A former Fairfax Public School student was introduced to vaping at school. He went through withdrawal from a nicotine addiction.
Photo courtesy of "David's" mother
David was a 15-year-old freshman in a Fairfax high school when friends asked if he wanted to try a JUUL, the flavored vaping product popular among young people. He was curious. He’d heard about e-cigarettes since elementary school, and now in high school, lots of kids would hang out in the bathroom vaping. His friends said it felt good; they described the head rush, the buzz. He tried it, and soon he was hooked. E-cigarettes aren’t allowed in school, so when a security guard caught him vaping in the bathroom, he got a one-day suspension and had to attend a class on the dangers of vaping.
All this came as a shock to his mother, Gail. Not only was she unaware her son was vaping, but she knew almost nothing about e-cigarettes. “When I first found little pieces of the device, the pods and batteries, I didn’t recognize them,” she says.
She read up, and talked to her son about the dangers of vaping, including the effects of nicotine on a developing brain.
But a few months later, David — whose real name has been kept anonymous out of concern for possible repercussions — was pulled out of class and searched. He had a JUUL in his pocket that he’d bought from another student, a senior. For his second offense, he was given a tougher punishment: a two-day suspension and a year with no after-school activities, including sports. No working out in the school gym, no attending Friday football games and no trying out for the baseball team. He was cut off from his friends, from exercise and from social events.
He tried to stop using JUUL. “And then I got nicotine withdrawal. Headaches and sweating and fidgeting. I would go to the office and call my mom and be like ‘can you pick me up? I don’t feel good. I would sit at home and do nothing. I didn’t really care about stuff at that point. I was like ‘well I’m addicted, what’s the point?’ ”
Gail watched her social, sports-obsessed son become withdrawn. She had to accept that her son was addicted. And she realized the school’s response — focused on discipline and not the underlying addiction — wasn’t helping.
“The school took a punishment-only approach. He was spiraling downward into depression and anger. He was isolated, and so he was using more. I reached out to anyone who would listen about how the punishment was driving him into a mental health crisis and not stopping his addiction,” she says.
‘Too Little, Too Late’
Across the country, including the Washington region, there are prevention efforts to limit access to e-cigarettes. New York and Michigan just banned flavored e-cigarettes, and the District just proposed similar legislation. You now need to be at least 21 to purchase an e-cigarette in Virginia, so seniors in high school will no longer be able to buy them legally. And Montgomery County this week announced a plan to ban vape shops from operating within a half mile of schools.
But these efforts won’t help students who are already addicted to e-cigarettes. And that’s a big problem, according to Dr. Karen Wilson, chairperson of the American Academy of Pediatrics Tobacco Consortium and professor at Mount Sinai School of Medicine. She says recent national studies have shown 27 percent of teenagers have used e-cigarettes in the past month. Many kids don’t realize just how addictive nicotine is, and e-cigarettes can deliver high concentrations — far higher than a cigarette.
“I would suspect that all of the adolescents that are currently using electronic cigarettes are addicted to them to some degree and need some help to quit.”
When a child brings a vaping device to school even after being caught, Wilson says it may not be because they’re being defiant; it may be because they can’t stop. “We’re hearing more and more from teenagers that they’re so addicted that they have to wake up in the middle of the night to use these products. They can’t go more than two hours. These are types of addiction we don’t generally see with cigarettes.”
The medical community also has been slow to respond. Wilson says JUUL’s popularity and the speed at which children became addicted took everyone by surprise. Research hasn’t caught up, so there still isn’t much know about long term health effects on children. And Wilson says doctors are still trying to come up with evidence-based recommendations for pediatricians to treat kids who already are addicted. For example, the nicotine patch is one of the most common replacement therapies, when adults are trying to stop smoking cigarettes. But it isn’t yet FDA approved for teens younger than 18. So many pediatricians won’t prescribe them for kids. And if they do, the child could get into trouble at school for using them.
Dr. Wilson says making vaping devices harder to get can help, but for kids who are already addicted it can backfire and drive them to buy bootleg, contaminated products. “I think this is a little ‘too little, too late’ but it is certainly better than nothing,” she says.
A New Approach In Schools
Stefan Mascoll is in charge of the Student Safety and Wellness Office for Fairfax schools. During the 2016-17 school year, they saw 69 students for tobacco related substance abuse. In just one year, that number jumped to 400, and last year it was more than 600.
In response, his office is changing its strategy, moving from a solely punitive response to addressing vaping as a health concern. “Fairfax has certainly moved in the direction of recognizing that there are students who need support, and we have a responsibility to provide as much support as we can.” It’s the kind of approach Gail has been advocating, and one which might have helped address her son’s nicotine addiction.
Brian Maslowski has been a substance abuse specialist for eight years in Fairfax County Public Schools. In the past, students who were sent to him for using a banned substance like an e-cigarette were usually suspended and had to sit through a three-day seminar off school grounds. It was mostly a “scared straight” approach, not uncommon in public schools across the county. They would have to do some self-reflection and listen to presentations by a lawyer and police officer about the dangers of vaping.
But this year, there will be 17 other specialists like him based in schools, with backgrounds in fields like psychology, social work and counseling, an acknowledgement that vaping is not only a disciplinary issue, but also an addiction and a health concern. “It used to be a kind of one time deal. Now there can be some follow up.” There will still be an education and prevention piece, but now the goal is to help students who are already addicted. And if the student needs more support than the school can provide, there are referrals to outside programs, including a community organization that can help. “We’re trying to fill the gap between someone who might just need education and someone who definitely needs treatment.”
'Parents Are Completely Oblivious’
There will still be consequences for vaping in school, but having substance abuse specialists means support and immediate steps to address the underlying addiction. For kids who need more help than the school can provide, the specialists will be part of a conference call to provide what’s called a “warm hand off” to someone at the Community Services Board in Fairfax County so they can be connected to behavioral help more quickly.
Students and/or their parents will be referred through the school system or juvenile court for a confidential assessment, which can be conducted in person or via video. They can enroll in a Substance Disorder Group available in four locations across the county. These 10-week outpatient sessions include psychosocial education and counseling for youth whose needs involve substance use. Another new initiative is Heads Up & Talk It Out, concurrent support groups for teens and parents working through emotional, mental health, or substance use challenges.
Increasing the number of substance abuse specialists in schools so significantly is also an acknowledgement of how widespread vaping is. A recent survey found that while alcohol, cigarettes and prescription painkiller use is decreasing, vaping is on the rise, with one in five kids saying they had vaped in the past month. Parents like Jane Miscavage, the president of the Fairfax Country Council of PTAs, which includes more than 40,000 members, thinks that figure is a low estimate. “You can imagine how many thousands of kids in this system are taking part in vaping. It’s all around us. It’s insidious and invisible. And parents are completely oblivious.” Miscavage says vaping is the number one issue the council will tackle this year.
David is now in a private school. And while his mother is happy she helped push the local school system to address the problem, she’s still like to see more coordination between schools when it comes to dealing with students who vape, along with more education for teachers. She still hopes David can attend his neighborhood Fairfax High School again someday with his friends.
Most of all, she feels we shouldn’t write off kids like David. “If they make bad choices, you have to provide a path for them to make good choices,” she says.
This story was updated to reflect the correct school year data from the Student Safety and Wellness Office for Fairfax schools.