Global Ganja Report

Over the past weeks, dozens of people across several states have experienced serious lung problems, even requiring hospitalization, apparently after using vape cartridges. It is unclear if cannabis products were at issue in all such cases, and authorities are still investigating. But the illicit market in unregulated knock-off dab carts may be to blame.

The federal Centers for Disease Control have opened an investigation into a mysterious wave of severe pulmonary problems across several states over the past weeks—principally in the Midwest, principally affecting youth, and seemingly linked to vaping. 

The CDC announced its investigation in a statement Aug. 17. It noted that "94 possible cases of severe lung illness associated with vaping were reported in 14 states from June 28, 2019, to August 15, 2019." Wisconsin has been hit the hardest, with 30 cases reported.  The CDC is also working with local health authorities to try to get to the bottom of the phenomenon in Illinois, Indiana, Minnesota and California.

Local doctors are in most cases not clear on what the victims had been inhaling.  Wisconsin health officials said that "[t]he products consumed could include a number of substances, including nicotine, THC, synthetic cannabinoids, or a combination of these."

The North Carolina Department of Health also reports three cases in the state, and has issued a recommendation that consumers of vaping products stop using them while authorities investigates.
 
"We know there are certain characteristics in common with these cases, but we have not been able to get to the bottom of exactly what aspect of the vaping habit or product or solvent or oil is causing the injury," Dr. Emily Chapman, chief medical officer for Children's Minnesota, a pediatric health system headquartered in Minneapolis, told NBC News. 

Again, prohibition part of the problem 
Chapman told NBC that the four teens admitted to Children's Minnesota all arrived with what staff originally assumed was a bad respiratory infection, such as pneumonia. This was ruled out when instead of getting better with treatment, they got worse.

"They have progressed to have significant difficulty with their breathing and increasing lung distress," Chapman said. "They've ended up needing our intensive care unit and in some cases assistance with their breathing."

Physicians in the other states report similar situations. "All patients reported vaping prior to their hospitalization, but we don't know all the products they used," Andrea Palm of the Wisconsin Department of Health Services told the NBC affiliate in Green Bay, Wisc.

One such unfortunate patient is Dylan Nelson, 26, of Burlington, Wisc. He began feeling sick after taking a few hits from a new vape cartridge. The next morning, he went to the hospital, and his condition continued to deteriorate throughout the day. By evening, his lungs were filling with fluid and doctors had to put him into a medically induced coma. He has since been discharged and is slowly recovering. His brother, Patrick DeGrave, told NBC that Nelson bought his vape cart off the street—not from a reputable shop.

DeGrave got to what may well be the root of the problem: "People will buy them from the states where it is legal and they'll bring them back to states such as Wisconsin where it's not legal," he said.  "You don't know if you're buying something from a middle man that picked it up from a dispensary or if you're buying it from somebody who has tampered with it and made their own mixture."

Manufacturers of vape carts filled with cannabis distillate for "dabbing" are facing something of a crisis as the market has been flooded with counterfeit products. These contraband knock-offs are apparently fooling many consumers—but may contain toxin-laden and adulterated substances. Industry voices are urging buyers to beware.

Producers of e-cigarettes have, of course, been quick to distance their products from the dab carts—although e-cigs face controversies of their own. As Ars Technica notes, their proponents argue that vaping nicotine is significantly safer than smoking tobacco in traditional cigarettes, and can help smokers quit, But some companies have faced harsh criticism over charges that they are marketing their products to teen-agers, contributing to what the FDA has called an "epidemic of youth e-cigarette use."

JUUL Labs, the top US e-cigarette producer (which has been censured by the FDA for its marketing practices), said in a statement to Reuters: "These reports reaffirm the need to keep all tobacco and nicotine products out of the hands of youth through significant regulation on access and enforcement." JUUL also emphasized that some reports indicated patients had used THC, "a Schedule 1, controlled substance that we do not sell." While noting the issue of unregulated knock-off products, the statement echoed prohibitionist assumptions: "We also must ensure illegal products, such as counterfeit, copycat, and those that deliver controlled substances, stay out of the market and away from youth."

Yet, once again, prohibition may actually be a big part of the problem. In one of the states where the grisly incidents have been reported, California, dab carts are available on the regulated market. But in most of the rest, they are not—certainly not in Wisconsin, where the greatest number of such cases are reported.

The laws governing cannabis extracts and dabs vary from state to state. And in states where marijuana is still illegal, dab carts are popular thanks to their relative lack of smell and resemblance to cartridges containing nicotine. But, by definition, the carts are not regulated by any authority in these states.

In a particularly strange irony, many of these potentially dangerous knock-offs are apparently being produced in China for the American illicit market. So this is a case of Chinese capitalism exploiting American prohibitionism.

Experts recommend herbaceous cannabis 
In an exploration of the controversies around vaping, Healthline interviewed Dr. Jordan Tishler, a Massachusetts medical cannabis specialist. Tishler urged those who choose to vape to use the safest method possible. "Not all vaporizing is the same," Tishler said. "I recommend vaporizing the whole cannabis flower. The little pen-shaped vaporizers that have become very fashionable and use cannabis oil should be avoided."

Tishler warned: "The cannabis in those devices is most often thinned with propylene glycol or polyethylene glycol. Neither of these are safe to heat and inhale. There are alternatives for patients who find loading a conventional vaporizer with ground cannabis is too much for them. I’d recommend looking into a pod-based device."

Pods, unlike vape pens, are reusable, and generally made out of better material—although this appears to concern what the device itself is made of, rather than the extract or distillate it is filled with.

But the fundamental paradox is this: In states where cannabis prohibition still reigns, herbaceous bud is of course not legally available—which is why some who wish to imbibe may be turning to cartridges in the first place.

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