THE VAPING CRISIS ONE YEAR LATER
Medical Monday’s | Project CBD Special
Scientists identify synthetic cannabinoid adulterants in CBD vape oil cartridges, warn of “devastating toxicological consequences.”By Martin A. Lee on September 14, 2020 (Updated on September 15, 2020)
It wasn’t so long ago that a frightening new lung disease linked to vaping dominated the news cycle. Although it might feel like a distant episode to Americans overwhelmed by COVID-19, during the summer of 2019 the vaping crisis became a national obsession. The Centers for Disease Control (CDC) issued an alarming report that attributed a sudden outbreak of deaths and pulmonary injuries to the consumption of harmful e-cigarettes and cannabis vape pen cartridges.
By February 2020, sixty-eight people in the United States, including teenagers and seniors, had died because of this mysterious respiratory illness and nearly 3000 were hospitalized with problems ranging from shortness of breath to severe nausea and coughing up blood. The CDC identified vitamin E acetate, a thickening agent added to poor quality cannabis oil extracts, as the likely culprit in cases of respiratory failure linked to vaping.
But the CDC stopped tracking vaping-related incidents shortly after the onset of the COVID-19 pandemic. Medical scientists turned their attention to the highly infectious coronavirus, which also kills by damaging the lungs – and does so in ways that aren’t easy to distinguish from the telltale signs of vaping.
COVID-19 and EVALI (the CDC’s acronym for e-cigarette or vaping-related lung injuries) have similar symptoms and share a common lethal mechanism. Severe cases of both diseases involve acute respiratory distress triggered by an immune system gone haywire. Medical scientists refer to this potentially fatal immune syndrome as a “cytokine storm.”
VITAMIN E ACETATE
We know that a voracious coronavirus can induce a cytokine storm. But what do we actually know about vitamin E acetate and vaping?
According to the CDC: “Vitamin E acetate is strongly linked to the EVALI outbreak. Vitamin E acetate has been found in [vape] product samples tested by FDA and state laboratories and in patients’ lung fluid samples tested by CDC from geographically diverse states.”The CDC stopped tracking vaping-related incidents shortly after the onset of the COVID-19 pandemic.
EVALI patients have been diagnosed with lipid pneumonia, a rare inflammatory condition that occurs when fat or oil enters the alveolar sacs of the lungs. This causes symptoms similar to other kinds of pneumonia, which is usually triggered by a bacterial, fungal or viral infection.
In a 2020 mouse study, vitamin E acetate appeared to replicate the lipid-associated lung damage of EVALI, lending support to the CDC’s contention that vitamin E acetate is a causative factor in vaping-related lung disease. Investigative reporting by Leafly also zeroed in on vitamin E acetate “among a gang of toxins” identified in illicit vape cartridges, including squalene, a skin cream ingredient, that shouldn’t be inhaled.
But a commentary in the New England Journal of Medicine, coauthored by a team of Mayo Clinic physicians, cast aspersions on the vitamin E acetate hypothesis, noting that the pathology of vaping-associated lung illness “is poorly understood” and that “few reports of vaping-associated lung injury have included histopathological findings.” A histopathological diagnosis is based on direct examination of diseased tissue or cells under a microscope.
Upon inspection, some cases of vaping-associated lung injury look more like a chemical burn than lipid suffocation – which suggests that additives other than vitamin E acetate are responsible for damaging lung tissue. Accordingly, another group of doctors advised in a letter to the Journal of American Medicine that the presence of lipid-laden immune cells in the lungs “should be interpreted with caution because it may merely be a marker of exposure rather than a marker of toxicity.”
VAPE OIL ADDITIVES
Project CBD has been beating the drumabout potential hazards of vape oil additives for several years. Thinning agents, such as propylene glycol and polyethylene glycol, and all manner of flavoring additives (staples of the ultra-processed food industry) are approved by the Food and Drug Administration (FDA) as safe for oral consumption. But many of these FDA-authorized texturizing agents and artificial flavors are poisonous when heated and inhaled.
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