Even in California, Nearly All Patients With Vaping-Related Lung Injuries Used Black-Market THC Products

A study in a state where marijuana is legal confirms the predominant role of cannabis products from illegal sources.


A new study of vaping-related lung injuries in California reinforces the evidence implicating black-market cannabis products, even in states that have legalized the production and distribution of marijuana for recreational use. In a sample of 160 patients, just 9 percent reported vaping only nicotine—a claim that is doubtful in the absence of blood or urine testing. Just 1 percent of the patients who reported vaping THC identified a state-licensed retailer as the source of the products they used.

In this study, which was published last Friday in JAMA Internal Medicine, 75 percent of the admitted THC vapers said they obtained the products from informal sources. Among the 25 percent who initially said they had bought vapes from legal sources, just one patient named a licensed retailer. The rest either could not name their sources or said they bought cannabis products from pop-up shops, other individuals, or from a storefront that was not listed in the Bureau of Cannabis Control's database of licensees.

Although licensed retailers have been selling marijuana to recreational consumers in California since the beginning of 2018, illegal dealers still account for about three-quarters of sales, largely because high taxes, burdensome regulations, licensing delays, and local bans have made it difficult for legal merchants to compete with the black market. This study suggests that the black market also accounts for nearly all of the products used by people with vaping-related lung illnesses.

The researchers, who work for the California Department of Public Health and the U.S. Centers for Disease Control and Prevention (CDC), analyzed 87 vaping products from 22 patients, 49 of which contained cannabinoids. Eighty-four percent of the cannabis products contained vitamin E acetate, a diluting and thickening agent that has been strongly linked to the lung disease outbreak, which included 2,807 cases and 68 deaths as of February 18. None of the nicotine liquids contained that additive. An October study by California's Anresco Laboratories found vitamin E acetate in 60 percent of the illegal cannabis products the company tested but none of the legal products.

"This report—the first to our knowledge to describe cases in a state with a legal adult-use (recreational) cannabis market—appears to confirm patterns of clinical findings and vaping practices previously reported in other states and nationally," the researchers say. "Although California has a legal adult-use cannabis market, the majority of affected patients reported using THC-containing products obtained from informal sources, such as friends or acquaintances or unlicensed retailers. In addition, most THC-containing products tested contained [vitamin E acetate], which has recently been identified in both clinical and product samples from patients with [vaping-related lung injuries]."

Given that nearly all of the THC vapers seem to have used black-market products, "the majority" is an understatement. Furthermore, 91 percent of the patients reported vaping cannabis extracts, and the actual percentage is probably higher, since people may be reluctant to admit consuming black-market marijuana products. The CDC has found that people who claim to have vaped only nicotine generally test positive for THC. Yet the authors of the JAMA Internal Medicine study reiterate the California Department of Health's recommendation that "individuals refrain from using any vaping or e-cigarette products" (emphasis added), although they note that "THC-containing products from informal sources" are especially risky.

The warning against any sort of vaping is hard to square with the evidence, which overwhelmingly implicates "THC-containing products from informal sources." The California Department of Public Health's advice is not just misleading but irresponsible when it comes to legal nicotine vaping products, which are indisputably far less hazardous than conventional cigarettes. The CDC, by contrast, is now recommending that people "not use THC-containing e-cigarette, or vaping, products, particularly from informal sources like friends, family, or in-person or online dealers." It adds that "adults using nicotine-containing e-cigarette, or vaping, products as an alternative to cigarettes should not go back to smoking."

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  1. But why are they using Vit E when VG and PG are cheap and plentiful?

  2. You know what I Dank?

    I Dank that the black-market suppliers have figured out the following:

    Stupid Government Almighty over-regulators (and stupid worshippers thereof) will take ILLNESSES AND DEATHS CAUSED BY BLACK-MARKET SUPPLIERS, and use that to justify FURTHER over-regulation of LEGAL suppliers, thereby feeding MORE business to cheaper, un-regulated black-market suppliers!!!

    So… Black-market suppliers need to sicken and kill more consumers!

    Follow the money, AND follow the stupid!

    1. Black market stuff usually isnt cheaper, because a premium can be charged for something that isnt easily obtainable and carries a risk with the sale of said product.

      1. I got cut off. I would guess as mentioned in the article is that the more likely culprit of why people are buying black market stuff is because excessive regulation makes california difficult to get your business set up. Licensing Laws, regulation etc.

      2. That may be true… I’ve not had extensive personal experience here, or researched it all that much.

        But… Price is not the be-all and end-all! In the Soviet Union, if you had a 7-hour wait to buy your cheap, subsidized bread… You might have turned to the black market for 5-minute-wait bread for MUCH higher prices! (And possibly riskier bread, yes).

        But that may be just a re-statement of what you just said! On 2nd thought…

        Bottom line? Government Almighty over-nannying in over-drive is NOT helping!

    2. “I Dank that the black-market suppliers have figured out the following”

      No. That’s just dumb.

      1. You’re just envious that you can’t come up with stuff like that, poor baby…

  3. › sos › cdn › bpd › c…PDF
    Web results
    10 Easy Steps to Start a Cannabis Business Entity in California –

    1. what to say except that people need to start thinking about what they are doing

  4. 10 Easy Steps to Start a Cannabis Business Entity in California

    Step 1 – Leave California.

    1. Ya but it seems likr the people who leave cali bring the same stupid thinking with them that ruined california. Af least they legalized pot, Indiana has a long way to go.

  5. Is there an easily referenced doctoral thesis on why legal but unobtainable is different from illegal?

    1. Yes!!! Holy Shiites!!! I approve of this message, in spades!!!

      (“Unobtainable because over-regulated” is understood by all attentive and sane humanoids, MeThinks!)

  6. “The authors of the JAMA Internal Medicine study reiterate the California Department of Health’s recommendation that “individuals refrain from using any vaping or e-cigarette products”

    Sounds like the precautionary principle at work again?

    If it were up to them, I wouldn’t be allowed to ride my motorcycle on the same principle.

    Each and every one of our choices has a qualitative aspect attached, and even when the qualitative aspect is a nearly universal value like safety, it varies from topic to topic and from person to person. Experts have no authority whatsoever when it comes to our qualitative preferences, which is why they shouldn’t be allowed to make as few choices as possible on our behalf.

  7. Well, I’ve bitched for a long time about those “Truth dot org” ads that insist that teen vaping is just as dangerous as teen smoking and I think I’ve figured out where they’re getting their data from – even though there have only been a handful of teens developing respiratory illnesses from vaping, it’s still a larger number than the number of teens who have lung cancer from smoking, isn’t it? I’ll bet the number of teens who have died from lung cancer from smoking is pretty close to the same number of teens who have died of old age.

  8. Maybe this is a get-off-my-lawn moment (and I’m not even 40!), but for the life of me, I cannot figure out why the frick anyone would want to consume or be associated with something described as “dank”:

    dank / dæŋk /
    , dank·er, dank·est.
    unpleasantly moist or humid; damp and, often, chilly:
    a dank cellar.

  9. Sorry, Jake, the mob has spoken! Monrail, monorail, MONORAIL!

  10. Funny how you don’t hear much about vaping anymore in the news now that everyone is freaked out about Coronavirus. Oh wait-maybe vaping causes cornonavirus? Quick! Give me some grant $ and alert the media

  11. If Marijuana were 100% legal with no restrictions or regulations, would all of it be black market?

  12. Buying vape cartridges on the street is just stupid. Like buying moonshine from some guy in an alley behind a legal liquor store.

    I bought one of those throwaway vapes on a recent visit to San Diego. Called up the weed store, they delivered it to my hotel. Didn’t cost much more than it did in Colorado.

    It ain’t about the money really, it’s about people’s stupidity.

  13. This is very Amazing when i saw in my Acount 8000$ par month .Just do work online at home on laptop with my best freinds . So u can always make Dollar Easily at home on laptop ,,.. Read more

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