Last year, a pattern of concern began to emerge surrounding the effects of using highly potent marijuana concentrates. You may have heard in the news that there were a number of spikes in emergency room visits and hospitalizations due to “vaping” (or e-cigarette) usage, particularly in younger adults. The patients were experiencing lung failure, and in some cases, even death. This spurred an investigation to uncover what was causing such harmful pulmonary conditions, and why. Here’s what we know.

Understanding THC (tetrahydrocannabinol)

Marijuana has evolved since gaining popularity in the 20th century. And while it’s been around for over 5,000 years (according to many historical accounts), it experienced a modern renaissance in 1960’s America. Back then though, testing of THC levels (the psychoactive part of the plant) were limited, it’s believed that the level of THC in traditional “weed” was about 2-4%. Today, due to the ways in which growers have learned to cultivate “designer” strains of the plant, THC levels can be anywhere from 15%-30% or more in the final product, derived from what would be considered traditional, dried marijuana leaves.

THC is the chemical responsible for most of marijuana’s psychological effects. It acts much like the cannabinoid chemicals made naturally by the body, according to the National Institute on Drug Abuse (NIDA). It’s also been linked to the more harmful side-effects of smoking marijuana, such as paranoia, anxiety, panic attacks, hallucinations, increased heart rate and blood pressure. It goes to reason that the higher the THC levels in the product, the more harmful it can be on the individual. Keep that in mind.

E-Cigarettes and “Vape” Culture

E-cigarettes (also referred to as “vapes”) we’re introduced to the American market in 2007 after being formally “invented” in 2003 (http://www.casaa.org/historical-timeline-of-electronic-cigarettes/). These handheld, battery powered vaporizers work by heating a liquid solution to create a “vapor” that can be inhaled, mimicking the experience of smoking a traditional cigarette.

Vaping has become a major concern for teens who often experiment with “gateway” drugs such as alcohol, tobacco and marijuana. The Monitoring the Future Survey, which gathers statistics of teens and their drug use and addiction rates, found that in 2019, the percentage of adolescents who had vaped marijuana in the last 12 months was 21% in 12th graders (a 7.7% increase from the year before), 19% in 10th graders, and 7% in 8th graders. Numerous studies have shown that about 30% of high school seniors are vaping nicotine products, and have a high propensity to shift to “CBD” formulated varieties which contain THC (http://monitoringthefuture.org//pressreleases/19drugpr.pdf).

What are Marijuana Concentrates?

Marijuana concentrates are highly potent cannabis-derived substances that contain high levels of THC. They come in the form of waxes and oils. They can be used in things like foods and drinks, or are sold as oils or butters to be used in recipes or for vaping.

Studies have shown that, on average, these derivatives are around 3x higher in THC potency than modern marijuana strains, averaging anywhere from 40%-80% levels of THC (https://www.sciencedaily.com/releases/2019/08/190826092256.htm).

Allegedly, one “hit” of wax, which is about the size of the head of a pin, is roughly equal to one or two joints, depending on the THC concentration (https://www.justthinktwice.gov/facts-about-marijuana-concentrates). Not only is this level of potency alarming, it also has unknown consequences on the human body as we don’t have studies that are able to show the long-term effects of smoking or ingesting such high levels of THC.

Risk Factors of Vaping Marijuana

THC found in marijuana can be calming for some, but for others, can cause cognitive impairment, psychosis and addiction. The higher the level of THC, the higher the risk factor for turning into full-blown addiction.

People who have existing mental health concerns, including anxiety, depression, bipolar disorder, and schizophrenia can make these conditions worse when they smoke traditional marijuana. High potency marijuana wax or oils increase the negative symptoms associated with these mental disorders.

Possible side effects from smoking high-potency marijuana concentrates include:

  • Increased anxiety
  • Changes in sensory perception
  • Poor memory
  • Paranoia or panic attacks
  • Hallucinations (both auditory and visual)
  • Temporary psychotic breaks (may require hospitalization)
  • Increased heart rate
  • Increased blood pressure
  • Formication, or feeling like there are bugs on or under the skin

A study from Arizona State University said that, “Frequent marijuana use from adolescence through adulthood is associated with IQ decline. Prior research has linked regular marijuana use during adolescence with the emergence of persistent subclinical psychotic symptoms.” (https://www.sciencedaily.com/releases/2019/08/190826092256.htm)

EVALI (E-cigarette or Vaping Product Use-Associated Lung Injury)

In mid-2019, hospitalizations of vape smokers were on the rise. While vaping was not a new phenomenon, the rates of lung failure were. By early fall, thousands of people had been hospitalized and deaths were mounting. They were experiencing acute inhalational lung injury as the cause of respiratory failure.

As explained by the ATS Journals, “Some oil products are extracted from marijuana using additives such as propylene glycol which, although classified as “generally recognized as safe” by the Food and Drug Administration when ingested orally, can potentially cause lung injury when inhaled at a high temperature. Heating can also transform propylene glycol into carbonyls such as formaldehyde, a carcinogen and respiratory irritant. Flavoring ingredients, including diacetyl, may also pose risks to respiratory health; although it is more recognized in e-cigarette use, it can be present in cannabis oil vaping. (https://www.atsjournals.org/doi/10.1513/AnnalsATS.201612-974LE).

The report went on to say that, “As wax is manufactured with butane, molecules of the solvent can remain in the wax. When smoked, these molecules will move into the lungs, causing harm. Some people who abuse marijuana wax have been found with lung conditions similar to “black lung.”

Another finding had to do specifically with Vitamin E. As the CDC puts it, “Vitamin E acetate is strongly linked to the EVALI (E-cigarette or Vaping Product Use-Associated Lung Injury) outbreak. Vitamin E acetate has been found in product samples tested by FDA and state laboratories and in patient lung fluid samples tested by CDC from geographically diverse states. Vitamin E acetate has not been found in the lung fluid of people that do not have EVALI.”

As of February 18, 2020, a total of 2,807 hospitalized EVALI cases or deaths have been reported to CDC from all 50 states, the District of Columbia, and two U.S. territories (Puerto Rico and U.S. Virgin Islands). Sixty-eight deaths have been confirmed in 29 states and the District of Columbia (as of February 18, 2020). The median age of the patient is just 24 years old. (https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html)

What’s Being Done

Manufacturers are now required to remove Vitamin E from the production of tetrahydrocannabinol (THC)-containing e-cigarette, or vaping, products. But this may not prevent all issues, as many patients were found to have acquired their oils from “informal sources” such as friends, family, online sources and illegal dealers. The illicit sale of these products has played a major role in the outbreak of EVALI, according to the CDC.

And while the manufacturers of e-cigarettes and “vapes” claim their products are safe, it’s just too early to know the long-term effects of smoking tobacco-free nicotine products. The implications of high-potency THC oils are alarming, and affecting a particularly susceptible population, increasing the propensity for addiction.

How To Know if Someone Vaping Marijuana

It can be difficult to tell if your teen is vaping nicotine products or high potency marijuana oils, as the vapor is odorless and easy to conceal. However, if you recognize any of these words, which have been associated with the products, you may want to ask them about it. CBD vapor oils are also referred to as: 710 (the word “OIL” flipped and spelled backwards), wax, ear wax, honey oil, budder, butane honey oil (BHO), shatter, dabs (dabbing), black glass, and errl (https://www.justthinktwice.gov/facts-about-marijuana-concentrates).

If your child or loved one is addicted to high-potency THC oils, or CBD vapor products, they may need formal help. While many believe marijuana products do not cause dependency or withdrawal, detoxification clinicians will confirm otherwise. Detoxing from marijuana is as much a physical process as it is a psychological one. Lumiere Healing Centers of Ohio is here to help you intervene in your loved ones life, and prevent them from a lifetime of addiction. To learn more about our detox and residential services, please call (513) 909-2225.