As Number Of Vaping-Related Illnesses Climbs, KUNC Asks 'What's In A Vape Pen?'

Sep 23, 2019

Since the first reports of a mysterious lung illness surfaced in August, the latest numbers from the Centers for Disease Control and Prevention are 530 cases, including six in Colorado. Seven deaths have also been associated with this condition, known as a “vaping related pulmonary injury.”

Researchers still don’t understand what’s causing it, just that the patients in question all have a history of using e-cigarettes or vape pens. And while these devices can be used for tobacco, the CDC says most cases of lung illness have reported vaping a marijuana product.

At his lab in Denver, Wonderleaf co-founder Kelby Cross pops the lid off a set of jars, each filled with an opaque, amber syrup. Wearing a pair of black latex gloves, he pulls the golden goo with a metal probe.    

“At room temperature a high-quality oil like this will flow like warm honey,” he said.

Marijuana concentrate at Wonderleaf in Denver.
Credit Esther Honig / KUNC

Wonderleaf specializes in marijuana concentrate, the stuff inside a vape cartridge, i.e. the small plastic tube that fits into a vape pen. The stuff Cross is showing off looks like honey but smells like a citrusy IPA (turns out pot and hops are distant relatives). It has the same flavor as marijauna flower, but it’s easier to inhale and produces less odor than smoking. That’s in part why this past year, marijuana vape products were one of the hottest items on the Colorado market. And Cross says Wonderleaf has found a niche: a concentrate that has nothing extra in it.  

“There is no cut, no filler, no non-cannabinoid containing oils that we ever use,” he said.

Cross uses CO2 extraction to separate the marijuana compounds, like THC and cannabinoids, from the organic plant material. A similar process is used to remove caffeine from coffee. In the simplest of terms, liquid CO2 is washed over the marijuana plant in a special machine, and then the CO2 is converted back to gas, breaking down the plant and separating out the marijuana concentrate (here’s a link to learn more about the process).

Credit Esther Honig / KUNC

Cross says CO2 extraction can take more time and the equipment requires upfront costs. He says other manufacturers might opt for a quicker route, like distilling marijuana with ethanol, which creates a THC concentrate. But that has to be mixed with a thickening agent — typically oils like vegetable glycerin or propylene glycol.

“It takes a lower quality product and makes it look better for longer,” Cross says. 

At Wonderleaf, Cross said they have a strict policy of “no additives ever” because there’s not enough research on the effects of these ingredients once inhaled. And while the CDC has not identified any one ingredient responsible for the illnesses, these additives are being closely examined — they’re commonly found in both tobacco and marijauna vape products.

To be clear, federal and state investigations still have a lot to pin down. The CDC doesn’t even know if this is a new outbreak of a disease or if we’ve just started to detect it, and it’s been around essentially since vapes hit the U.S. market in the mid-2000s.

Many experts point to the general lack of research and oversight when it comes to vaping. The Food and Drug Administration has postponed regulating many tobacco vape products until 2021. 

In Colorado, the Marijuana Enforcement Division says that while they regulate how the marijuana concentrate is made, their rules don’t apply to vaping products

That’s led many in the marijuana industry to call for legalization at the federal level. This would allow federal research and oversight on all marijauna products says, Morgan Fox with the National Cannabis Industry Association.

“Federal prohibition obstructs research,” Fox said. “It prevents the FDA and similar federal agencies from researching and developing safety protocols and guidelines for cannabis and cannabis products.”  

Guidelines that he says manufacturers welcome. In fact, legalization would replace the illegal marijuana market in many states, where some of the affected patients reportedly bought their vape products. 

Many in the marijuana industry have been quick to place blame on illicit dealers, who operate with zero oversight and perhaps less regard for consumer safety. But Daniel Shodell, the medical director of disease control at the Colorado Department of Public Health and Environment, says it doesn’t matter where you buy your vape products — so little is known about the potential dangers.   

“I don’t think the most important distinction is legal versus illegal,” he said.

In fact Shodell, along with the CDC, suggests people discontinue vaping until more is understood. Meanwhile, he says one emerging theory has to do with lipids, for example those oils that are sometimes added in the vape liquid. Shodell says bringing oil into the lungs causes them to shut down.

“This is something that’s been known to science for a very long time,” he said. 

As investigations continue, manufacturers like Kelby Cross are waiting for more information. As soon as it’s determined what’s wrong, he says the industry is prepared to adapt.   

“This all is very uncharted territory. The industry has to be very reactive, very nimble and so far we've demonstrated that we are,” Cross said.