Monday, 9 September 2019

Don't get your vaping news from Radio New Zealand

There have been a lot of news reports out of the United States over the past month on people coming down suddenly with severe lung problems, with those news reports often linking the problems to vaping.

Sometimes the story would note that the vaped substance wasn't the typical nicotine e-liquid, but rather a THC-based one. And even more rarely the story would note that the THC cartridge had been purchased from a strange street dealer, or was counterfeit.

More stories started coming out noting that the problem-causing e-liquids were dodgy-as. They were often finding vitamin E in them as a thickening agent. I was seeing a lot of those stories come out last week.

The media reports in the States were fodder for a lot of scaremongering. Most stories didn't note just what was vaped. Where it was a younger person who fell ill, there was little checking of claims of that the vaped substance was nicotine rather than a dodgy back-alley THC cartridge.

And all of that fuels demand for tighter regulation of normal nicotine e-liquids.

The Washington Post finally caught up with the play last week:
State and federal health officials investigating mysterious lung illnesses linked to vaping have found the same chemical in samples of marijuana products used by people sickened in different parts of the country and who used different brands of products in recent weeks.

The chemical is an oil derived from vitamin E. Investigators at the U.S. Food and Drug Administration found the oil in cannabis products in samples collected from patients who fell ill across the United States. FDA officials shared that information with state health officials during a telephone briefing this week, according to several officials who took part in the call.

That same chemical was also found in nearly all cannabis samples from patients who fell ill in New York in recent weeks, a state health department spokeswoman said.
Now there's still work to do in checking that that's what's causing the problems, but Prof Siegel seems to have a smoking gun here:
There has been a major breakthrough in the investigation of the outbreak of more than 300 cases of a "mysterious" lung disease that the CDC and many other health agencies have told the public is due to the vaping of electronic cigarettes. And now, everything is starting to make some sense.

Illicit THC vape carts that were obtained from a number of case patients that were tested in federal and state laboratories have tested positive for vitamin E acetate, an oil that just started to be used late last year as a thickening agent in bootleg THC vape carts. Apparently, for every single case in New York State for which testing is complete, vitamin E acetate was found in at least one of the THC vape carts that were used by the patient. Almost simultaneously, testing of recovered THC vape carts by the FDA revealed vitamin E acetate in 10 of 18 tested samples. Importantly, the FDA reported that it found no contamination in any of the nicotine e-liquids tested.

The Rest of the Story

While there are still a lot of unknowns, the pieces of the puzzle are just beginning to fit together. One the great mysteries about this outbreak is "Why now?" Nicotine e-liquids have been on the market for many years and are being used by millions of vapers but there has never been a problem. Something must have changed to result in the outbreak occurring at this time. But what?

Now there is a possible explanation: it turns out that there was a major change made in the bootleg THC vape cart drug dealing industry late last year. It appears that a new thickening agent started to be used in bootleg THC vape carts. Very possibly, that new agent was vitamin E acetate. Tocopherol acetate (the fancy name for vitamin E acetate) is a thickening agent that is typically used in cosmetics like skin cleansers. But late last year, it apparently began to be used for thickening the THC oil (presumably to hide the fact that it had been highly diluted, which is a clue to some buyers that they are not getting much product). Here is what has to say:
"Peter Hackett of Air Vapor Systems and Disinger and Heldreth of True Terpenes both mentioned the recent introduction of a novel diluent thickener called Honey Cut. The product swept through LA’s pen factories late last year. Honey Cut maintains a website, but the identity of the product manufacturer remains unknown, as does the chemical makeup of the substance. Leafly has made many attempts to reach officials at Honey Cut, but they have chosen not to respond.
Honey Cut’s introduction last year proved so popular that competing products by other diluent makers soon began appearing."

What was the new diluent thickener in Honey Cut?

You guessed it ... tocopherol acetate.
Siegel started warning about this mess in late August.
This emerging story shows the dangers of bias in public health. The long-standing bias of the CDC against vaping has resulted in the agency failing to warn the public in clear and specific terms about the risks associated with the use of bootleg THC vape carts and instead, issuing warnings against "vaping" and "e-cigarettes" generally and making meaningless statements like "e-cigarette aerosol is not harmless water vapor."

On my blog, I first issued a warning about the use of black market THC oils on August 25, and then on August 28 I blogged and tweeted an unequivocal warning, since the CDC had failed to do so. It is now 11 days later, and we are still waiting for the CDC, HHS, and other health groups to issue a clear and specific warning against the use of bootleg THC vape carts. We are still waiting for these groups to stop blaming the outbreak on vaping or on e-cigarettes. Although we cannot completely rule out any role of e-cigarettes, it now appears very unlikely that they have anything to do with the outbreak, which appears to be due to e-cannabis, not e-cigarettes.

The truly unfortunate rest of the story is that in their zeal to demonize e-cigarettes, the CDC and other health agencies have put the lives of our nation's youth at risk. They should have issued a warning 11 days ago. During the past 11 days, how many youth continued to vape THC oils because of the failure of health agencies to accurately convey the known information about the potential causes of the outbreak? The CDC and other health agencies and some anti-tobacco groups have gone to great lengths to protect the illicit cannabis industry. But they have no problem with attacking the e-cigarette companies and telling ex-smokers to return to smoking rather than continuing to vape. Why?
This stuff is or ought to be common knowledge among anyone half-way paying attention to the vaping file.

Meanwhile, here's how Radio New Zealand headlines and leads a story on a death in the US subsequent to another THC vaping issue - although this time bought from a dispensary rather than a roadside stand.
I put in a press council complaint about a misleading headline, as the story does acknowledge that in this case the death was linked to a THC cartridge rather than to nicotine containing e-liquids.

RNZ is really failing on this. It is very important that people who vape know the importance of buying products that they can trust from manufacturers who wouldn't add oil-based ingredients. Instead, RNZ gives them scaremongering about vaping in general, and none of the detail needed to help consumers make informed decisions.

I've not heard of any of the dodgy products making their way here, but it's impossible to guarantee that it won't happen - again, though, the US cases are primarily around dodgy THC-based products. A responsible version of Radio New Zealand would have warned vapers to make sure they're buying their product from trustworthy sources.

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