The vaping illness outbreak is strengthening the argument for legalizing marijuana
One class of vaping product, however, has consistently been implicated in the illnesses: unregulated and unlicensed cartridges that contain THC, the main psychoactive chemical in cannabis.
According to the latest CDC data, 78 percent of the 849 patients who have provided information on their vaping habits reported using THC-containing products. Though the agency isn’t tracking whether people were using legal or black market sources to vape, the data we have from states suggests it’s overwhelmingly illicit, pre-filled THC vape cartridges making people sick.
On Tuesday, the CDC’s Mortality and Morbidity Weekly Report published a study from Utah showing 92 percent of patients interviewed reported vaping THC — and mostly from pre-filled cartridges — before falling ill. The vape products, the CDC said, “were acquired from informal sources such as friends or illicit in-person and online dealers.” Dank Vapes, a popular black-market manufacturer, was the most commonly used brand. Research in Illinois and Wisconsin shows the same pattern. And in New York, the state Department of Health commissioner has said the vast majority of the 125 cases there have been linked to black market THC cartridges.
As this data has emerged, the outbreak is looking less like a story about general vaping risks and more about the harms of vaping certain THC products. It’s also a reminder that the way people use THC is shifting.
“What’s changed is that people used to vape dried herb and now you have more vaping of preprocessed manufactured oils, which involve different ingredients,” said David Hammond, a public health researcher at the University of Waterloo in Ontario who studies the e-cigarette and THC vape markets in Canada and the US.
Yet health regulators haven’t kept up with this new reality, Hammond and other experts told Vox, even in states where marijuana is legal. That’s why experts increasingly view the outbreak as evidence in the case for decriminalizing marijuana at the federal level. States haven’t been able to protect the public from dangerous vape products, and so it may be time for agencies experienced in regulating consumer products, like food and drugs, to take over, they say.
To understand why, let’s take a closer look at the black market for THC vape products and its role in vaping-related lung disease.
What are black market THC vape products and what do we know about them?
A quick tour of the basics of black market THC vape products: Vape devices, also known as e-cigarettes, are battery-powered gadgets that deliver nicotine or flavors through an aerosol. They do this by heating a solution of colorless solvents (most commonly propylene glycol and vegetable glycerin) and other additives. When people vape THC, the solution also contains THC oil. (Note the difference here from smoking a joint or using a dried herb vaporizer.)
There are a variety of devices that aerosolize THC liquids. But the most common, according to the Wisconsin and Illinois data, are vape pens that take pre-filled cartridges, and tank-based devices, that can be filled with THC-containing liquid. The cartridges or liquids that go into the devices can be purchased from authorized stores in states like Colorado that have legalized marijuana products or from unauthorized, black market sources, such as dealers or online shops. (In states that haven’t legalized marijuana, all sources are considered black market. But states with legal markets also have black markets — more on that later.)
We don’t have a lot of information about the black market for cannabis products. “It is somewhat shocking how little we know,” said Hammond. And that’s the nature of black markets: They are, by definition, murky and hard to track — and the one for pre-filled vape cartridges is also relatively new.
Here’s what we do know: In 2016, the overall market for cannabis in the US — from both licensed and unlicensed sources — was estimated at $50 billion. An analysis by RAND found the fastest growing segment of the state-legal cannabis market in Washington state (one of the first to legalize recreational marijuana) was “extracts for inhalation”, which includes vape pens and cartridges.
The International Cannabis Policy Study, which surveyed 30,000 people in September 2018, uncovered a similar trend: While dried herb remains popular, more than 30 percent of users report vaping THC oil. Many others are using edibles and concentrates (cannabis that’s been processed to increase its potency).