The Lung Disease Outbreak in the US Explained

We looked at a lot of the facts of THC and CBD, and asked our own in-house chemist about the compounds mentioned in correlation to the disease.

Anyone who listens to the radio, or reads the news will no doubt have seen the recent ‘outbreak of lung disease caused by vaping’ in the USA. Many different news sources have covered this story, from both pro and anti vape stand points. We ourselves at Emporium Vapour HQ have been keeping an eye on the news as it has developed, and shared what we can with our followers when we could.

However it’s hard to separate hard fact from sensationalised news, so we are hoping to lay down some of the facts, and have some questions answered by our own in house chemist about what has been happening, and why it’s been happening.

First of all, it’s a tragedy. As it stands up to 5 people have died from this lung disease that has supposedly been caused by vaping. Nothing can dispute the fact that no matter what the cause, it is a tragedy. Nonetheless, we must look further into the facts, and the cause of these fatalities.

The Problems

The 300+ cases of lung disease of all happened in the USA, specifically in areas where the use of e-cigarettes was banned or had similar regulations to smoking cigarettes. Seems a bit coincidental? Or maybe not, as that is the case for more or less all states, in the US, and not too dissimilar to how vaping to regulated and treated here in the UK. Furthermore, many of the patients have been under 21. But isn’t there an age limit for those who can vape and/or smoke in the US? Yes, in fact in most states have the legal age being 18, while some of the affected states restrict the purchase of tobacco products for those under 21. It would seem then that these products have been purchased illegally. And that is one of the many problems.

The case that these e-cigs could have been purchased illegally, they also contained a few ingredients that are both illegal and not included in your regular and regulated nicotine containing products. They contained THC. THC is a chemical usually found in cannabis related products, and is the part of cannabis that is supposed to illicit hallucinations. THC is not an approved substance for use in e-cigs, both in the US and in the UK. Of course people can find ways around this, and it seems that that is just what these poor 300+ people did. The very unfortunate thing in this case is that it wasn’t specifically the THC that caused the respiratory illness, it was another another agent that was added to the THC liquid that made people sick. An agent called Vitamin E Acetate.

We asked our chemist – P. Orr, MSc Medicinal Chemistry (postgraduate), BSc Chemistry (hons) – about THC, Vitamin E Acetate, and its effects. This is what he said:

What is THC?

THC or Tetrahydrocannabinol is the principal psychoactive constituent of cannabis. THC is one of three cannabinoids listed by the UN convention on psychotropic substances, out of a total of one hundred and thirteen known cannabinoids.

What is the difference between THC and CBD?

THC and CBD are similar compounds as they are both cannabinoids. They have the same empirical formula, ie they have the same amount of carbon hydrogen and oxygen atoms. They are both derived from the same starting compound of cannabigerolic-acid. But they differ in their respective synthetic metabolic pathways. The different pathways lead to slightly different conformations of similar compounds. This difference in arrangement leads to a vast difference in their properties and efficacies.

THC

THC binds with strongly with cannabinoid 1 (CB1 and CB2) receptors.

[THC] is psychoactive and is responsible for producing the “high”

[THC] is well known for its properties as an appetite stimulant, analgesic and changes brought about in emotional and cognitive abilities.

CBD

CBD binds very weakly with (CB1 and CB2) receptors.

It acts more as a negative modulator of (CB1 and CB2) receptors.
CBD can block the mode of action of [THC] and therefore lessen the psychoactive effects of THC
It’s a non-psychoactive and will not produce a “high”
CBD is being investigated for is properties in relation to analgesic, anticonvulsant, muscle relaxant, anxiolytic, and antipsychotic. It has also shown neuroprotective, anti-inflammatory properties.
It is still being debated whether its properties are more effective than existing treatments.

Why is THC a controlled substance?

[THC] is a controlled substance for a number of reasons.

Because it is a highly active psychoactive with well-known negative emotional and cognitive abilities.

Lack of acceptable medical use. [ Although THC] has positive medical attributes it also comes with an unacceptable level of side effects.

Public perception of unfashionable lifestyles, addictive properties and links to other narcotics.

Unconvincing advocacy for legalisation. The drug claims to be a cure all, aka (Snake Oil) with little hard evidence of actual therapeutic benefit.

With it being a controlled substance, how do you think people are managing to purchase THC products?

Being a controlled substance in the UK I can only assume that people seeking to purchase THC are doing so by underground methods; ie drug dealers, Dark web, etc.

What is Vitamin E acetate?

Vitamin E acetate is one of the group of 8 Vitamin E complexes. It is fat soluble antioxidant necessary for protecting cell walls from free radical damage. The mostly commonly used in topical creams and lotions. It typically is not used for internal consumption or vaping. Vitamin E acetate may have been added to THC bearing liquid to either enhance the solubility of THC in the carrying eluent, or to improve the flavour.

Why is it dangerous to vape Vitamin E acetate?

Vitamin E acetate at first seems a likely candidate to be one of the common factors in the spate of recent deaths in the US. It is potentially dangerous due to the nature of its lipid structure. Lipids and other fats present in the lung are well known to have the ability to cause “lipoid pneumonia”. This is where fats or lipids enter the lungs and fail to disperse out of the lungs. The lipid residue left in the lungs causes’ inflammation. Where severe inflammation can cause permanent damage.

Are there any regulations in using Vitamin E acetate in e-liquid in the UK?

There are no regulations in the UK regarding the Vitamin E acetate content of e-liquid in the UK. The only compounds that are required to be reported in nicotine bearing e-liquid are Nicotine, Acetaldehyde, Acrolein and Formaldehyde. 0 mg e-liquids have no requirements for reporting their content.

Unfortunately now there is a call from those affected by the lung disease for a blanket ban on e-cigs altogether. Specifically is the case of 18yr old female who was starting a campaign from her hospital bed. There is plenty to counter her call for a ban, with professionals saying that there is no correlation between nicotine containing products, and these specific THC filled cartridges that were used by the 300+. The problem here, however, is the sensationalising of the news, and now we see that President Trump has asked for flavoured e-liquid to be banned.

But what does this mean for us in the UK? Vaping has been a thriving business in the UK for a decade or more, and there have been no similar events like what has happened in the US. Even with our own little health scares like popcorn lung (which was debunked), the UK vaping community has powered on and now there are estimated to be over 3 million people in the UK who now vape.

So what does our Chemist think that UK vapers need to know about this news from the US?

There has been a number of deaths associated with vaping THC products reported in the media. The number of deaths remains relatively small compared to the total amount of regular vapers. The deaths have been among a small number of users in an isolated geographical area of the US i.e. it is not nationwide. Additionally it has been reported that many of the deaths had a few common factors. The patients all had existing medical conditions of “severe pulmonary disease” and they were vaping [THC] oil and not E-liquid. Furthermore the [THC] oil in question was contaminated with Tocopheryl acetate (Vitamin E acetate).

So how can vapers ensure that their e-juice is safe to use?

Vapers can ensure their e-juice safety by going to reputable suppliers that can supply full MSDS / SDS (Material Safety Data Sheet/Safety Data Sheet) documents for their products. E-liquid normally is free from THC and contaminates and poses little risk to the regular e-liquid user.

Finally, how can vapers ensure that their liquid doesn’t contain Vitamin E acetate?

It is highly unlikely that an e-liquid manufactured in the UK would contain any Vitamin E acetate. But to be sure any reputable manufacturer should be able to supply MSDS / SDS

details of the compounds in their respective liquids.

Studies have proved that vaping is safer than smoking. A few years ago, Public Health England released a statement saying vaping is 95% safer, which they still stand by. So as long as you know where your liquid is coming from, and always check for reliable resources, then we should all be able to vape safely.