FDA hasn’t isolated substance responsible for illness and deaths, while New York focuses on Vitamin E Acetate.

There have now been at least six confirmed deaths and over 450 reported illnesses linked to vaping across the United States.

Health officials in Indiana confirmed that a patient had died in that state from a “severe lung injury due to vaping” and Minnesota health officials verified that a patient’s death in August was caused by vaping e-cigarettes. Four additional deaths have been reported in Illinois, Oregon, California and Kansas.

The FDA and other health officials are currently investigating the outbreak of “vape sickness” that has spanned 33 states, between June 28 and September 10, 2019.

“While the investigation is ongoing, the CDC has advised that individuals consider not using e-cigarettes, because as of now, this is the primary means of preventing the severe lung disease,” said Dr. Dana Meaney-Delman of the CDC.

Health officials are taking note that this lung disease is primarily affecting young people – more men than women – and Dr. Meaney-Delman points out that while CDC officials believe that some “chemical” is involved, they have not identified a single responsible “device, product or substance.

Is Vitamin E Acetate to blame?
While the FDA and CDC have not yet narrowed their investigations, New York State Department of Health is focusing on lab results pointing to high levels of Vitamin E Acetate.

“The cases of pulmonary illness associated with vaping are continuing to rise across New York State and the country,” said Health Commissioner Dr. Howard Zucker. “We urge the public to be vigilant about any vaping products that they or any family members may be using and to immediately contact their healthcare provider if they develop any unusual symptoms. In general, vaping of unknown substances is dangerous, and we continue to explore all options to combat this public health issue.” 

The focus seems to be on cannabis-containing vape products, as the high levels of Vitamin E Acetate were not found in any of the nicotine-based products that were tested. According to the statement issued by the Department, “Laboratory test results showed very high levels of Vitamin E Acetate in nearly all cannabis-containing samples analyzed by the Wadsworth Center as part of this investigation. Vitamin E Acetate is not an approved additive for New York State Medical Marijuana Program-authorized vape products.”

Can a Vitamin really kill you?
Vitamin E oil has been long known for its reparative qualities in helping to reduce fine lines and wrinkles and slowing down the aging process. There has been conflicting research on the benefits of Vitamin E, but some claim that it may prevent coronary heart disease, reduce inflammation, promote eye health and lower the risk of cancer. 

Inhaling Vitamin E oil, however, can be fatal.

Many of the recent lung illnesses have been diagnosed as a form of pneumonia known as lipoid. Lipoid pneumonia is caused when fatty acids, or lipids, enter the lungs causing severe inflammation. Lipoid pneumonia can only be caused by one of two ways: physical injury to the lungs or by inhalation of oil.

In a recent Health article, Dr. Andrew Freemen, a pulmonologist with University of Utah Health explained how a patient may develop Lipoid Pneumonia. “The oil contained within vaping cartridges is heated up to produce a vapor, and within that vapor may be tiny aerosolized droplets of lipids which can be inhaled.” He continued, “When large enough amounts of lipid droplets are inhaled into the lungs, they can cause irritation and damage to the lung, leading to the condition termed lipoid pneumonia.”

The FDA is taking no chances
The Food and Drug Administration is on high alert and is testing over 100 vape oil samples from across the country, including those with nicotine, THC and other cannabinoids. They have not ruled out any potential contaminants, and are investigating cutting agents, diluents, pesticides, opioids, poisons, toxins and other additives as potential causes.

“No one substance, including Vitamin E Acetate, has been identified in all of the samples tested,” an FDA spokesman told NBC News. “Importantly, identifying any compounds that are present in the samples will be one piece of the puzzle but will not necessarily answer questions about causality.”

Parents are panicked
Piper Johnson packed up her bags and headed out with her parents to make the trip from their suburban Chicago home to her new dorm room at Northern Colorado University. Soon into the trip, Piper began coughing and was experiencing shortness of breath and chest pain. After a visit to urgent care, it became clear that Piper was suffering from an aggressive form of pneumonia. 

Piper required liter after liter of oxygen, IV fluids, antibiotics, pain medications, anti-nausea medicines and a diuretic to clear fluid from her lungs. She was ultimately transferred to the ICU where doctors diagnosed her with a sudden and severe lung illness due to vaping. Piper had been vaping nicotine prior to falling ill.

“When you watch your 18-year-old child, who was healthy a week ago, in a hospital bed, in intense pain, and needing more and more oxygen, and being transferred to the intensive care unit, and you have no idea what’s going to happen, or how much worse it’s going to get, it’s terrifying,” said her mother, Ruby Johnson.

Long Beach, NY teen, Simah Herman, aged 18, shares an eerily similar experience. 

Herman recounted her medical nightmare via Instagram and vowed to start a “no vaping campaign” after she suffered for months with nausea, loss of appetite, and ultimately severe shortness of breath that landed her in the ICU in a medically-induced coma.

“It took less than 48 hours for me to be put in a drug induced coma and a tube put down my throat because I could no longer breathe on my own. The dangers of vaping are real and this can happen to you,” said Herman. “Please don’t let it.”

A sudden outbreak
One compelling piece of information on this rash of respiratory issues is the timeframe in which they were reported. The cases, in large part, were reported during the summer of 2019, suggesting that if vaping is indeed the source, it’s likely a new product or additive that is the true culprit.

Former FDA Commissioner, Dr. Scott Gottlieb, said, “It’s probably something new that has been introduced into the market by an illegal manufacturer, either a new flavor or a new way to emulsify THC that is causing these injuries.”

A number of illnesses have been linked to the shadowy brand, Dank Vapes. Nobody can really say for certain who or what Dank Vapes is. They have a logo, sell swag, and boast a loyal online following. However, by all accounts, Dank Vapes is a black-market brand run by individuals who are working out of their garages filling vape carts and selling them online and on the streets. There is no regulation, no oversight, no quality control. 

Inverse recently interviewed Myron Ronay, the CEO of BelCosta Labs, a cannabis testing lab in California. Ronay said they “often see black-market products that contain unsafe levels of myclobutanil – a fungicide. When myclobutanil is heated, it releases toxic fumes, one of which is hydrogen cyanide. Small amounts of HCN are released when smoking cigarettes, but larger doses are lethal. HCN was a major component of Zyklon-B, the gas used in Nazi gas chambers.” He continued, “Unregulated products, like black-market Dank Vapes, have no one checking to see where that line is drawn.”

Too hot to handle
Vaping requires precise temperature control. For cannabis, the ideal range is between 315°F and 450°F. Above that, it begins to combust instead of vaporize. Many vape batteries have demonstrated wildly inconsistent temperatures, with some reaching as high as 800°F. At temperatures that high, the concentrate additives that have been deemed acceptable, like terpenes, coconut oil, glycol and glycerin, may surpass their boiling points, which can lead to unpredictable effects when inhaled.

The summer of 2019 saw unusually high temperatures across the country. It begs to ask if this sudden uptick in vape-related illnesses is due to the fact that vape batteries and cartridges may have been improperly stored in hot vehicles. When batteries and carts are exposed to excessive heat, they are known to malfunction and chemical composition does degrade.

Look to the companies who are doing it right
There are literally thousands of cannabis and nicotine vape products on the market. It is estimated that the United States e-cigarette market will reach $6.41 billion by the end of 2020. According to Zion Market Research, the cannabis concentrate market, (concentrates are used for vaping), generated close to $4 billion in 2018.

These dire warnings being administered by health officials are certainly warranted, but could put a serious damper on cannabis companies who are going above and beyond to adhere to stringent regulations.

Marijuana Business Daily spoke with Morgan Paxhia, the managing director of San Francisco-based Poseidon Asset Management for his opinion. Paxhia said the vaping illness “definitely could throw some cold water on the (vaping) space,” perhaps depending on how many more people get sick and how long the issue lasts. 

According to the article, Paxhia said he doesn’t expect any drastic downturn in sales for marijuana vape cartridges or cannabis in general, in part because the vast majority of users haven’t reported negative side effects and the products remain incredibly popular. “If people are getting sick from illicit-market products, pointing the blame at the legal operators is not going to correct the (situation),” he said. “It is likely an unfair characterization of those trying to do things properly and just caused more confusion.”

AbsoluteXtracts (ABX) is a company that has prided itself on doing things right. Their website asks a very simple, but powerful question. “If you don’t know what’s in your vape of cannabis products, do you really want to be inhaling or ingesting it?” ABX is completely transparent with process and lab results on their website. The company explains that they are “fully engages in the entire production process to create the best cannabis products. From tiny seedling to the final lab-tested, quality-assured product in the dispensary, we’re involved…we have always embraced this process as our commitment to transparency, sustainability, and ensuring the highest quality medicine for our patients.”

Do your research. Make informed choices.
It is so important to know what is going into our bodies. Be it a Big Mac or Blackberry Kush, understanding the ingredients and the process behind what is being consumed could literally be the difference between life and death.

While health officials scramble to identify and control this epidemic, the rest of us – consumers, lawmakers, parents, corporations and the legal cannabis industry – must work to ensure that once this problem is contained, it never happens again.