Vaping Deaths Tied to Contaminated THC 

Credit: Vaping360

For the past several months, the U.S. has seen a surge in hospital admissions of young people with unexplained respiratory symptoms ranging from chest pain and shortness of breath to frank respiratory failure. As of Sept. 6, 2019, over 450 cases of the mysterious illness have been reported across 33 states — more than double the number reported by the CDC just one week ago. A number of those afflicted have been hospitalized on ventilators, and at least three people have died. All of the patients have been young, in previously good health, and had one thing in common — they had been vaping in the days before the illness occurred. 

Now, public health officials believe they may have found the source of the mysterious illness — contaminated THC (the psychoactive ingredient in the marijuana plant). According to several sources, investigators have learned that a contaminant, vitamin E acetate, has been found in the THC used by many of the people who have fallen ill. They have not found the substance in e-cigarettes containing nicotine. 

Vitamin E is harmless when ingested or applied to the skin. But its oil-like properties make it dangerous when inhaled.

How Vaping Works

Unlike smoking, which involves the combustion of tobacco or marijuana, vaping works by turning liquid into steam, which is then inhaled. When a person vapes nicotine or THC, the active ingredient is mixed in a solvent, which is typically oil-based. Theoretically, the oil is vaporized completely during the heating process and thus rendered harmless. But invisible oil droplets may form as the liquid cools and be inhaled accidentally. And even a little oil in the lungs can be extremely dangerous. 

Vaping liquids may contain an unknown substance that is causing the respiratory illness that has killed three people thus far

Officials warn, however, that they don’t know for certain that vitamin E is the cause of the mystery illness or if other solvents are to blame. Many vaping products are purchased from bootleggers, who are generally unconcerned about the ingredients they use. According to former FDA Commissioner Dr. Scott Gottlieb, “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.” 

But even that idea may not hold true. At least one of the people who died from the illness is believed to have purchased the vaping device from a licensed dispensary, Oregon officials report. In a statement issued on Sept. 3, 2019, Dr. Ann Thomas of the Oregon Health Authority’s Public Health Division urged vigilance. “We don’t yet know the exact cause of these illnesses — whether they’re caused by contaminants, ingredients in the liquid or something else, such as the device itself,” she said. Anyone who has been vaping or using e-cigarettes and develops symptoms such as a cough, fever, vomiting, chest pain or respiratory distress should seek immediate medical attention, she said.

How Concerned Should We Be?

On a national level, the Food and Drug Administration and the CDC are warning the public not to use vaping devices until more is known. In a press release issued September 6, the CDC said:

“While this investigation is ongoing, people should consider not using e-cigarette products. People who do use e-cigarette products should monitor themselves for symptoms.”

Dr. Panagis Galiatsatos
Credit: Panagis Galiatsatos via Twitter

Still, some public health officials believe they should take a more drastic approach.

Dr. Panagis Galiatsatos, a pulmonary specialist and director of the Tobacco Treatment Clinic at Johns Hopkins Medicine, for example, believes the public should be told to avoid vaping entirely until more is known. “I would plead with the CDC to take a harsher approach,” Galiatsatos told NBC News. He believes that the several hundred cases the CDC knows about may be the “tip of the iceberg” and that many others may have been sickened but not yet sufficiently ill to seek medical care.

“I would recommend everyone stop using these products until more is known,” he said. 

Given how little we know and how quickly the illness is spreading, that sounds like a wise idea.