"This is not about regular e-cigarettes"
Five people have died and hundreds have fallen ill after inhaling improperly manufactured, THC-containing e-liquid in the US. US authorities are now advising e-cigarette users not to vejpake e-juice containing cannabis.
At the same time, the authority is criticised for not being clear about the cause of the outbreak.
"This is not about regular e-cigs and we knew that from the beginning," says public health researcher Michael Siegel.
(NB: the death toll eventually reached 60 people. see also article here!)
Over the summer, doctors in the United States began to notice that more young patients were seeking medical attention after experiencing breathing problems and chest pain. The symptoms appeared in several states and grew in number over a short period of time. There were initially about a dozen patients, mostly young people, in Washington, Salt Lake City, San Francisco and elsewhere, suffering from a 'mysterious lung disease'.
THC-containing e-juice
The doctors in charge soon realised that the common denominator was the recent use of vejpdon (e-cigarettes) containing THC/cannabis. In most cases, the patients themselves told us what they had inhaled. But finding the reasons could be quite complicated.
"An 18-year-old boy nearly died from his lung injuries, and we simply couldn't find the cause," Dr Melodi Pirzada, a pulmonologist at New York University Langone Hospital, told the New York Post newspaper.
"The boy insisted that he never used e-cigarettes or drugs. Then his parents found a tank of THC-containing e-juice in his room and everything came to light," says Dr Melodi Pirzada.
Chemical pneumonia
During August and September, the number of cases of the serious lung condition increased dramatically and by mid-September the number had risen to over 200 and five deaths.
The CDC and FDA are now investigating all cases to determine the causes of the outbreak. At the same time, it became clear that the mysterious lung condition was a so-called lipid "chemical" pneumonia caused by something the victims inhaled. The common denominator of the five deaths is the inhalation of some form of THC/cannabis.
Not ordinary THC juice
Cannabis and marijuana have been legal in some US states for some time, and in addition to traditional use, vejpning has become a popular way to inhale the drug. Since e-juice with THC is so common and widespread, the FDA suspected early on that it is not "regular" e-juice or even THC that is the culprit.
"Much evidence suggests that these are non-traditional products" says FDA director Ned Sharpless to the online magazine Politico, but emphasises that he does not want to pre-empt the investigations.
E-acetate in illegal e-liquid
FDA sources told Politico magazine that all the cases so far have originated from some form of vitamin E. Vitamin E (also known as e-acetate) is often used in the illegal production of THC juices. It replaces the traditional propylene glycol in the e-liquid. E-acetate is more viscous and has the ability to dissolve the oil-based cannibal extract in vegetable glycerine. E-acetate is a cheap way to quickly produce THC juice and therefore attracts many home blenders and black market operators.
The problem with vitamin E is that when it is heated, it turns into an oil-like substance that gets stuck in the lungs and clogs the pores - which can lead to a so-called lipid pneumonia.
Lipid pneumonia was also the cause of death in all five cases during the early outbreak. The substance is considered highly unsuitable for the production of THC juice, according to major manufacturers. However, there is no legislation on the substance.
Warned about e-cigarettes - not illegal THC
The news of the five deaths and more than 200 cases of illness has spread around the world, particularly via social media. At the same time, the CDC has been heavily criticised for its ambiguous approach to the outbreak.
Instead of warning the public about uncontrolled THC products, the CDC has chosen to warn about e-cigarettes in general.
"It is not only wrong, but downright dangerous," writes American public health researcher Professor Michael Siegel in his blog Tobacco analysis.
Michael Siegel believes that the CDC is acting on its own agenda where vejping and e-cigarettes are not high on the agenda. According to Michael Siegel, e-cigarettes have been wrongly identified as the culprit. When in reality they are very dangerous products that the population should refrain from using.
"The CDC should be warning people not to use marijuana, especially in black market e-juice. Instead they are warning people not to use e-cigarettes at all" writes Michael Siegel. "It is extremely irresponsible and misleading"
Reporting in Sweden
Even in Sweden, the reporting of the deaths and outbreaks has focused on e-cigarettes and not the main cause of the disease.
Vejpkollen has reviewed three major articles on the subject (in the Expressen, Aftonbladet and SVT).
- Expressen does not mention THC, but refers to the WHO, which considers e-cigarettes to be harmful.
- Aftonbladet mentions THC in the last sentence of its article, but mainly focuses on the fact that e-cigarettes are considered harmful according to some public health debaters.
- SVT has written two articles about the events, but only one of them links the outbreak to THC products, but only after the introduction, where e-cigarettes are said to be the cause.
The headlines in all articles refer to e-cigarettes and not to THC or cannabis.
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