An organization for safe medical cannabis products is calling for the state to test cartridges used in e-cigarette devices for two substances suspected of being involved in hundreds of lung illnesses and a dozen deaths across the country.
Rita Montoya, director of Americans for Safe Access Maryland, urged the commission to begin testing for propylene glycol and vitamin E acetate — two substances that have not been definitively linked as the cause of lung illnesses. Montoya said the state must work to verify that medical cannabis products in the state are free of the substances as claimed by the industry.
“We appreciate their prompt attention to this matter and their commitment to transparency so that patients may make informed medical decisions,” said Montoya. “Safe Access Maryland maintains the belief that the only way to ensure that medical cannabis patients are not exposed to harmful ingredients such as propylene glycol or vitamin E acetate is to require license holders to test their vaping products for these ingredients. Without well-regulated, third-party laboratory testing for these ingredients, Maryland medical cannabis patients cannot be assured that products they are purchasing and using are in fact safe.”
Requests for comment from the state cannabis commission went unanswered.
Mackie Barch, chairman of CANMD, the state trade association for growers and processors, said the bigger concern is black market devices.
“Maryland already has some of the most stringent testing standards in the country,” said Barch. “We need to get the word out that if you’re buying off the black market you’re literally playing with your life.”
Barch said more testing is not needed.
“This is a complete enforcement issue,”said Barch. “We hate the fact that the vaping issue is happening, even though we’re not connected to it, because it leaves a black mark on the industry.”
So far, more than 800 cases of e-cigarette lung illnesses have been reported in 46 states and one U.S. territory. A dozen deaths have been confirmed in 10 states, according to the Centers for Disease Control and Prevention.
Symptoms of the illness include shortness of breath and pain associated with breathing and cough. Nausea, fever, vomiting and diarrhea are also symptoms.
About 77 percent of those cases reported using cannabis-related vaping products but also used nicotine products. More than a third of cases reported exclusive use of cannabis e-cigarette products, according to the centers.
Barch said there are questions about the statistics because so many affected are under 18. He and others believe the use of cannabis vaping cartridges is being underreported. Those cartridges are likely illegally made on the black market, he said.
“When you buy on the black market you have no clue what you’re getting. It might not even have THC in it,” said Barch.
As of last week, 20 cases of the lung illness have occurred in Maryland and include persons using cannabis and nicotine products, according to the Maryland Department of Health.
“We, as a Maryland industry, are aware of some ingredients that, when inhaled, appear to cause significant harm to users,” said Montoya. “Safe Access Maryland maintains that the only way to ensure that Maryland medical cannabis patients have safe access to their medication is through comprehensive, patient-focused regulations and testing standards.”
Vitamin E has been identified as a potential cause of the illnesses. The CDC reports that it is testing for a broad range of substances in vaping cartridges, but so far none, including vitamin E, have been found in all of the samples.
The compound is found in common household oils such as canola and sunflower oil. Barch said some do-it-yourself black marketeers can make their own product by soaking low grade marijuana in those oils. The active chemical in marijuana is fat soluble.
The resulting oil will vaporize in an e-cigarette but returns to a oil state when it cools. That oil would coat the inside of the lungs and cause illnesses, said Barch.
Earlier in September, the commission quietly issued a directive to medical cannabis licensees and patients warning of potential illnesses related to medical cannabis vaping. Licensees were told they were required to report suspected illnesses related to the products.
The memo was sent to patients and licensees but did not appear on the commission’s website. It was released after The Daily Record filed a Public Information Act request.
In Maryland, scrutiny of e-cigarette devices used in the medical cannabis industry has increased since June when the commission issued a warning about the potential for heavy metals and other contaminants.
The commission issued the warning after a 2018 Johns Hopkins University School of Health report raised concerns about toxins in vaping devices. Researchers tested e-cigarette devices of 56 patients and “found that significant numbers of the devices generated aerosols with potentially unsafe levels of lead, chromium, manganese and or nickel.”
But the commission issued no recalls of products. Some advocates complained the commission wasn’t doing enough to protect the health of medical cannabis patients, whose health is already compromised.
Currently, the commission requires vaping products testing for contaminants including heavy metals, microbials and pesticide residue.