President Trump has meandered into the recent wave of reports which sensationally claim that there is “a vaping epidemic”. Trump is even tossing around language that indicates a full or partial ban of all vape devices. However, the solution isn’t to restrict yet another freedom; it’s to erase the gray area created by federal cannabis prohibition.
Trump, being no stranger to sensationalism and fond of political distraction, has found a domestic cause to champion, despite obviously having no comprehension of the matter.
This is an excellent opportunity for the rest of us to educate ourselves and respond wisely, instead of react off-the-cuff and risk a real epidemic.
There is no epidemic
First thing’s first and most crucial: There is no “vaping epidemic”, at least not on a national level. The majority of cases have been from the midwest states, involving black/gray market marijuana extract vaporizers. (Oregon has little to worry about, but we’ll get there in a bit.)
As of last year, 1 in 10 American adults use nicotine vaporizers, and millions vape cannabis extracts safely within legal cannabis states all the time. While over 500 illnesses and 7 deaths is certainly alarming and should be addressed immediately, those incidents (except one outlier) occurred in states that have been unable to conjure cannabis legalization, ensuring the rise of an unregulated black market to compete with demand.
There is a case of a Seattle-area resident who became ill from nicotine vaping, but he admitted to using homemade vaporizers and home-produced vape liquid. These amateur hobbyist vape “mods” are known to explode in rare cases, and the ingredients used for mixing vape liquid is not regulated. It can be purchased easily online.
Based on the statistics above, if there was a national epidemic, our hospitals would be overflowing with vape-related cases across the US.
Kneejerk reactionary moves on a federal level would serve to push all vaping into the black market, and we’d truly see what an epidemic looks like with zero regulation anywhere.
The Oregon Outlier
Only one case, as mentioned above, involves a product purchased from a state with legal cannabis, in a licensed dispensary: Oregon. The death of an Oregonian kicked Oregon’s weed market into gear, with retailers removing vaping products from their shelves and offering returns on previously purchased vape pens.
While there’s no public details about the Oregon case, we can extrapolate a few things:
The Oregon consumer who died bought a product that others have certainly been buying. Vape pens aren’t made in one-gram batches, so we can be sure others would be exhibiting some signs of illness from said product- if the regulated, legally-sold product were solely to blame. The only reasonable deduction is that there must be an unknown x-factor.
Oregon’s wellness-focused marijuana industry acted quickly nonetheless. Kind Leaf Pendleton, a cannabis retailer with the largest inventory in Oregon, said it has already pulled 68 vaping products from 15 brands amid uncertainty over what is causing the lung-related illnesses.
“What would really hurt is having someone purchase a product and die from vaping,” said Erin Purchase, director of operations at Kind Leaf. “Safety is priority here.”
Kind Leaf said it identified all products on its shelves that listed “non-cannabis derived terpenes and artificial and natural flavors” on the label without specifying the ingredients in those additives.
Terpenes are the building blocks that give a plant its aroma and flavor, such as lavender or tea tree oil. Some cannabis oil manufacturers add terpenes from other plants to their products for consistency and cost effectiveness.
Steve Marks, executive director of the Oregon Liquor Control Commission, told The Associated Press Wednesday his agency plans to ask store owners to voluntarily review the products on their shelves and pull any they feel might be unsafe.
When Kind Leaf tracked down the companies that sold non-marijuana terpenes to makers of vape pens, they noticed that some of them also make and sell the so-called cutting agents, or thickeners, which have come under scrutiny.
“We can’t prove that those products are not in these vape pens because we’re retailers, not processors,” Purchase said. “They’re allowed to have trade secrets and proprietary information so we just felt uncomfortable. It’s unsettling.”
This brings us to the Prime Suspect in the vape cases and alleged vaping epidemic: Vitamin E Acetate
Vitamin E Acetate
Before 500 cases of a “vaping-related illness” during this so-called “vaping epidemic” caught the attention of various state health departments, the FDA, and the CDC, sellers within the black market vaping economy were aware they had a problem: Consumers were getting wise to the knock-off THC vaping products being sold in marijuana-prohibited areas.
The solution to their problem came in the form of vitamin E acetate, a thickening agent that would allow sellers to trick buyers, to ultimately disastrous effect. The same thickening agent used to cover up low-quality THC oil now ironically looks to be what brings the illicit market into full regulatory view.
“The black market started to see that we looked for ‘thick’ oil, so they developed a thickener with zero regard for safety,” says dankbustersofficial, a watchdog Instagram account that calls out the most infamous black market “brand” in its handle. “I started seeing oil that looked ‘clean’ on the black market about two months ago.”
Two months ago? That’s about when reports of illness first began to arise.
Traditional cuts included medium chain triglycerides (MCT) — a component that’s found in coconut oil, for instance. More recently, vitamin E acetate has emerged as a new alternative because it offers an even thicker cut that allows sellers to beat the “bubble test,” a way that consumers used to be able to judge a quality distillate.
“When you turn the vape cartridge the other way, if the bubble freely flows then it’s got some kind of cutting agent. It’s not high-potency distillate,” Myron Ronay, the CEO of BelCosta Labs in California, tells Inverse. “The thickeners, this vitamin E acetate, is a much thicker product so that when you do the bubble test, it moves slower, which makes it appear, on visual inspection, to be a more concentrated distillate.”
Ronay says that his lab will test for vitamin E acetate in vaporizer cartridges in light of the investigation into the thickeners. They expect to have those tests up and running in the next few weeks. Before this, vitamin E wasn’t something labs even knew to test for.
What we know, per CDC (9/19)
- There are 530* cases of lung injury reported from 38 states and 1 U.S. territory. Seven deaths have been confirmed in 6 states.
- CDC has received complete sex and age data on 373 of 530 cases.
- Nearly three fourths (72%) of cases are male
- Two thirds (67%) of cases are 18 to 34 years old
- 16% of cases are under 18 years and 17% are 35 years or older
- All reported cases have a history of e-cigarette product use or vaping.
- Based on initial data from certain states we know: Most patients have reported a history of using e-cigarette products containing THC. Many patients have reported using THC and nicotine. Some have reported the use of e-cigarette products containing only nicotine.
What we don’t know
- We do not yet know the specific cause of these lung injuries. The investigation has not identified any specific e-cigarette or vaping product (devices, liquids, refill pods, and/or cartridges) or substance that is linked to all cases.
What the CDC recommends
- CDC has released interim recommendations for healthcare providers, health departments, and the public.
- Until we know more, if you are concerned about these specific health risks, CDC recommends that you consider refraining from using e-cigarette or vaping products.
- If you are an adult who used e-cigarettes containing nicotine to quit cigarette smoking, do not return to smoking cigarettes.
- If you have recently used an e-cigarette or vaping product and you have symptoms like those reported in this outbreak see a healthcare provider.
- Regardless of the ongoing investigation:
- Anyone who uses an e-cigarette or vaping product should not buy these products (e.g., e-cigarette or vaping products with THC or CBD oils) off the street, and should not modify or add any substances to these products that are not intended by the manufacturer.
- Youth and young adults should not use e-cigarette products.
- Women who are pregnant should not use e-cigarette products.
- Adults who do not currently use tobacco products should not start using e-cigarette products.
What federal and state governments are doing about it
The CDC is working closely with affected states to understand the nature of the illness and the extent of its impact. The Food and Drug Administration issued a statement saying it is “deeply concerned about these incidents” and is working closely with the CDC to investigate the outbreak as quickly as possible. The FDA is analyzing a collection of over 120 product samples provided by state public health officials for the presence of a broad range of chemicals, including nicotine, THC and other cannabinoids, cutting agents, additives, pesticides, opioids, poisons, heavy metals and toxins.
“More information is needed to better understand whether there is a relationship between any specific products and any specific substances in those products and the reported illnesses,” Mitch Zeller, director of the FDA’s Center for Tobacco Products, said in a press briefing earlier this month.
On Monday, the CDC announced it activated its Emergency Operations Center to provide increased operational support for the response.
The FDA announced Thursday it has enlisted the help of its office of criminal investigations, the law-enforcement arm of the FDA. “We are in desperate need of facts,” Zeller said. He emphasized that the FDA is not looking to prosecute anyone for personal use of any of the substances linked to the vaping illnesses.
The long-term answer to this “epidemic” is clear to anyone with honest intentions: Federal legalization and regulation of cannabis and its extracts would create industry-standard practices, ingredients, testing, packaging, labeling, and recorded chains of possession from source to shelf.
Any other federal response is misguided and likely influenced by corporate interests.