What about Regarding Nicotine Overdose

You must have heard about cyanide being less poisonous as compared to nicotine or how lethal even a little e-liquid can be for a kid. The toxicity of nicotine is quite well known.

Thus, one thing that you need to understand is that vape is a source of nicotine which is toxic along with being poisonous. 

Vapers often tend to express concern regarding overdose of nicotine or its poisoning that can occur owing to vaping. This is among the significant factors that make people hesitant to vape.

The question which now merits attention is whether the vapers indeed need to be concerned about the overdose of nicotine. What symptoms should one be cautious about that direct towards nicotine toxicity? What steps should be taken if you indeed end up consuming excess nicotine content?

Dealing with the myth surrounding the dose of nicotine

Let us first deal with a myth that is still being supported by many sources about the nicotine dose that can be toxic. According to these sources, the range of toxic dose is 30 to 60mg.

If we connect this with vapes, it implies that 12mg/ml of e-liquid containing 4ml of nicotine would be toxic. Processing of nicotine in the body is quite rapid with the amount decreasing by half within a couple of hours. Thus, the said amount of nicotine has to be consumed in a single go for toxicity to occur which is indeed not an easy feat.

In his short paper, Bernd Mayer proved how indefensible this lethal dose value is.

He has shed light on numerous cases in his paper, where people even after consuming more than the said amount experienced little symptoms. Furthermore, the blood tests of those who expired owing to nicotine poisoning revealed nicotine levels more than 20 times than what the guidelines suggested. According to Mayer, as per his results, the dose should be revised to a lethal dose range being between 500 and 1000mg.

One must wonder where this myth originated from.

After following on leads, Mayer found that the myth stemmed from a textbook published in 1906 by a toxicologist from Germany.

Thus, it is apparent that the source cannot be trusted completely. While the toxicologist was a trusted one during his time, but there have been significant advancements in the medical field since then. Therefore, merely relying on this source is not really a good idea.

In the textbook, there were mentions of a few incidents of self-experiments conducted in that century. The experiments revealed that people suffered from seizures along with faintness when they consumed nicotine roughly amounting to a few cigarettes. It can be suspected that an error occurred in the measurement of the dose since chain smokers do not suffer from these symptoms.

Is cyanide indeed less toxic as compared to nicotine? The answer is in negative.

Signs of consumption of excess nicotine

While vapers suffering from nicotine toxicity is rare, it is common for one to end up consuming a bit too much of nicotine in a single sitting.

One of the most prominent signs that should alert you of the same is nausea. This is commonly experienced when session of vaping that lasted for a tad bit too long nears its end. This is a signal from your body to stop vaping for some time.

From personal experience, the nauseous feeling witnesses a gradual increase. However, it would work best in your favor if you stop vaping the moment you experience the symptom. This ensures that things do not get out of hand and you prevent the next stage, which is vomiting.

Taking a break is not really difficult. This is the instinctive reaction that majority of vapers have even when they do not realize the reason. Some also experience headache owing to excess nicotine but it is nausea which is the most reliable signal.

Symptoms of nicotine toxicity

In case you do not stop, or some of the e-juice comes in contact with your skin that you do not clean, the symptoms take a severe turn. 

Enhanced salivation, abdominal cramps, headaches, and diarrhea can then be experienced. You may also feel agitated or confused.

The severe symptoms of nicotine toxicity are even rarer but still need to be mentioned. Seizures and coma can also result along with a decrease in heart rate. The worst possible symptom can be respiratory failure. 

Can vaping cause nicotine poisoning?

This is the main question that haunts the vapers. Can vaping lead to nicotine overdose or poisoning? Is there a possibility of experiencing the severe symptoms and signs of nicotine toxicity?

The most straightforward way to deal with this would be to determine the amount of e-juice you would be vaping within a few hours to reach the lethal dose of nicotine, that is 500mg.

If we use 12mg/ml of e-juice as standard, 40ml has to be vaporized to reach 500mg nicotine level. This is not a very realistic scenario. Even with e-liquid of 18mg/ml, vaping of up to 28ml would be required within a few hours to reach the level.

This is just the first barrier. The nicotine has to be subjected to vaporization before being absorbed by the body before poisoning can occur.

It is not easy to estimate this. However, Dr. Farsalinos conducted a study wherein vapers, the levels of nicotine in plasma were checked in experienced vapers after a session of vaping via mod during which 18mg/ml of e-liquid was used. No modern device was used in the study. The vapers had ten puffs for five minutes followed by an hour of using the device as per their liking.

Five minutes of vaping revealed nicotine of 8 nanograms in one ml blood. Following an hour and five minutes, 24.1ng/ml nicotine levels were recorded with the highest level reaching 48.1ng/ml.

According to the paper by Bernd Mayer, the level of nicotine in plasma in cases of fatal overdose of nicotine was 4mg/l or 4000ng/ml.

Thus, if we consider the vaper with the most level of nicotine, the amount has to be increased by 80 times for the lower range of toxic dose to be reached. Furthermore, this would have to be done within a couple of hours which sounds next to impossible.

Thus, it is evident that the overdose of nicotine cannot occur via e-cigarettes. Inhaling so much of vapor is not realistically possible.

What to be cautious about while vaping

Thus, it is unlikely that one would end up with lethal nicotine toxicity owing to vaping. However, certain symptoms can still be experienced if excess vaping is done, especially using e-juice with high nicotine content.

Some vapers will have occasional symptoms of headache and nausea. However, this has never progressed to the stage of other symptoms or vomiting.

Other vapers have had similar experiences wherein they felt nauseous and had headaches and occasional confusion, but things rarely progressed.

These signs should alert you that your vaping is getting a bit out of hand. If you experience these symptoms all too often, you need to simply vape less or reduce the nicotine content of the e-juice.

If this is a rare occurrence, taking a break until the symptoms resolve would be a good idea.

What happens if you ingest nicotine?

It is essential to know what can happen if anyone ingests e-juice. For instance, if your pets or children manage to get the e-juice, there is a high chance that they drink it which can turn dangerous for them. People have attempted suicide by drinking e-juice.

Thus, what we now need to determine is whether nicotine poisoning can occur owing to e-juice ingestion.

A German blog site reported three cases where suicide was attempted by ingesting e-juice. All the attempts failed.

A woman consumed 360mg of nicotine by drinking 20ml e-juice of 18mg/ml variant. She experienced no symptoms.

She then opted for 30mg/ml strength of e-liquid wherein she drank 50ml, making the dose of ingested nicotine 1500mg. This crosses the upper range of toxic dose. However, only nausea, vomiting, and abdominal pain were experienced.

In another incidence, a young boy of about 13 years consumed 3ml e-juice to attempt suicide. The strength is not known, but he only experienced shivering and nausea.

These incidences reveal that perhaps e-juice drinking is not as dangerous as it appears. The most significant symptom is vomiting. If someone ends up drinking more than the toxic dose range, similar to the woman mentioned, the e-juice has to pass via the digestive system to reach your blood without being vomited out.

It is nausea and vomiting that occurs in the initial time of nicotine poisoning thereby reducing the dose rapidly.

Other cases of nicotine have also been reported wherein the source is something else such as tobacco. In three recent incidences, instructions were acquired from online sources on using tobacco to extract nicotine. Two out of these three individuals passed away. According to their autopsy reports, the nicotine levels in their urine and blood was quite high.

The UK has witnessed a suicide incidence where e-juice was used.

While he also consumed cider, his plasma levels and e-juice revealed nearly a lethal amount of nicotine. Thus, while usually using e-juice for suicide results in failed attempts, sometimes, the opposite also occurs.

In the case of pets and children, the danger increases all the more.

It is highly likely that they would consume the e-juice on finding it. Furthermore, since they are quite small, a lesser amount of nicotine would lead to dangerous results.

The weight of a boy aged two years, on average is 14kg. According to estimations by Mayer, the minimum lethal nicotine dose is 6.5mg/kg which in one year and six months old boy amounts to 91mg. Thus, 5ml of e-juice with strength 18mg/ml would have to be consumed which is entirely possible.

This is where the problem lies. Adults, unless voluntarily would not think of drinking e-juice. Even if they drink it, they will at most experience only vomiting and unpleasantness. Therefore, it is essential to ensure that the e-juice is inaccessible to pets and children. Failure in this can lead to dangerous repercussions. Thus, storing e-juice properly is critical.

Consequences of nicotine getting in contact with the skin

Those who harvest tobacco sometimes end up with green tobacco sickness. In this condition, symptoms of nausea and vomiting, headache and dizziness are experienced. The situation is more common after a long working day or following a rainy morning. Recognizing these symptoms is vital since they point to nicotine poisoning.

These symptoms are experienced by the workers owing to absorption of nicotine via the skin, similar to nicotine patches. Thus, vapers need to understand that if e-juice spills on your skin, an overdose of nicotine can occur.

However, similar to pretty much everything that we have discussed so far, the actual risk is relatively smaller. Tom Preun who is a part of the Electronic Cigarette Industry Trade Association read up a study that revealed that the absorption rate of nicotine in the tests of e-liquid of 8mg/ml strength was quite low. As per the study, the absorption rate was 0.00482mg/cm/hr. Thus, if you end up with a coating of e-juice on your palm, the absorption rate would be 0.482mg/hr.

The speed of e-juice in your skin is quite slow, and it seems highly unlikely that you would leave the e-liquid coating on your skin for long hours. Washing it off would be the first thing that you do. The rate of absorption would be increased with high levels of nicotine, but it is unlikely that the overall results would be changed owing to this. 

The case with children is slightly different. They have low body weight while their sensitivity is high thereby making them more susceptible to danger. While probably not lethal, such spills would be more problematic in children as compared to adults.

Since nicotine can be absorbed via the skin, one case of attempted suicide is documented where nicotine patches were used. The girl was suicidal with a history of multiple attempts. She was discovered lying unresponsive in her bed. Fourteen nicotine patches were found on her body, the strength of which is not known. After removal of these patches, washing down of her skin was done. Activated charcoal was then used for her treatment.

Fortunately, she did not take long in recovering although she had also consumed some medication from her mother's cabinet. She was then handed to psychiatric care. It is clear that if more patches had been used or if the strength of the patches was higher, she might not have survived.

Therefore, it is prudent to stress on this; in case your skin is exposed to nicotine, washing it off should be your priority.

What needs to be known about making your own e-juice and the base of nicotine used?

When it comes to nicotine base in mixing of e-juice by yourself, things tend to get somewhat complicated. This is because, in mixing e-juice on your own, high strengths of nicotine are used. Indeed, people can use about 72mg/ml or can go even higher. Thus, the risks involving nicotine are changed drastically.

It would take just a quarter teaspoon of the e-juice in a child for the dose to turn lethal. There is an increase in risks with spills as well. While you might avoid vaping it, in case of some error in your calculations during mixing, you can end up with an e-juice of very high strength. 

Therefore, it is essential to be highly cautious while mixing e-liquid. Wearing protective equipment including nitrile gloves is mandatory. The nicotine base should be stored at a place that is out of reach for pets or children. The advice stated with regards to e-liquid holds weight for nicotine base as well but assumes even greater importance.

Nicotine bases with high strength can be purchased in Europe till the month of May in 2017. This is the grace period during which time the companies can dispose of the stock they have. Even beyond that, the vapers will manage to get their hands on it.

What should be done when the symptoms are experienced?

Taking steps for the prevention of nicotine toxicity is crucial. However, there is still a chance that things do not go as planned. You might end up spilling some of it on yourself and not notice it. Your children might gain access to the juice and consume it. There is also a possibility of things getting severe while mixing.

  • In case of excess vaping

If you have indulged in a bit too much of vaping, the least worrisome situation would be experiencing some nausea and headache.

If you take a break from vaping at this point, the symptoms will resolve. This is of immense importance. You need to stop vaping the moment you experience any slightest sign. Continuing to vape will only make things more troublesome and dangerous for you. In this case, you will keep reeling in the effects even after you stop vaping.

If you end up vomiting or have any other symptoms that you think are serious, it is better to call National Health Services of your area. If you feel things are going out of hand, acquire medical attention without delay.

  • Accidental ingestion of E-juice

In case, anyone has ingested e-juice accidentally, attention needs to be given to the strength of the e-juice and the amount consumed. For instance, if just a little amount of nicotine juice of low strength is consumed, you will feel a bit unwell, similar to when you vape excessively and revert to normal after a short while. 

The case is different if e-juice has been drunk by a child and all the more severe if the amount is large or the strength is high. It needs to be treated as an emergency. While there might not be any life-threatening conditions, risk should not be taken. Seek prompt medical assistance.

According to NHS, certain symptoms of poisoning should be considered an alarming sign and medical help should be sought immediately.

These include dizziness, feeling of unwell, palpitations, a problem in breathing, agitation or restlessness, fits, drowsiness and faintness. 

These symptoms are not only experienced when e-juice is consumed. The symptoms can be caused by nicotine toxicity as well. If the condition is under control, NHS can be called, but it would still be better to be cautious. After treatment with nicotine charcoal, the affected person will likely not take long to recover unless a large amount of nicotine was involved.

  • In case e-juice is spilled on the skin

Follow the advice mentioned above in case of any spills. If little e-liquid is spilled, washing it off promptly will do the trick, and no symptoms will likely be experienced. If the amount is large, after washing, get rid of any clothing that has traces of liquid followed by wiping off any surfaces that came in contact with it.

If the spill were massive, it would be a good idea to get some ventilation by opening the windows. Keep in mind that nicotine of high strength poses more risk, particularly when it comes to the nicotine-base that is used in mixing.

If you experience any serious symptom, get medical attention without delay.

Final words

Nicotine is toxic, but there is no reason to panic. An overdose of nicotine via vaping is quite unlikely. Usually, vapers tend to be quite cautious about storing e-liquid and ensure that it is inaccessible for children and pets. Most people opting for making their own e-juice are aware of the risks involved with High strength of nicotine and thus take precautionary measures. 

While cyanide is indeed more poisonous, this does not negate that nicotine is toxic as well. Thus, risks should be taken seriously. Things get under control within a couple of hours usually, but sometimes severe repercussions might result.

Thus, while you do not have to panic, you still need to be cautious. Take quick steps to ensure that everything remains under control.

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