Health authorities have named Vitamin E acetate as a likely suspect in the serious illness that has now affected hundreds across the country after vaping either cannabis or tobacco products. In many of the cases illicit-market dab carts appear to be responsible for the severe pulmonary problems that have now resulted in five deaths. But public authorities and the cannabis industry alike caution that research is ongoing.
Hundreds of people across the country have taken ill over the past weeks with a severe pulmonary affliction apparently linked to vaping—whether of cannabis products of e-cigarettes. The victims are now said to number over 450—and many were otherwise healthy young people, in their teens or early 20s. State and federal health authorities are investigating, and have just issued preliminary findings naming a particular additive found in illicit-market dab carts.
As of Sept. 6, five deaths have been reported in the wave of mysterious illness—in Indiana, California, Minnesota, Illinois and Oregon. In the Illinois case, the victim had apparently been using e-cigarettes. In the other three, they were likely using cannabis products. This has seemingly been confirmed in the California case, the Minnesota case and the Oregon case.
The federal Food & Drug Administration on Sept. 6 issued a statement on what is known so far. As the New York Times said in its summation, the statement warned that "there appears to be a particular danger for people who vape THC, the psychoactive chemical in marijuana."
But it does not appear to be THC that is the culprit here, contrary to the implication of this wording. The Times follows up by saying the FDA found that "a significant subset of samples of vaping fluid used by sick patients included THC and also contained a chemical called vitamin E acetate."
The actual FDA statement makes clear this distinction: "Because consumers cannot be sure whether any THC vaping products may contain vitamin E acetate, consumers are urged to avoid buying vaping products on the street, and to refrain from using THC oil or modifying/adding any substances to products purchased in stores."
And many of the victims apparently did not vape THC. In 53 cases of the illness in Illinois and Wisconsin, 17% of the patients said they had used only nicotine products, according to an article published in the New England Journal of Medicine, cited by the Times.
The FDA statement also stressed the tentative nature of the findings: "While the FDA does not have enough data presently to conclude that Vitamin E acetate is the cause of the lung injury in these cases, the agency believes it is prudent to avoid inhaling this substance."
The New York State Department of Health also announced findings of its investigation into the "vaping-associated pulmonary illnesses" that have been reported across the state. Tests at the department's Wadsworth Center Laboratory in Albany likewise "showed very high levels of vitamin E acetate in nearly all cannabis-containing samples analyzed... At least one vitamin E acetate containing vape product has been linked to each patient who submitted a product for testing."
The statement noted that Vitamin E acetate "is not an approved additive for New York State Medical Marijuana Program-authorized vape products and was not seen in the nicotine-based products that were tested."
Natual and necessary —but don't inhale it
Vitamin E acetate—simply the oil form of the vitamin, which is naturally found in foods such as olive oil, canola oil and almonds—is widely available as a nutritional supplement, and is especially used in topical skin treatments. It is not known to cause harm when either ingested or applied to the skin.
As the Mayo Clinic notes, Vitamin E has antioxidant properties that protect cells against the harmful effects of free radicals. As a nutrient, it's important to vision, reproduction, and the health of your blood, brain and skin.
But, as a Washington Post account states, "its molecular structure could make it hazardous when inhaled." And it is apparently among the substances being added to cannabis distillate in illicit-market dab carts to help make the extracts form a vapor.
Mitch Zeller, director for the Center for Tobacco Products at the FDA, told the New York Times, "If you’re thinking of purchasing one of these products off the street, out of the back of a car, out of a trunk, in an alley, or if you’re going to then go home and make modifications to the product yourself using something that you purchased from some third party or got from a friend, think twice."
Jim Makoso, vice president of Lucid Lab Group, a cannabis extraction company based in Seattle, had similar cautions when contacted for comment by Cannabis Now.
"At the moment we do not know exactly what products and what compounds in those products have led to these extreme cases," Makoso said. "The Minnesota case investigation revealed that the vape product was purchased from the illicit market. In the California case, officials did not specify the origin of the vape product involved. Consequently, definitive information as to what may be the root cause of the recent increase in pulmonary illnesses related to vaping is speculative at best."
He repeated the common-sense warning that all informed commentators have stressed: "I would suggest that consumers procure vape products through a licensed retailer where 3rd party QA [quality assurance] testing is mandatory. At the moment I don’t believe there is any discernible link between vape products procured from licensed retailers in the regulated cannabis market and these cases of pulmonary illnesses."
Cross-post to Cannabis Now
Image: Cannabis Now
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