Most vaping-related lung disease in Ohio linked to illegal marijuana vapes but medical marijuana program is taking caution – Cincinnati.com

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The Associated Press commissioned laboratory testing of vape products sold as CBD and found dangerous synthetic marijuana instead of the natural cannabis extract. One of the samples belonged to Jay Jenkins who was hospitalized after vaping. (Sept. 16) AP, AP

COLUMBUS – For months, the advice has been passed along among Ohio’s medical marijuana patient community: Don’t buy marijuana vape pens off the street – stick to legal, tested products.

It’s advice that has again cropped up amid a rash of mysterious lung disease that has struck at least 530 people and killed eight.

But are vaping products sold through Ohio’s medical marijuana program safe?

Public health officials are warning people to cease all vaping until a cause for the illness has been determined. Meanwhile, Ohio medical marijuana businesses are distancing themselves from unregulated products believed to be the culprit in these cases. 

In Ohio, 90% of the 17 confirmed cases involve vaping illegal cannabis products, but nicotine products were also used in many cases, according to the Ohio Department of Health.

None of the cases has been linked to product sold at an Ohio medical marijuana dispensary. More than 57,000 Ohioans have registered under 21 qualifying medical conditions including HIV and cancer.

State regulators say they’re talking with state health officials and can notify patients quickly or initiate a product recall if an ingredient is found to be a problem. 

“Regardless if there’s a connection or or not, we just want to make sure we’re staying on on top of this.” Greg McIlvaine, medical marijuana policy chief for the Ohio Department of Commerce, told The Enquirer. 

What we know

The illness has been described by treating physicians as resembling acute lipoid pneumonia, caused when oil enters the lungs. Symptoms include shortness of breath, cough, chest pain, nausea, vomiting, fever and abdominal pain.

The exact cause hasn’t been determined. But all reported cases had a history of vape or e-cigarette use and many involved bootleg cannabis vape pens – handheld devices that heat an oil or liquid heats a liquid to produce vapor that is then inhaled. 

Only one reported case, in Oregon state, has been linked to a legal cannabis product.

New York officials tested cannabis and nicotine vape cartridges from people with the illness. They found found large amounts of vitamin E acetate, an oil used as a thickener, in all of the THC vapes but not the nicotine products.

Vitamin E acetate is found in lotions and skincare products, but little is known about its effects when inhaled. The additive was not found in nicotine vapes also used by the New York patients.

The federal Food and Drug Administration has not identified a single ingredient in common among all the samples it has tested. The FDA is testing products from Ohio and other states for a range of chemicals: nicotine, THC and other marijuana compounds, cutting agents, additives, pesticides, opioids and toxins.

What’s in Ohio’s vape products?

Ohio does not have a list of banned additives for medical marijuana vaping liquids and cartridges. But there are some restrictions. Non-marijuana ingredients must be nontoxic and safe for human consumption and can only come from licensed and regulated sources that comply with state and federal laws.

Food grade glycerin and propylene glycol, used as base liquids for vaping oils, are allowed but none of the products currently on the market use them.

All medical marijuana products are tested at multiple stages for toxic metals, pesticides, bacteria, residual solvents from extraction methods and other harmful contaminants. The labs also test for the amount of active compounds, called cannabinoids, present, including tetrahydrocannabinol (THC) and cannabidiol (CBD).

Medical marijuana businesses say testing sets apart their products from those sold on the illicit market at half the price or less.

Manufacturers defend products

None of Ohio’s medical marijuana vape manufacturers uses vitamin E acetate or other cutting agents in their products, the companies told The Enquirer. 

Vaping oils and cartridges sold by Standard Wellness Company, Grow Ohio and Firelands Scientific do not contain any non-cannabis additives. The companies make their oils by extracting cannabinoids as well as terpenes, compounds that add flavor and aroma.

“We take seriously the trust placed in us, and we will continue to operate at the highest standards possible to produce top-quality cannabis options – our patients deserve nothing less,” Firelands Scientific spokeswoman Cassie Neiden said in an email.

Neiden said that doesn’t mean the company is claiming vaporization cannabis oil is a safer or healthier alternative to other methods of administration.

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Cure Ohio’s vape oil contains botanical terpenes that do not come from cannabis, and company officials note they have passed state tests.

“That does not happen in the black market. We’re incredibly clear about exactly what’s in our product,” Cure Ohio Chief Operating Officer Ryan Smith said. “We want patients to have pharmaceutical-grade medicine. That’s what we’re producing.”

Ohio does not require the actual vape cartridges be tested for potential metal leakage, which was a problem in Michigan earlier this year. Several companies have voluntarily had empty cartridges tested at the state’s two operating testing labs. 

Vaping was supposed to be safer

Health officials and physicians have told consumers to avoid vaping marijuana or switch to other methods, including smoking.

But in Ohio, state law prohibits patients from smoking medical marijuana. State lawmakers crafting the law said they couldn’t support the idea of someone “smoking their medicine.”

Most Ohio patients who vape are vaporizing dried flower, or bud. That could change as cheaper vape oils and products such as disposable vape pens become more widely available.

Dr. Amy Acton, director of the Ohio Department of Health, is mirroring the CDC’s advice and recommending patients stop vaping. 

“The illness is very, very severe and we just don’t know enough yet,” Acton said in an interview. “They’re looking into all possibilities form devices to what people are buying off the street to what people are buying off the shelf.”

But Acton also understands that some patients can’t take an edible, which is absorbed through the digestive tract, or other form of marijuana to treat their symptoms. Acton said patients who are concerned should talk with their health care provider about the possible risks and benefits of continuing use.

Medical marijuana patients can report adverse effects to the state’s toll-free help line 1-833-464-6627. Anyone experiencing symptoms of the illness should contact their doctor.

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