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The Trouble With Cannabis Vapes

Recent outbreak of severe lung disease related to vaping highlights just how little we know about the safety of the practice.

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From a purely functional standpoint, cannabis vapes are a godsend. They are compact, and eliminate the need to carry weed. Unlike edibles, they the offer the immediacy of smoking but without the smell. They often taste really good.

But now we're learning that they might not be so good for you. This shouldn't be too surprising: while vaping (nicotine or cannabis) is surely better than breathing the smoke of burning leaves into your lungs, it still requires breathing something, other than air, into your lungs.

There's been a recent spate of U.S. illnesses, and one death, associated with vaping. In the cases where the cause has been determined, the vapes were all bought on the black market. They might have been made in some dude's garage. Black-market vapes are often tainted with nasties like fungicides, pesticides, or residues from the solvents used to extract oil from cannabis. But that doesn't mean that legit, well-tested, government-approved vapes bought from licensed retailers are necessarily harmless. The fact is, we just don't know yet.

But black-market vapes are of immediate concern. On Friday, the Food and Drug Administration and the U.S. Centers for Disease Control issued a warning: nobody who is not already a smoker should use vapes of any kind — nicotine or cannabis-derived — until the cause of the outbreak (or outbreaks) can be determined. Whether all 215 cases of illness reported since June are tied to a single product is not yet known. Cases have been reported in 25 states.

"At this time, there does not appear to be one product involved in all of the cases, although THC and cannabinoids use has been reported in many cases," according to a statement from the CDC.

California health authorities are investigating 21 cases of severe lung disease, all of which appear tied to black-market vapes. Seven of those occurred in Kings County, in the Central Valley. All seven reported having vaped cannabis products shortly before falling ill. The vape products were purchased from an unlicensed black-market seller. It's not known where the remainder of the afflicted Californians lived.

Before the federal government issued its warning last Friday, USA Today quoted Michael Siegel, a health professor at Boston University, as saying everybody should stop using cannabis vapes altogether. "Based on what we know now, I think there's enough to tell people: Don't vape THC oils — especially products that are bought off the street," he told the newspaper.

He backed away from that slightly in a later interview with Chronic Town. "There is a measure of safety in buying vapes from a licensed seller," he said, noting that regulations are tight in all states that allow legal sales. And so far, he noted, no vapes purchased from a licensed vendor have been identified as causing any health problems.

Siegel is a proponent of the use of nicotine vapes to help people quit smoking cigarettes. He noted that there's a big difference between nicotine and cannabis vapes: cannabis vapes ignite oil extracted from the pot plant. Inhaling vapor from oil might be harmful to the lungs in a way that nicotine vapes aren't, for example by causing "lipoid pneumonia," caused by fat particles entering the lungs. But no cases of that malady have been traced to legal cannabis vapes. Legit vapes are generally designed to minimize the transfer of larger particulates.

The problem with black-market vapes is that there is often no quality control. Legit producers must invest in expensive equipment to extract the oil and to remove contaminants. Do-it-yourself black marketeers can do it fairly easily, but at grave risk to the public. The main problem with them is that the makers often don't have the means (or perhaps, the desire) to remove contaminants and solvents, which Siegel suspects might be the cause of the outbreak. Solvents are used to extract the oil, but then must be removed. "Licensed facilities completely remove those solvents," Siegel said. "There's no way to know whether unlicensed ones have done so."

Perversely, this problem exists in part because of legalization. With legal pot has come a host of manufactured products, like vapes and edibles, that are now overtaking flower in terms of sales. Without the creation of that legal market, it's unlikely that there would be very many black-market operators making vapes — they'd likely just be selling weed as they always had. However, it should be noted that most of the cases in the illness outbreak occurred in states where cannabis sales are banned. And Kings County does not allow cannabis sales.

The California Department of Public Health has perhaps the strictest rules in the country governing the manufacture and sale of vape products. "Cannabis products sold by licensed retailers must comply with strict state testing standards to ensure that they are produced safely, properly packaged and labeled, and have not been tampered with," the department notes in a FAQ on its Web site about the outbreak.

There hasn't been much research on the health effects of cannabis vapes, thanks to the fact that they are still federally illegal, which makes it hard to fund research. Yet in terms of the known risks, California is probably the best state in which to buy legal products. Products here "are tested at a level above and beyond any other produce or product available in the U.S. market," said Josh Drayton, spokesman for the California Cannabis Industry Association. "Our cannabis is held to a higher standard than organic produce."

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