By Angela Underwood
The CDC’s latest report notes due to the Thanksgiving holiday, the next available outbreak data on case counts and death will be released Dec. 5.
The data, which will be collected between Nov. 17-30 will only include hospitalized e-cigarette or vaping product use associated lung injury (EVALI) cases and up-to-date deaths. Since the CDC linked Vitamin E Acetate, a thickening agent used in THC-infused cartridges, there are 47 confirmed deaths in 25 U.S. states and D.C. cannabisMD Medical Advisory Board Members Dr. Jordan Tishler and Dr. Junella Chin said no one could’ve seen Vitamin E as the culprit.
And that was exactly the case, according to The Minnesota Department of Health, which reported Tuesday 20 vaping products annexed by police in 2019 all tested positive for Vitamin E acetate, an additive used in THC oil, but the same additive was not found in 10 products seized a year ago.
“Prior to the initial reports, I don’t think anyone would have suspected that Vitamin E would be added to an oil cartridge,” Dr. Tishler said. “It’s so patently obviously a bad idea. Vitamin E is markedly allergenic, so once it was suspected, it was no surprise that Vitamin E would be a bad idea.”
Dr. Chin concurs.
“Unfortunately, no one would have suspected this ingredient in the vape cartridges,” she said. “When you are dealing with unregulated/black market products, there can be a host of contaminants or counterfeit substances that consumers are not aware of.”
The report comes on the cusp of the New York City Council approving the ban, prohibiting the sale of flavored electronic cigarettes and flavored e-liquids after a Manhattan man in his 30s died directly due to vaping.
Dr. Tishler said the problem is not that the vaping scare has harmed oil pens, but rather that it has harmed the whole concept of medical cannabis treatment.
“Further since these oil pens (notice I don’t use the term vape) get confused with flower vaporizers, it has scared patients away from any legitimate, safe form of inhalation treatment,” he said.
Dr. Tishler said long before the current scare, he was recommending that patients avoid oil pens.
“The technology is fundamentally flawed and unsafe,” he said. “Regardless of the bad chemicals added to the cartridge, these devices are so crude that they cannot control temperature.”
He added that even those that “pretend to control temperature” are only estimating it, not actually measuring and adjusting the actual degrees.
“As a result, they are not really vaporizing, they are combusting the oil,” Dr. Tishler said. “This exposes us to toxins that are not present in true vaporization. The only machines that do true vaporization at present are flower (herbal) machines.”
As for restoring the public’s trust, well that is where it gets difficult, according to Dr. Tishler.
“I don’t think that any trust should have been given to the current crop of machines,” he said. “They need to be replaced by machines that actually measure and control temperature; this technology does not yet exist.”
In the meantime, flower vaporizers are effective and safe, according to Dr. Tishler.
“We need to place our emphasis there,” he said.
While the CDC reports on the cannabis related cause, the U.S. government is considering removing marijuana from the Schedule 1 class of drugs with the MORE act.
“The real issue is federal prohibition of medical cannabis. Until the U.S legalizes and appropriately regulates medical cannabis, how can researchers and scientists study the plant, let alone the vaping crisis?” Dr. Chin said. “The Catch-22 of legalization: lawmakers insist on more research before legalizing but research in the U.S. is highly restricted.”
Both doctors deem regulation and eliminating the black market are key.
“The CDC has made it clear that the Vit E is only one possible culprit and that likely there are others,” Dr. Tishler said. “It’s too easy to blame one chemical when, in fact, there are many other possibly additives that could cause this type of harm.”
He added it’s too easy to say “we’ll regulate for safety when we don’t know what to regulate,” which is why avoiding these devices is the only safe approach at the moment.
Dr. Chin concludes when you are getting products sold by underground dealers, it passes through “eight hands” before it even gets to the consumers.
“Who knows what is exactly in that product by then?” he asked. “Shop in regulated dispensaries and always consult your health care provider.