Vaping nicotine or marijuana has been considered safer than cigarettes by many Americans as seen in a 2018 Gallup poll.
However, questions about the safety of vaping, either nicotine or marijuana, are now rising. Recently, there has been an increasing number of reported severe pulmonary illnesses in people who vape along with eleven confirmed deaths.
The specific cause of vaping-related illnesses is unclear at present, which is contributing to confusion among consumers. The U.S. Centers of Disease Control (CDC) and U.S. Food and Drug Administration (FDA) have not found one substance, product, or device linked to all cases. They are working closely with state health departments to determine the cause or causes.
That said, two factors under investigation are the substance Vitamin E acetate and illegal vaping products bought in the black market.
How Might Vitamin E Acetate Be Involved?
Vitamin E acetate hasn’t been found in all vaping-illness cases across the country. However, the New York Department of Health (DOH) found nearly all cannabis cases in their state contained high levels of vitamin E acetate. This finding has made vitamin E acetate a primary substance under investigation by the DOH.
While vitamin E acetate is known to be safe when ingested in pill form or applied topically, the safety of this vitamin when inhaled has not been established. So why is it in vaping products?
Vitamin E acetate helps thicken the vaping oil. While it’s not an approved additive in state medical marijuana programs, it has been used as an additive in some illegal products.
The concern that it may be contributing to pulmonary illnesses is due to its oil-like properties. Once vitamin E acetate is heated enough to vaporize, it can decompose, making it difficult to know what is being inhaled. Furthermore, when the vapor cools in the lungs, it will return to its normal state, essentially coating your lungs in oil. The lungs are not built to deal with having oil—fat particles—in them. Therefore, the lungs struggle to remove the particles. As lung cells die, an inflammatory response is triggered. But, this process can cause problems with breathing and even result in an accumulation of liquid in the lungs.
The symptoms that result from having oil in the lungs are very similar to those found in cases of vaping-related illnesses. According to the CDC, symptoms of the vaping-related illness start gradually, including coughing, breathing difficulty, shortness of breath, or chest pain. Some people also experience vomiting, nausea, fever, fatigue, stomach pains, and diarrhea.
Consumers are being urged to avoid products with this additive until more is known about the impact of vitamin E acetate in vaping liquids.
Why Are Products Bought Off the Street Dangerous?
In Ohio, 90% of the 17 confirmed vaping-related illnesses involved illegal cannabis products. Buying cannabis products on the Black Market is extremely risky for a variety of reasons.
1. Products off the street are unregulated.
There is a higher risk of the marijuana containing molds, pesticides, cobwebs, or mites when produced in unregulated facilities. These contaminants can cause consumers to have poor quality marijuana that can cause health problems.
2. It’s unclear what types of additives or cutting agents are in the vaping product.
When marijuana is distilled into vape oil, it should have a distinct look. If one starts with low-quality marijuana, the oil is unlikely to look right. Therefore, additional substances and chemicals are added to achieve the look and viscosity consumers recognize.
This process can have dangerous results and is how substances like vitamin E acetate get introduced into a product. Unfortunately, consumers may not know what else is in the vaping oil, especially if it was purchased from the black market or from a friend of a friend.
3. Increased risk of buying products that use dangerous cartridges.
Many black market products use cartridges that are from overseas and may contain dangerous materials. In Michigan, several vaping cartridges were found to contain lead. This finding caused officials to warn users to have their cartridges tested.
Additionally, a study in the 2018 Environmental Health Perspectives found lead and other heavy metals were leaking from the heating coils of some metal cartridges. The leaks caused these dangerous metals to mix with the vapor and be inhaled.
4. Increased chance of purchasing a bootleg brand.
To avoid buying an inferior quality product, some consumers try to stick to purchasing known brands. Unfortunately, if you’re buying off the street or from an unlicensed shop, you might be fooled into thinking you’re buying a brand name when you’re not.
What Can Medical Marijuana Consumers Do to Stay Safe?
Consumers are strongly encouraged to buy products only from licensed state dispensaries to ensure they’re receiving quality products.
While the medical marijuana regulations and guidelines vary across states, buying products from a legal state dispensary ensures that the product has met that state’s requirements. Consumers will know that the marijuana is of high quality and that additives are safe and approved.
For instance, in Ohio, all medical marijuana products are tested for toxic metals, bacteria, pesticides, and other harmful materials. Similar to the state of New York, vitamin E acetate is not an approved cutting agent. Furthermore, all non-marijuana ingredients must be nontoxic and safe for humans.
Until more is known, the FDA is encouraging consumers to stop using vaping products containing marijuana. The agency suggests using medical marijuana in different ways, such as smoking, until more information is found.
However, this advice doesn’t help consumers that live in states where smoking medical marijuana is prohibited.
What About Consumers Who Live in States That Prohibit Smoking Medical Marijuana?
Unfortunately, not all forms of medical marijuana can be used effectively by all patients. For instance, some individuals don’t benefit from edible forms of medical marijuana.
Equally challenging is that some states like Ohio, New York, Pennsylvania, and Utah don’t allow medical marijuana to be smoked.
What are patients to do when they have been approved to vape medical marijuana to treat their condition?
If other forms either won’t help or aren’t approved by a particular state, patients should:
- Only buy medical marijuana from legal, licensed state dispensaries which are regulated,
- Consult with their prescribing physician about continuing to vape marijuana and any other alternatives,
- Be sure to consume marijuana only in the amounts recommended by their physician, as using more may not be beneficial,
- Seek treatment immediately if any changes in breathing occur.
What is the Future of Vaping Medical Marijuana?
The future of vaping is unclear until more is known about the cause or causes of vaping-related illnesses. Hopefully, discussions to ensure the safety of medical marijuana across all states will continue, as the FDA and CDC work with state health departments to solve this problem.