Vaping has become so normalised in schools that a confiscated device barely raises an eyebrow anymore - but the contents should. At Black Country Pathology Services (United Kingdom) we conducted a recent pilot study in which we analysed 204 vapes confiscated in local schools. Vape liquid was extracted and analysed in our toxicology laboratory using high resolution mass spectrometry (HRMS). Illicit substances were identified in 7% of devices, predominantly synthetic cannabinoid receptor agonists (SCRAs), often collectively referred to as ‘Spice’ or ‘K2’ (1). These are not natural cannabinoids but more potent and dangerous synthetic compounds with unpredictable side effects. These substances, often sold as “THC vapes”, can cause agitation, seizures, psychosis, and in some cases hospitalisation (2). The packaging of all 204 vapes were reviewed, and nothing on the packaging of these vapes suggested these compounds were present.
Only one sample contained natural cannabinoids (THC and CBD), whilst 13 samples contained SCRAs such as MDMB 4en PINACA, 4F MDMB BINACA, or 5F ADB. This aligns with national reports from Greater Manchester and WEDINOS (3,4) showing that young people are frequently exposed to “Spice vapes” disguised as cannabis products. Social media platforms such as Snapchat, TikTok, and Instagram appear to be common purchase routes, making regulation and traceability even more difficult (2).
Our study also found that refillable devices were far riskier: nearly one in five refillable devices contained illicit substances, compared with just 4.3% of disposable vapes. This is an important insight as the UK has recently moved to restricting single use vapes. Eliminating disposable vapes may reduce environmental waste, but it won’t solve the problem of adulterated liquids circulating through refillable devices.
These school based findings mirror what clinicians in our region are seeing: young people presenting to emergency departments with agitation, seizures, or collapse after using vapes in which the same SCRAs have been detected (5). We also note that toxicology testing requests from emergency departments appear far lower than the number of young people presenting with symptoms consistent with SCRA exposure, indicating likely undertesting of both clinical samples and vape products. This lack of testing presents a risk that the actual numbers of hospital presentations are significantly under-reported, and risks misdiagnosis and inappropriate patient treatment. This gap is further compounded by limited routine communication between ED teams, public health and laboratory services, meaning important signals may be missed.
So where does this leave us? There is an urgent need for increased toxicological testing, both of clinical and vape samples, however ability to test for synthetic cannabinoids in laboratories is variable. Most cannabis assays will not detect synthetic cannabinoids, and synthetic cannabinoid measurement often requires mass spectrometry-based equipment, restricting testing to more specialist laboratories. Laboratories that can test for synthetic cannabinoids in biological matrices will likely need to develop new extraction methods to analyse vape liquids.
There is also a need for multi agency surveillance between toxicology laboratories, emergency departments, schools and public health teams, all working together to test surrendered or confiscated vapes and rapidly share findings. This kind of early warning system could help clinicians and educators recognise emerging risks and tailor messaging for young people who may be unknowingly exposed to potent synthetic cannabinoids or ‘Spice’ in vape products.
The takeaway is simple: we can’t address the harms of youth vaping if we don’t know what’s actually in the devices.
References
- Sharrod-Cole, H. et al. Illicit substances in school-confiscated vapes: Lessons from a laboratory-driven public health pilot (2026) Public Health in Practice vol 11
- University of Bath Communication: published at https://www.bath.ac.uk/announcements/up-to-1-in-4-vapes-confiscated-in-schools-contains-spice-and-these-are-pushed-on-social-media/ (accessed 2026)
- Greater Manchester Trends (GMTrends). GM Trends 2023-24 Main Report [Internet] (2024) Manchester Metropolitan University
- WEDINOS. Welsh emerging drugs and identification of novel substances: annual report 2021-22 (2022) [Internet] available at: Annual-Report-21-22-English.pdf
- Pucci, M., Moyns, E., Welby-Everard, P., Starbrook, L. Seven Patients with analytically confirmed MDMB-4en-PINACA toxicity associated with the use of electronic vaping devices (2025) Clin Toxicol (Phila) 63(5) 360-362
