Although the War on Drugs has plagued the United States in various forms for decades, a new outbreak of lung illnesses related to illicit vaping products is sweeping the nation. Unfortunately, it seems that black market products containing THC, a psychoactive chemical found in the cannabis plant, are the source of many cases.
So far, these are the current facts we have from the Centers for Disease Control and Prevention (CDC). As of October 10, 2019, there have been over 1,299 lung injury cases associated with the use of vaping products reported to the CDC. These cases have been reported from 49 U.S. states, the District of Columbia, and 1 U.S. territory. The death toll so far has amounted to at least 26 people across 21 states.
All of the patients reporting have a history of using vaping products and most report a history of using THC-containing products as well. Latest findings and reports highly suggest that the products containing THC play a role in the outbreak. Of those who reported cases, approximately 80% of patients are under 35 years old, with 21% being 18-20 years old, and 15% under 18 years old. As this data clearly shows, the youth are particularly vulnerable to the consequences of the black markets produced by the War on Drugs.
The CDC lists the following symptoms reported by some patients in this outbreak:
- cough, shortness of breath, or chest pain
- nausea, vomiting, abdominal pain, or diarrhea
- fatigue, fever, or weight loss
For some these symptoms developed over a few days, whereas for others it was over several weeks. These differences could be explained by different chemical additives in the e-cigarette liquid or THC oil, frequency of use, or other factors.
“The data that we’re getting does not suggest this has peaked. It doesn’t suggest that it is declining and we’ll need more observations,”CDC, Oct. 3, 2019
In-depth interviews conducted with sick patients by officials in Illinois and Wisconsin have provided the strongest clues so far into what might be at the root of this outbreak. The vast majority of those patients interviewed reported using illicit THC-containing pre-filled vape cartridges. The patients reported buying these products from informal sources (i.e. the black market).
Industry experts have said that dealers have been using thickening agents to dilute THC oil in illicit products. These thickening agents are being marketed and made available online “…as a cheaper, safer alternative that does not negatively impact flavoring or odor of existing products and can be used to cut vape products to any level of THC,” the governor’s office said in a news release.
In September, New York Governor Andrew Cuomo ordered the state health department to issue subpoenas to three companies that the department had identified as selling substances linked to this lung illness outbreak. The companies being served with the subpoena are Honey Cut Labs in Santa Monica, Calif., for its Honey Cut Diluting Agent; Floraplex Terpenes in Ypsilanti, Mich., for its Uber Thick agent; and Mass Terpenes in Amherst, Mass., for its Pure Diluent.
The New York Health Department’s lab obtained samples of thickeners from three companies and determined they are “nearly pure” vitamin E acetate, an oil derived from vitamin E. Federal and state authorities have identified vitamin E acetate as a potential clue in the unfolding mystery because it is a common element in cannabis products that have been collected from patients who have fallen ill.
New York State health officials have reported that vitamin E acetate was found in nearly all cannabis samples tested from patients who fell ill in New York in recent weeks. The report notes that, “Vitamin E acetate is not an approved additive for New York State Medical Marijuana Program-authorized vape products and was not seen in the nicotine-based products that were tested.” As a result, this chemical is now a key focus of the Department’s investigation.
Vitamin E acetate is the first common element to be found in samples from all across the country. However, it is important to be wary that this may not be the only chemical contributing to this outbreak. Any product purchased in a black market should be considered dangerous and buyers should proceed with caution.
NBC News commissioned its own laboratory tests of illicit THC cartridges and found that 10 out of 10 of the cartridges tested for pesticides contained myclobutanil, a fungicide that can transform into hydrogen cyanide when burned.
California is home to the largest legal cannabis market in the world, and it has a black market that is three times bigger. Some have suggested that these thickening agents are being used more frequently to dilute THC oil because of a crackdown by state authorities that has made the oil scarcer on the black market. A report by Leafly in early September helped shed some light on the gravity of this outbreak.
“Officials at the terpene manufacturer True Terpenes, based in Portland, OR, told Leafly they tested Honey Cut earlier this year and found it to contain Vitamin E oil, aka tocopheryl-acetate. Two brands—Mr. Extractor of Oregon and Constance Therapeutics of California—told Leafly they’ve been selling forms of vitamin E oil into the vape cart market. Mr Extractor’s Drew Jones told Leafly he believes up to 40 companies sold a copycat oil, and the oil is in 60% of carts in the US. Lab tests have found the oil in multiple thickener products, including Peak Terpenes’ Thicc Stretch.”David Downs (Leafly.com)
The American Medical Association has urged the public to avoid e-cigarette use amid this lung illness outbreak. The Food and Drug Administration has warned the public to stop using THC-containing vaping products and any vaping products obtained off the street. Leafly has advised, “If you own illicit vape cartridges, throw them away immediately.” I suggest sticking to the real thing until more information is revealed and stricter regulations and oversight procedures are put into place.