Disclaimer: This article is meant for informational purposes only and is not intended as medical advice. For medical advice, please consult a medical professional.
There has been some excellent (and not so excellent) reporting about the recent outbreak of vaping related lung illnesses. In this post, we will highlight information from the best sources we can find, and expand the discussion to include “dry herb vaporization.”
E-cigs, or vaping, defined
“Vaping,” as reported by most news outlets, is defined as “heating a liquid to produce an aerosol that users inhale into their lungs. The liquid can contain: nicotine, tetrahydrocannabinol (THC) and cannabinoid (CBD) oils, and other substances and additives.” This definition doesn’t account for dry herb vaporizing, which is different from vaporizing liquids.
When asked to define liquid vaping, he had the following to say.
“What you do when you are using liquid vaporizers, with pre-filled pods, it means that somebody else has already made a whole bunch of decisions for you about not just the variety, you never get to see the variety so you have to trust that it is what they say, but also the chemistry involved in the extraction, the decarboxylation if they did that, winterization, the adding of flavors, and the removing of chlorophyll, things like that - that’s all done for you. And that doesn’t necessarily mean you have to have a very, very different effect. If it’s done right, maybe you get the same components in your lungs after inhalation. But the thing is, with the dry herb (vaporizer) you can kind of make those decisions yourself, and with liquid vaporizers, those decisions are made for you. And one of my issues with that is you don’t know what the quality is of those liquids.”
“The big problem is that somebody else has cooked up that entire liquid for you, and you don’t know what’s in there. So it’s processed food versus the pure, natural ingredients, which is the herb. You can see it (dry herb). You can touch it (dry herb).”
Summary of Vaping-Associated Pulmonary Injury (VAPI)
As of October 29th, 2019, the CDC has identified 1,888 cases of vaping related lung illness in every state except Alaska, the District of Columbia, and one U.S. territory, with 33 deaths. All patients reported a history of e-cigarette use, which the CDC defines as “electronic cigarettes – or e-cigarettes — are also called vapes, e-hookahs, vape pens, tank systems, mods, and electronic nicotine delivery systems (ENDS).”
The exact cause(s) hasn’t been determined yet, but one possibility is black market cartridges tainted with Vitamin E acetate. Raw cannabis oil is too thick to work in most cartridges, so packagers add thinners to make it runny enough to vaporize. This has been going on for years without much issue. But recently, as customers realized runny oil was weaker, packagers added a thickener (most are made of Vitamin E acetate) to make it ‘look’ more pure. The customer ends up with a thc cartridge that has been weakened twice, once with the thinner, and again with the thickener. Tragically, the thickener also deposits in the lungs, possibly causing the illness. This excellent article reported as many as 60% of THC cartridges on the black market could be affected.
The CDC doesn’t think one cause is responsible for all the illnesses, and they are investigating multiple possibilities. NBC commissioned some tests of 18 THC cartridges, and found a fungicide that turns into hydrogen cyanide when burned. The cartridges obtained from the black market also tested positive for pesticides and Vitamin E.
On October 2, Doctors at the Mayo Clinic examined samples of lung tissue from 17 patients, all of which looked as if the people had been exposed to toxic chemicals, the researchers said.
Reported symptoms of the illness include shortness of breath, tightening in the chest, coughing, nausea, and stomach pains. Coughing is not unusual when vaping, unless it’s intense or painful. If you vape with an oil cartridge and experience these symptoms, see a health professional, and bring your cartridge with you.
What is dry herb, or flower, vaporization?
An alternative to vape pens, which use concentrated oils, is vaporizing dry herbs. With a dry herb vaporizer, you’re in control of what you vaporize, and it’s much harder to adulterate the herbs without detection. You load the vaporizer like you would a pipe, but instead of burning the herbs and inhaling smoke, you inhale vapors as they boil off the heated herbs.
Dr. Arno Hazekamp explains dry herb vaporizing as simply “smoking without smoke.”
The dry herb vaporizer market has been growing for two decades without incident.
What do we know about dry herb vaporization?
Vaporizing dry herbs has been practiced for quite a while. There is a wealth of scientific studies on the subject, most performed in countries that have long regulated cannabis, such as Israel and the Netherlands. Bedrocan has performed a number of studies, including an excellent discussion on dry herb vaporization, titled “Vaping vs vaporization”. It’s important to note that none of the cases of VAPI have involved vaporizing dry herb. Instead of giving you our opinion, we’ve gathered some significant studies to help you research and make your own decision. All of the studies below were performed with dry herb vaporizers.
“The results indicate that vaporization can deliver therapeutic doses of cannabinoids with a drastic reduction in pyrolytic smoke compounds. Vaporization therefore appears to be an attractive alternative to smoked marijuana for future medical cannabis studies.”
“Data from a large Internet sample revealed that the use of a vaporizer predicted fewer respiratory symptoms even when age, sex, cigarette smoking, and amount of cannabis used were taken into account. A significant interaction revealed that the impact of a vaporizer was larger as the amount of cannabis used increased. These data suggest that the safety of cannabis can increase with the use of a vaporizer. Regular users of joints, blunts, pipes, and water pipes might decrease respiratory symptoms by switching to a vaporizer.”
There is no shortage of reliable information on the subject available on the internet. Our intent is to help you cut through the clutter to be armed with facts that lead to responsible decisions. These are not the only articles available on the subject, but finding them can be difficult the first time. The easiest way to find more articles, is to read the list of references at the end of each study.
Medically approved dry herb vaporizers (not for sale in US)
Storz & Bickel manufactures two vaporizers (under the 'Vapormed' brand) that have been licensed for medical use in Canada and Israel: the Volcano Medic and the Mighty Medic. These vaporizers are only available by prescription in Canada and Israel, but their mass-market counterparts are very popular in many countries. Due to friendly regulation, Israel is one of the world leaders in cannabis research.
Some vaporizer manufacturers have made public posts or statements about the illness. Magic Flight made several Instagram posts about the differences between their Launch Box dry herb vaporizer and concentrate vaporizers. Storz & Bickel made a statement reminding us that none of their dry herb vaporizers have been involved in any of the incidents, and they are the only manufacturer to produce and distribute medical cannabis vaporizers internationally. PAX also made a public statement on their site, and followed it up with an announcement of the creation of a Health Advisory Board.
Legalize with sensible regulation
Government officials seem confused, and lack understanding about vaporization, but are forging ahead with policy. Some states are banning flavored e-cig sales. Bans proposed in Michigan and New York were challenged and reversed. Massachusetts went a step further, and banned all vaporizer sales in the state for four months. This ban included dry herb vaporizers, even though all reported cases involved e-cigarette style vaporizers.
“It is now the responsibility of Congress to end prohibition and regulate cannabis without delay. By removing cannabis from the schedule of controlled substances and instituting a clear regulatory framework through existing agencies, the federal government can provide helpful guidance to states that have or wish to establish regulated cannabis control systems while helping put irresponsible illicit market producers out of business for good.” -- Aaron Smith, executive director of the National Cannabis Industry Association
We need changes that address the root of the problem, not reactionary swings at easy targets.
How to stay safe
While the CDC has not been able to isolate a single cause, they report there is evidence that a large number of those affected used illicit THC oil carts. The safest thing to do is completely stop using cartridges from the black market. Always know what you’re vaporizing. Only vaporize products obtained from a trusted source, preferably with lab test results that you can analyze. Whenever possible, vaporize dry herbs.
“Personally, I would be a little bit of a purist and say go for dry herb until you really know what you’re doing, you really know what you want, and then maybe make the step to liquids, if you feel that the quality has improved enough to not get into trouble like we’re seeing today.” -- Dr. Arno Hazekamp.
Where do we go from here?
As NCIA members, we fully endorse their proposal for cannabis legalization, and for a sensible regulatory framework. Without legalization, we can’t research the plant and implement safety guidelines. We need a system that incentivizes both buyers and sellers to participate in the legal market, while discouraging the black market. In today’s legalized cannabis markets, over 50% of the market is illicit, because both buyers and sellers are motivated by price, taxation, and the regulatory burden. Contact your representatives and let them know what aspects of a legal market are most important to you.
Finally, listen to your conscience. If you find the media frenzy about vaporizing disturbing, take the time to research and digest the latest news before having a session. Now is not the time for knee-jerk reactions. We need educated, calm minds when we approach the plant, and its impending regulation.