Better regulations, not bans, are needed to curb the THC vaping crisis

Representatives with the U.S. Centers for Disease Control have for the first time identified a specific contaminant as a “very strong culprit of concern” in EVALI (e-cigarette or vaping product use-associated lung injury) — the e-liquid vaping illness that is associated with over 2,000 cases nationwide and 39 fatalities.

Agency representatives last week highlighted the likely role of vitamin E acetate (oil) as a primary contributor to the lung illness. To those following the EVALI outbreak closely, the CDC’s focus on the contaminant hardly comes as a surprise.

In early September, health officials in New York State publicly acknowledged finding high levels of vitamin E oil in several unregulated cannabis-vape products, all of which were suspected to be linked to the illness.

Weeks earlier, reporters affiliated with the online publication Leafly.com also speculated that vitamin E contamination was likely to blame for the EVALI phenomenon.

According to their reporting, beginning in late 2018, some clandestine manufacturers of unregulated and counterfeit THC vapor cartridges began to use the oil as an additive in an effort to thicken the consistency of their cannabis e-liquids and to mask dilution. 

Bolstering this theory is the reality that the overwhelming percentage of products associated with the illness have been linked to those obtained informally on the underground market. “The data so far point to a much greater risk associated with THC-containing products from informal sources than licensed dispensaries,” affirmed Anne Schuchat, principal deputy director at the Centers for Disease Control and Prevention.

The CDC’s latest advisory similarly acknowledges, “The latest national and state findings suggest products containing THC, particularly from informal sources like friends, or family, or in-person or online dealers, are linked to most of the cases and play a major role in the outbreak.”

Of course, it remains possible that other factors may also be at least partially responsible as well. Some have suggested that the abundance of heavy metals present in cheaply manufactured vape pens may be a contributing factor.

Others have pointed to the presence of illegal synthetic cannabinoids, which have been identified in some unregulated THC and CBD vape products. The ingestion of such compounds, which are more typically identified with illicit substances like “Spice” and “K2,” can be especially dangerous to health. 

As is the case in virtually any unregulated market, the unscrupulous manufacturers responsible for these contaminated and adulterated products are largely unknown. Yet, for too long these predatory players have tacitly operated on the fringes of the commercial cannabis industry. That is because as long as all cannabis-specific products remain federally illegal, the FDA is largely powerless to provide or enforce appropriate regulatory standards, oversight, or quality controls to separate the bad actors from the good ones. 

As a result, this heavy burden for now falls solely upon state regulators in those jurisdictions that have legalized cannabis use. But the regulations governing the THC/CBD vapor market are not consistent from state to state and are often far from sufficiently comprehensive.

Nonetheless, even these patchwork regulations are better than no regulations at all — as illustrated by the fact comparatively few state-regulated vaping devices have been definitely linked to the illness. 

Furthermore, many state regulators are now moving quickly in response to the crisis to further update and strengthen their existing guidelines – such as engaging in targeted testing for the presence of vitamin E acetate and by banning the its use state-regulated in vapor products.

Many states are also responding by mandating more extensive lab testing for the presence of heavy metals and other potentially dangerous chemicals. States are also moving forward with public awareness campaigns warning of the perils associated with the informal market and are engaging greater efforts to crack down on the illicit, counterfeit cannabis marketplace — as they should. 

But they shouldn’t have to do so alone. Rather than use the unfortunate incidents of the past few months as an opportunity to further drive this market into the shadows, the Trump administration should move ahead to better empower states to regulate cannabis and cannabis-related businesses.

This can be done by once and for all removing the cannabis plant from its onerously restrictive schedule I classification under federal law. This would facilitate and empower the FDA to better study and regulate these emerging THC and CBD delivery devices. It would also allow federal and state regulators to better oversee those who are operating in this commercial space. Such action is both necessary and is long-overdue.

Paul Armentano is the deputy director of NORML — the National Organization for the Reform of Marijuana Laws. He is the co-author of the book, “Marijuana Is Safer: So Why Are We Driving People to Drink?” and the author of the book, “The Citizen’s Guide to State-By-State Marijuana Laws.”