14 January 2020
John BaconJayne O’Donnell
One-sixth of patients who developed lung injuries after vaping marijuana obtained the product from legal dispensaries, a new federal report says, which the Centers for Disease Control and Prevention said reinforced its current recommendations to not use THC-containing e-cigarette, or vaping, products.
The CDC report is based on 809 patients in Illinois, Wisconsin and Utah who provided data on the source of THC-containing products. The CDC said 131, or 16%, reported acquiring their products from only commercial sources. The majority, 627, cited “informal” sources such as family, friends and in-person or online dealers. Fifty-one, or 6%, cited both types of sources.
The CDC noted that even states with legal recreational marijuana, consumers may not know whether stores or dispensaries are actually licensed by the state. In California, the CDC said, the Bureau of Cannabis Control seized nearly 10,000 illegal vape pens from unlicensed retailers in two days last month.
The report looked at 1,979 patients with available data on substance use. A total of 1,620, or 82%, had used marijuana products. Patients ages 13-17 were more likely to acquire the marijuana from informal sources than adults were, the report says.
The CDC said the best way to be safe is to avoid the use of all vaping products.
Sean Jorgensen Callahan, a pulmonologist and University of Utah professor who has treated and written about patients with vaping lung illness, said he expected the number of illnesses related to legal THC vapes to be higher.
Vaping has been linked to 57 deaths and lung illness among more than 2,600 people since a national outbreak began last spring. The CDC investigation began with no distinction between nicotine and marijuana-based THC. It grew to emphasize black market, street-sold THC cartridges and includes legally purchased products containing THC, the ingredient in marijuana that creates a high and is vaped in oil.
At least eight states have reported lung illnesses linked to legal THC cartridges. Unlike consumer products and some food, identifying information about the products and stores that sold them isn’t available.
“The data is clear on two fronts,” said Kevin Sabet, president of Smart Approaches to Marijuana and a former senior drug policy adviser to the Obama administration. “Legal, licensed products cannot be conclusively stated as safe – as Big Marijuana’s lobbyists have so desperately tried to do – and legalization has only served to make the underground market more dangerous.
“The significance of this data release cannot be understated.”
Though vitamin E acetate in THC appears to be the most likely culprit, Callahan said it is important to remember the data is “correlative and not causative.” Something else could cause the lung illnesses, and the vitamin E acetate may be “an innocent bystander,” he said.
“The incentive to cut vape materials will always exist, and it stands to reason other adulterants may exist that can cause EVALI (the vaping lung illnesses) beyond just vitamin E,” Callahan said. “We can’t just play whack-a-mole.”
Almost two weeks ago, the Food and Drug Administration announced it will ban fruit- and mint-flavored products in e-cigarettes and vaping products while allowing vape shops to sell flavors from tank-based systems. The ban was designed to target products widely used by children while allowing vaping as a “potential off-ramp” for adults who want to quit smoking.