Blame the vape crisis of 2019 on EVALI - e-cigarette, or vaping, product use-associated lung injury - claims a University of Michigan researcher. This affirms what the CDC had been saying about why Americans were getting sick and as many as 68 died from this illness in 2019 and 2020.
"This surprised us," states Carol Boyd, co-director of the school's Center for the Study of Drugs, Alcohol, Smoking & Health. "We thought we would find more negative respiratory symptoms in both cigarettes and e-cigarettes users. Without a doubt, cigarettes and e-cigarettes are unhealthy and not good for lungs. However, vaping marijuana appears even worse. Since many teens who vape nicotine, also vape cannabis, I recommend parents treat all vaping as a risky behavior." Read the study here.
Vaporizers didn't exist before 1989. That year a mysterious character named Dr. Lunglife submitted two articles to High Times that were published. They provided diagrams for making your own portable weed vaporizer - the kind with a dome and a hose. Vaporizers have come a long way in 30 years. But unforturnately some unscrupulous processors began adding vitamin E acetate, which looks like cannabis oil, to vape-oil cartridges, setting off this crisis.
Deaths by Vaping
In the fall of 2019, reports began to surface of people who inhaled cannabis oil in vape pens suffering respiratory problems and requiring hospitalization. Then some started to die. Through the end of the year and into early 2020, there were 68 deaths due to vaping pens or e-cigs and more than 2,800 cases.
On September 27, the Centers for Disease Control (CDC) said 82% of the cases were marijuana-related. “The outbreak is currently pointing to a greater concern around THC containing products,” the CDC's principal deputy director Anne Schuchat stated.
Sixteen states have legalized marijuana. Thirty-five states have broad medical marijuana laws. Vape pens are legally manufactured and sold in these states. The cannabis oil in the cartridges that's vaporized when connected to a battery and inhaled is generally safe since its required to be tested for toxins, mold and pesticides in legal states.
But, still the vast majority of Americans don't have access to these legal, safe products. In the other 34 states, illicit markets are thriving. No longer content to smoke joints or take bong hits, consumers want the convenience and discreetness of vape pens. Bootleg manufacturers sprung up around the country to cater to these needs. Their oil cartridges are not tested for diluents or flavorings, which can contribute to lung irritation and possibly death.
David Downs at Leafly compared the "outbreak to bathtub gin under alcohol prohibition. It is generally a creature of unlicensed markets where consumers have no legal alternative. It’s akin to recent Spice/K2 poisonings, as well as unregulated CBD market poisonings."
By February and March of 2020, the CDC, the agency tracking vape deaths and cases and researching the causes had a new problem: Covid-19. They stop counting the vape deaths and cases on February 18. There must have been more cases and deaths that just weren't reported.
The Problem with Vitamin E Acetate
Vitamin E acetate was commonly being used as a thickener in cannabis oils. Also known as alpha tocopheryl acetate (ATA), vitamin E oil is generally included skin-car ine products, foods like cereals and juices, multi-vitamins and supplements. According to Healthline, the potential risks of taking high doses of ATA (more then 1,000 mg) are dizziness, fatigue, headaches, blurred vision, abdominal pain, diarrhea and nausea. It's not supposed to be heated before ingesting.
The symptoms in most of the 2,800 reported cases of vape-oil poisoning were coughing, shortness of breath, chest pain, difficulty breathing, nausea, vomiting, diarrhea, fatigue, fever and weight loss. UM's Boyd noted "wheezing or whistling" among the teen canna-vapers.
"When inhaled," FilterMag reported, "vitamin E acetate becomes grease-like and coats the lungs, which damages them."
BuzzFeed interviewed Sven-Eric Jordt, a toxicologist at Duke University School of Medicine, who said about Vitamin E: "If inhaled at sufficient amounts, it could certainly cause respiratory problems, maybe even lipoid pneumonia. It is an antioxidant, and may burn and disintegrate when heated in an e-cigarette, releasing toxicants.”
On November 8, the CDC reported vitamin E acetate was found in numerous lab tests of fluid samples: "This is the first time that we have detected a potential chemical of concern in biologic samples from patients with these lung injuries. These findings provide direct evidence of vitamin E acetate at the primary site of injury within the lungs."
According to Leafly: "(Vitamin E) disrupts the function of the lungs’ fluid lining, impeding oxygen transfer, and triggering a progressive and severe immune reaction. Some reports indicate a person’s lungs can begin to lose function as quickly as a week after exposure to THC oil heavily cut with vitamin E acetate."
More Disturbing Developments
On September 27, NBC News reported that 13 out of 15 bootleg cartridges they had tested by CannaSafe "contained myclobutanil, a fungicide that can transform into hydrogen cyanide when burned."
NYU Winthrop Hospital pediatric pulmonologist Dr. Melodi Pirzada said it's "very toxic effect on the lungs" and "should not be inhaled."
On October 2, the Mayo Clinic in Scottsdale, AZ reported that it had taken biopsies from 17 people who were stricken (two had died) and concluded they all suffered "direct toxicity or tissue damage from noxious chemical fumes.”
Dr. Brandon Larsen, a surgical pathologist at Mayo, stated: "While we can't discount the potential role of lipids, we have not seen anything to suggest this is a problem caused by lipid accumulation in the lungs. Instead, it seems to be some kind of direct chemical injury, similar to what one might see with exposures to toxic chemical fumes, poisonous gases and toxic agents."
On June 4, 2020, reseachers at Portland State University reported that pine rosin (colophony) as well as vitamin E acetate had been found in oil cartridges.
States Enact Vape Bans
On September 24, Massachusetts Gov. Charlie Baker announced a ban on both marijuana and tobacco vape products through January 25, 2020. Despite a legal challenge, vape cartridges remained banned, but flower vape products were available.
Another legal state, Washington, prohibited the use of vitamin E acetate as a thickener in cannabis oil products as of November 20. "