular in methylenedioxy-methamphetamine (MDMA) and in its derivative, ecstasy.[3]. Usually sold in powder or crystal form, and sometimes as tablets or capsules, they are most often ingested, snorted, or inhaled after being heated. Mixed with an e-liquid, methamphetamines can therefore be consumed using electronic cigarettes.

The wave of EVALI (e-cigarette, or vaping, product use associated lung injury) pathologies in 2019 in the United States, during which 2,807 people were hospitalized and 68 of them died, had implicated e-liquids with an oily cannabis base. The presence of vitamin E acetate in these solutions containing THC had then been identified as the element responsible for severe respiratory disorders.[4].

Vaping is, for its part, very common among CBD users, and at least one death, linked to an e-liquid containing CBD, has been reported in Belgium.[5]Thailand, where vaping products have been banned since 2014, recorded its first EVALI death, without the presence of narcotics being mentioned.[6]Misuse of electronic cigarettes for the consumption of synthetic cannabis, DMT or cocaine has also been reported.

From misuse to risk reduction

On the harm reduction side, two German researchers have argued that e-cigarettes could be a less risky way to consume cocaine in its free-base form, crack, than other routes.[7]The aim would then be to reduce the risks of overdose as well as those of lung diseases ("crack lung"), the damage linked to crack being even more significant than that of cocaine in powder form.

Mark Tyndall, a professor of public health in British Columbia (Canada), has developed a similar idea for heroin or fentanyl smokers, who represent 30 to 40% of users of these drugs. The widespread distribution in recent years of naloxone inhalers (antidote for opioid overdoses) among drug users is probably not unrelated to this reasoning. However, these visions of risk reduction in addiction have little to do with that put forward by the tobacco industry in communicating about their new products.

Indonesia faces its contradictions

With 279 million inhabitants[8], Indonesia is the fourth most populous country in the world and is characterized by some of the most severe drug laws regarding illicit drugs. Drug trafficking can lead to the death penalty and simple possession of illicit drugs can be punished with 4 to 12 years in prison.

On the other hand, Indonesia, the second largest tobacco producer, has long been favorable to the tobacco industryIt is one of the few countries that has not ratified the Framework Convention on Tobacco Control (FCTC) and is characterised by difficulties in implementing a coherent policy to combat smoking.

For example, Minister of Economic Affairs Airlangga Hartarto officially inaugurated the new IQOS and Heets heated tobacco product factory in West Java by Philip Morris International (PMI) on January 12, 2023.[9].

However, health organizations regularly remind us that ratification of the FCTC and the impetus for a more determined anti-smoking policy, including the various vaping and nicotine products, would help reduce the impact of smoking in this country. They also call for regulation of electronic cigarettes, particularly with a view to protecting the youngest, as the only restrictions on the sale of these products concern only advertising and are themselves not respected.

Keywords: electronic cigarette, methamphetamines, diverted uses, Indonesia

©Generation Without Tobacco

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[1] Beritasatu, Meth-Infused Vape Liquid Home Industry Sparks Concern over E-Cigs, Jakarta Globe, published January 18, 2023, accessed January 19, 2023. [2] Methamphetamine, Drugs Info Services, The Drugs Dictionary. [3] MDMA ('ecstasy'): drug sheet, EMCDDA. [4] Outbreak of lung injury associated with the use of e-cigarettes, or vaping products, CDC, updated August 3, 2021, accessed January 19, 2023. [5] AFP/Europe 1, First death in Belgium attributed to the use of electronic cigarettes, Europe 1, published on November 14, 2019, consulted on January 19, 2023. [6] Wipatayotin A, Hospital confirms first case of vape-linked lung infection, Bangkok Post, published November 11, 2022, accessed January 19, 2023 [7] Farah T, Cocaine E-Cigarette Could Help People Struggling with Addiction, Discover, published January 17, 2022, accessed January 19, 2023. [8] Indonesia, World Population Dashboard, UNFPA, 2022 data. [9] Minister Airlangga inaugurates Sampoerna's smoke-free tobacco product factory and export, The Jakarta Post, published January 18, 2022, accessed January 20, 2023. National Committee Against Smoking |