All posts tagged: vaping

Vape-Gate 2019: Review of The Risks of vaping

Risks on the Production Side of the Market:

  • Bacteria: Within facilities that lack appropriate oversight, any bacteria present during the manufacturing of a vaped product can be a source of risk for the consumer.
  • Fungus: Similarly, fungus can be a normal part of ambient air and life on earth, particularly around plants and soil. If production facilities do not have state-of-the-science monitoring or control mechanisms to limit mold, fungus can accumulate during the manufacturing process and can be transmitted to consumers.
  • Particles: Nicotine- or cannabis-containing products that are not produced in regulated facilities (home-grown and/or street-sold real or counterfeit products) may contain dangerous solvents, including solutions that contain lipid content that does not belong inside human lungs. Equally concerning, even in states with strict regulatory oversight over cannabis, the regulations may not cover particulate matter which may come into the consumer’s body from the containers that store tested cannabis products. For example, labs across the US have identified particles of vapor cartridge construction materials that become airborne during the heating process of vaporization. There is currently no testing standard for such circumstances. More, the sheer volume of particles emitted by a tool producing vapor is unregulated. With respect to its effects on the lungs, it is likely that there are meaningful differences (and potential risk differences) between a vaporizer which produces a small cloud of particles compared with one that produces a large, dense cloud.
  • Nicotine/E-liquids: Many nicotine vaporizers contain flavoring, coloring, preservative liquids that can be irritating to the lungs and breathing architecture. Non-nicotine liquid mixers can include sugary substances which promote dangerous growth of bacteria, inside the lungs.
  • Supervision: Street or home-produced products lack quality control measures to ensure that they are made safely, and/or contain safe ingredients, and are being delivered inside safe devices. In contrast, most FDA-overseen nicotine products and state-overseen cannabis production facilities limit many risk factors for currently-known threats to health

Risks on the Consumer Side of the Market:

  • Bacteria: Once purchased, products exposed to everyday life can acquire potentially dangerous bacteria after they are produced and sold. When used with poor maintenance practices, or by a consumer with hygiene practices that may add additional risk, bacterial infections can arise.
  • Fungus: Like bacteria exposure and potential infections, mold/fungus can accumulate after a vaping product is purchased. Good maintenance/cleansing practices help to prevent this risk, and appropriate hygiene around the consumption of vaping products typically minimizes this concern.
  • Particulate Matter: When using and re-using vaporizer tools (pens, vaporizer ovens, edibles), foreign particulate matter may break-off from cartridges, or may accidentally enter into products that were previously free of these contaminants. Many of the popular vaporizer cartridges, for example, seem to come from three facilities in China and are sold, worldwide, because of the attractive low price-point. Across the US, lab evidence has discovered evidence of small particles of the cartridges themselves (plastics, metals, other materials.) These particles can cause irritation to the lungs and may stimulate an inflammatory response.
  • Coughing: Vaporizing a product which causes the user to cough excessively can risk the accidental aspiration of bacteria or particles from the mouth. These particles, if small enough, can cause inflammation or infection in the lungs.
  • Nicotine: In addition to the well-documented increased risk of cancer from the consumption of nicotine, this chemical is an irritant to the tissues with which it interacts, causing arterial wall constriction and thickening. It increases blood pressure and heart rate, promotes increased inflammation and suppresses normal immune system function. More, it also artificially elevates dopamine, norepinephrine, and acetylcholine, with poorly understood consequences that are unlikely to be healthy for the lungs.
  • Maintenance: Vaporizing old or poorly-kept products may ignore the very real effects of deterioration of materials which may pose health concerns. A product which is not well-maintained or regularly cleaned may contain infectious particles, irritating particles, toxic elements which may also be found in a pocket or storage container (insecticides, animal poisons, other chemicals which may preserve or protect during production or travel)

Individual Differences:

Between the production and the consumer sides of the vaporization arena, individual differences and outside influences can have a tremendous impact on the experience of vapor. Someone with a history of lung disease may tolerate a very different product than someone without such a history. Similarly, someone with a weakened immune system may have a more difficult time healing from an average exposure (to an irritant or an infectious particle) than someone with different circumstances. These are not likely to explain a large incidence of illnesses, but in addition to the concerns above, they may help explain a smaller portion.

Some of the Medical Illnesses Potentially Associated with Vaping:

1. Pneumonia (bacterial)

2. Aspiration Pneumonia

3. Idiopathic Acute Eosinophilic Pneumonia

4. Hypersensitivity Pneumonitis (extrinsic allergic alveolitis)

Typically this is related to the components of e-cigarettes: nicotine, propylene glycol/glycerol, ethylene glycol, any of >7000 flavorings, metals including tin, lead, nickel, chromium, manganese, and arsenic (have all been found in e-cigarette liquids), also nitrosamines common to tobacco, carbonyl compounds, volatile organic compounds, and phenolic compounds.

General Recommendations for Safer Consumption:

  • Use state-supervised companies, including dispensaries for cannabis-related vaporizer materials, and reputable nicotine suppliers
  • Convection vaporizer ovens that involve safe heating materials (ceramic, glass, quartz) are preferable to vaporizer cartridges.
  • Any means of detaching product from direct contact with a heat source is preferable. For example, stainless-steel containers that hold product, and are then placed into a heating chamber, is likely to be safer than placing product directly against heat.
  • Safe heating elements: chamber-based convection/conduction heating
  • Avoid direct contact with coils, and avoid combustion
  • Use fresh products from state-sponsored dispensaries or stores
  • Avoid products that are repeatedly reused (including vaporizer pens and vaporizer heating tools that stay full of organic material for more than a brief period of time
  • Prefer systems that include the opportunity to easily clean and replace individual used components
  • Use rubbing alcohol to clean any heating tools regularly

Sample Reference News Articles:

1.

https://www.nytimes.com/2019/08/31/health/vaping-marijuana-ecigarettes-sickness.html?smid=nytcore-ios-share

2.

3.

https://www.washingtonpost.com/health/2019/09/05/contaminant-found-vaping-products-linked-deadly-lung-illnesses-state-federal-labs-show/

4.

https://www.foxbusiness.com/healthcare/electronic-cigarettes-vapes-scott-gottlieb

5.

https://www.cnbc.com/2019/08/26/fake-juul-pods-fill-shelves-after-vaping-giant-pulled-fruity-flavors.html

6.

https://www.latimes.com/california/story/2019-08-25/knockoff-cannabis-products-headache-for-california-legal-weed

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Benjamin Caplan, MDVape-Gate 2019: Review of The Risks of vaping
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Video: 4 major risks of recreational cannabis use

Though cannabis has many medical benefits, using the drug without professional guidance can cause serious harm. Watch this video to learn about 4 major risks associated with recreational cannabis use

Benjamin Caplan, MDVideo: 4 major risks of recreational cannabis use
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5 Benefits of Vaping Cannabis (vs smoking)

Within the inhalation method of consuming cannabis, there are many different ways one can inhale it.

The ancient way was almost always to smoke it. In the modern era of cannabis consumption, there are many more popular and advanced ways to consume either flower or concentrates:

  1. “Desktop” models that may use electricity for amplified power,
  2. Portable models that are more useful for inhalation-on-the-go,
  3. Cartridge-based “vape pens” to vaporize potent concentrates in a simple mechanism.

In short time, we will likely see adoption of (and a quickly massive rise in popularity of) aerosolization and nebulized cannabis consumption too!

Are the benefits of vaping strictly limited to cannabinoids? Certainly not.

Are the benefits of vaping even limited to terpenoids? Certainly not.

What else is there? Flavonoids.

And still more? Combinations of these that create entirely new results!

Benjamin Caplan, MD5 Benefits of Vaping Cannabis (vs smoking)
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Cannabis: Vaporizing vs Smoking

Smoking cannabis brings toxins and unhealthy combustion byproducts into the body. With temps in the ~2000’F range for flame, burning flower incinerates a large portion of the product being consumed. As the distance from the point of flame grows, temperatures are lower, and cannabinoids are vaporizing, in addition to being burned by the flame. Over time, as heating technology has improved, there is no longer a need for blasting temperatures way beyond what the material can safely sustain before turning to tar and ash.

Beyond developed habits of consumption, social familiarity, and simplicity of use, one of the reasons many enjoy combustion is the other effects of heat. As with any human contact with extreme heat, blood rushes to the source of heat, and this may present a platform, through which cannabinoids may enter the bloodstream more quickly. The extravagant heat is also aerosolizing many more cannabis compounds than vaporization temperatures typically support, so the effect of flame is often felt to be more intense.

Vaporizing cannabis, however, is less likely to introduce mutations in the polyphenol compounds found in abundance within cannabis, and some of the mutations create terrible molecules known to be caustic and destructive.

If the medical rationale for vaporizing (over combustion) is not convincing, please consider the financial argument: Though purchasing a vaporizer may be costly, it’s a smart investment that could save money in the long run. Learn more by watching this video:

Benjamin Caplan, MDCannabis: Vaporizing vs Smoking
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Consuming CBD with THC Decreases Systemic Availability of THC

Title: Model-based analysis on systemic availability of coadministered cannabinoids after controlled vaporized administration 

A new study revealed findings that vaporizing cannabidiol (CBD) with ∆-9-tetrahydrocannabinol (THC) lowers the systemic availability of THC.

Researchers analyzed the blood plasma level of CBD and THC in a randomized, double-blind study, and found that those who inhaled a high dose of CBD were found to have lower levels of THC. Frequent cannabis users were found to have only minorly decreased levels of THC in their plasma when high doses of CBD was coadministered. Future studies should be conducted to examine the validity of these results for other consumption methods. 

This work highlights how those who have consumed too much THC can combat some of the symptoms associated with THC by consuming CBD. Occasionally, cannabis users may overindulge in THC and feel anxiety, panic, or dizziness. One of the best ways to combat such overindulgence (and lower the effects of THC) is to consume a high dose of CBD. Other, non-cannabis related, methods are also commonly recommended, such as relaxation or food with high levels of the terpenes caryophyllene and limonene. When using cannabis it’s important to start low and go slow in order to minimize the possibility of overindulgence. 

View this review (yellow link) or download:

This paper is also stored here:   http://bit.ly/2xNCHkw      inside the CED Foundation Archive

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Benjamin Caplan, MDConsuming CBD with THC Decreases Systemic Availability of THC
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Vaping cannabis among adolescents: prevalence and associations with tobacco use from a cross-sectional study in the USA

Out of 2,835 high school students from North Carolina, 272 students (or 9.6%) reported ever vaping cannabis. Interestingly, the odds of ever vaping cannabis were significantly higher among males (11.0%) compared with females (8.2%), and significantly higher among non-Hispanic white students (11.3%) compared with non-Hispanic black students (5.0%).

It’s clear that white males are the most likely to have ever vaping cannabis. Why might minority students engage less with recreational drug use?

View this review (yellow link) or download:

This paper is also stored here:    http://bit.ly/2L6zYdv     inside the CED Foundation Archive

Benjamin Caplan, MDVaping cannabis among adolescents: prevalence and associations with tobacco use from a cross-sectional study in the USA
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Medical Cannabis: Vaping Over Other Delivery Options

Medical cannabis users prefer vaping for fast, portable, discrete treatment

Previous research shows that medical cannabis users prefer vaporization, or vaping, as a means for drug administration. In a Brown University study, 25 consumers of medical cannabis were surveyed to further investigate this phenomenon. Participants largely preferred vaping over other forms of delivery. Patients cite increased cost efficiency, discrete use, more ease in transporting medication when traveling, and more immediate symptom relief as reasons for this preference. Based on these data, vaping may be a valuable drug delivery option for cannabis users seeking a discrete, portable, effective treatment vehicle. bit.ly/2W378N3

Benjamin Caplan, MDMedical Cannabis: Vaping Over Other Delivery Options
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