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Home City Unlicensed Marijuana Vaping Products Eyed In 21 Lung Disease Cases In Calif.

Unlicensed Marijuana Vaping Products Eyed In 21 Lung Disease Cases In Calif.

Unlicensed Marijuana Vaping Products Eyed In 21 Lung Disease Cases In Calif.
Check out this informative article by Erin Allday and the San Francisco Chronicle.

California public health authorities are investigating 21 cases of severe lung disease that appear to be connected to vaping unlicensed cannabis products and may be part of a larger outbreak that has sickened at least 150 people around the United States since June.

It’s not yet clear what exactly is causing the illness, but in California the victims had vaped cannabis or CBD oil not long before they got sick, according to the state public health department. In Kings County, a rural Central Valley county where eight people fell ill in July and August, public health officials collected recently used vaping products that were purchased from “pop-up” cannabis dealers that were not licensed by the state.

The victims have developed severe lung illness that was not caused by an obvious infectious agent — such as a bacterium or virus — and required aggressive treatment, including ventilation. Many of the patients have been teenagers and young adults. There have been no deaths.

Nationwide, 153 suspected cases have been reported in 16 states since June 28, the Centers for Disease Control and Prevention said Wednesday. There were 59 new cases reported in the last week alone.

Cases have been reported across California, though the public health department would not say which counties were involved other than Kings County. State public health officials reported one new case Wednesday afternoon.

“Our doctors noticed these cases of acute respiratory distress syndrome, and typically this time of year you’d see maybe one case. We had seven inside a month,” said Nancy Gerking, assistant director of public health in Kings County. “That’s when the alert was sounded.”

Gerking said the eighth case came to the county’s attention when a person who had previously been treated for pneumonia saw local news reports about the outbreak and came back for further testing.

“Everyone was purchasing from these pop-up shops,” Gerking said, referring to unlicensed dealers of cannabis products. “That seems to be the similarity among the cases.”

Though recreational cannabis is legal in California, an underground marketexists where users can buy cheap products that are not licensed by the state. Licensed dealers said they have feared that these products could be harmful because they are not subject to rigorous lab testing — of both the cannabis that is inhaled and the devices used to heat it — that the state requires.

Licensed cannabis products are tested at state-certified laboratories for pesticides, solvents that are used to extract THC from cannabis plants, heavy metals in the vaping devices, and disease-causing microbes like E.coli and salmonella. The state has set limits on what kinds of foreign matter and at what levels are acceptable.

“People just think it’s cannabis, it’s a plant, how much risk can there be?” said Myron Ronay, chief executive of BelCosta Labs, a licensed cannabis testing lab in Long Beach. “Within the underground market is potentially a high risk for pesticides and other contaminants because it’s not tested. There’s definitely reasoning as to why California has such low levels of pesticides and solvents that are allowed within these oils.”

Ronay added that it’s not always easy to tell unlicensed cannabis dealers from licensed ones. Some unlicensed operations have storefronts and may even provide a license number. Consumers can look up licensed dealers at the California Bureau of Cannabis Control’s public education campaign website, bcc.ca.gov/consumers/weedwise.

“Just because there is a dispensary in your city doesn’t mean it’s a legal, licensed operation,” Ronay said. “There are unlicensed operations in many if not most cities in California.”

Justin Hall, co-founder of Bud.com, a Bay Area cannabis delivery company, said he was troubled by the recent spate of lung disease cases and worried that consumers might be scared off from the industry as a whole. Vaping is generally a safer alternative to smoking cannabis products, “as long as people aren’t using these shady, not-legal, cheap providers,” he said.

He added that marijuana legalization in California has made licensed products safer — but it’s also made them more expensive, as legitimate dealers raised prices to cover lab testing and state taxes. That makes the cheaper, unlicensed products more appealing to some consumers.

“Every bit of cannabis we sell in San Francisco is 25% higher in price just due to taxes compared to illegal stuff. And we spend a lot of money on testing and certifying and compliance,” Hall said. “We’re not just jumping through hoops for our own amusement, this is to protect public health. We can sell our products without fear. But we have a ton of competition from people who don’t have to pay taxes.”

Investigators still don’t know that it’s the cannabis or the vaping devices that are making people sick — it could be something unrelated that authorities haven’t found. It’s also not yet known whether there is a single bad product sickening people or if the cause is more nuanced — for example, the patients themselves may simply be at heightened risk of lung disease.

E-cigarettes have long been a source of concern among anti-smoking and public health advocates, who say that the health risks aren’t yet clear and there may be short- and long-term consequences to using the products for tobacco or cannabis. In particular, public health officials worry about use by teenagers, roughly a third of whom have tried vaping, according to some studies.

“What we’re seeing now are acute, dramatic cases. The bigger risk is the experiment we’re doing on millions of high school kids in America,” said Dr. Robert Jackler, a Stanford expert on vaping. “If they continue to use this over time, we won’t know for decades what the effect will be.”

He added that one possible cause of the ongoing outbreak is the oil in the vaping product. Inhaling vaporized oil can cause lipoid pneumonia, in which the lungs become finely coated in oil, leading to difficulty breathing. There is no specific treatment for lipoid pneumonia, and patients often are put on a ventilator and treated with steroids to reduce inflammation and give their lungs a chance to recover.

“My hope is that it proves to be something very specific to a kind of oil. There may be some bad batch out there, and we won’t know for sure until the epidemiologists trace it back,” Jackler said. “The greatest fear would be that it is something that we’re going to start to see in increasing numbers.”

Erin Allday is a San Francisco Chronicle staff writer. Email: eallday@sfchronicle.com

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