Verified products, including these on the cannabis vaping market, are crucial for the safety of people. EVALI is an example that users may not be aware of risks which illegal, not controlled markets bring into their lives and lungs. Thus, below we describe a short example of why verified products are important and what to do to mitigate the risks.
EVALI as a reason to legalise and analyse cannabis
EVALI stands for e-cigarette, or vaping, product use-associated lung injury. It has first appeared in 2019, particularly among Americans who used illegal, unregulated cannabis vape goods. In April 2019, the first cases were discovered in Illinois and Wisconsin. There were 68 confirmed deaths by February 2020, and there were 2,807 hospitalised patients.
The EVALI was closely associated with the presence of vitamin E acetate, according to the US Centers for Disease Control (CDC). However, they noted that other substances, such as those in THC and non-THC products, might also be important factors.
The number of EVALI cases has greatly decreased since its peak in September 2019. Due to the reduction, the CDC stopped reporting on EVALI cases in February 2020. However they still continue to track potential cases in emergency departments. Even after the most recent CDC update, some states, including California and Utah, have reported new cases.
The Food and Drug Administration (FDA), which regulates items containing nicotine and focuses on health, has not given its approval for any vape products to be sold. Federal law prohibits THC products, although they are legal and subject to regulation in several states. Vitamin E acetate was used as a thickening agent in low doses before the outbreak. However, unauthorised vendors increased the use of diluent thickeners in their formulas, including vitamin E acetate.
In reaction to the crisis, some states limited the sale of goods containing vitamin E acetate. But illegally produced THC products were and are still a risk.
Nearly 2,000 compounds occured in the popular vape brands’ aerosols during analysis by Johns Hopkins University researchers in 2021. The majority of they is still unknown. CDC has not excluded nicotine vapes as a potential additional cause of some EVALI cases. That was another complexity of the problem.
According to a March 2022 article in the Radiological Society of North America news, EVALI cases are still being identified, with some initially misdiagnosed as COVID-19.
The CDC determined that exposure to substances found in illegal cannabis vaping products was the most likely cause of the EVALI outbreak. However, they did not rule out the possibility of other substances found in nicotine vapes. Particularly associated with lung conditions linked to THC-based vaping products is vitamin E acetate. However, it is difficult to identify a single reason for all cases given the variety of chemical compounds present in e-cigarettes. Although the majority of those affected admitted using THC, patients reported using vape devices that contained nicotine, THC, or both.
The EVALI outbreak is a clear warning of the dangers of using unregulated cannabis and vaping products, especially those that contain THC. Measures to control the outbreak and regulate these products have been taken. But there still must be research and surveillance to guarantee public health and safety in the face of changing vaping patterns.
What can be done to avoid the risk?
Illegal cannabis market always brings the risk of non-controlled products with contaminations. Thus, access to verified products should be the way to avoid health issues. Verification of existing products by laboratory with accreditation can be part of the supply chain on the legal market.