It’s all over the news. Vaping is dangerous, no it’s better than smoke. The problem involves tobacco. No, THC. Additives should be outlawed – no – marijuana should. If you’re confused, concerned or even cautious, let’s shed some light on this new health problem.

First, who started vaping? Inventor Herbert A. Gilbert first conceptualized a “smokeless non-tobacco cigarette” device for inhaling vapors in 1963. Phil Ray, a NASA engineer and father of the desktop computer,” coined the term “vaping” in the early 1980s as part of his push to reduce cigarette risk with a device that eliminated the toxic byproducts of smoke while leaving nicotine. In the cannabis world, the famed “Volcano” created by Markus Storz and Jürgen Bickel hit the market in the mid-2000s. A 2007 study published in the Journal of the American Academy of Neurology found that "there was virtually no exposure to harmful combustion products using the vaporizing device."

What is vaping? Vape or vaping can be practiced in several forms that include the stationary metallic “Volcano,” a portable dry herb vaporizer and a “e-cigarette,” which, as the name implies, can look like the famed tobacco product. The objective is to heat either dried herb or oils to a temperature just below combustion so that the resulting vapors can be inhaled.

The high in marijuana is derived from THCA, or tetrahydrocannabinolic acid, a non-intoxicating cannabinoid found in the raw plant. To enable psychoactivity and absorption of vapors by the lungs, the plant material or its oils must be decarboxylated (remove carbon), which necessitates heat. To produce the vapors without fire while retaining cannabinoid integrity – 30 percent of THC can be lost with smoking – a heating element called an atomizer raises the internal temperature in the vaporizer to a noncombustible range of 200-450° Fahrenheit.

While the herbal plant is consumed via the Volcano or a dry herb vaporizer, the e-cigarette utilizes extracted oil stored in a small refillable tank or single-use, screw-on cartridge. Pressing a battery-operated button activates the atomizer, which causes the oil to saturate a small wick. The heat transforms the oil into the inhaled vapor.

Is vaping a health problem? It should first be made clear that recent issues concerning vape only involve e-cigarettes. Reducing exposure to toxic byproducts of smoke remains a healthful goal and plant material needs no thickening. Viscosity agents, additives, solvents and pesticides can be present in or added to oils at some point during processing, depending on who does the processing. That is believed to be the nexus of the current “vaping crisis.”

Otherwise healthy individuals in acute respiratory distress began appearing at hospital emergency rooms earlier this year. Common symptoms include shortness of breath, fatigue, coughing and fever, indicative of pneumonia but without a bacterial or viral infection. The common denominator appears to be illicit e-cigarettes most containing THC, but in a few cases, also nicotine.

While public health officials remain unclear whether this illness is associated with the e-cigarette devices themselves, or with specific ingredients or contaminants inhaled, a few clues are emerging. One focus has been chemical exposure to contaminants in illicit THC vaping products. A significant subset of patients inhaled THC suspended in vitamin E acetate, a common thickener that first appeared in vape pens near the end of 2018. Inhalation of this agent can trigger an immune response in the lungs that can lead to a rare form of pneumonia.

On August 31, 2019, the Center for Disease Control issued the Official Health Advisory: “Severe Pulmonary Disease Associated with Using E-Cigarette Products.” As of that date, 215 possible cases of a severe pulmonary disease had been reported from 25 states. One month later, that number has risen to 530 in 38 states with 8 deaths. The FDA has now launched a criminal investigation.

What should be done? If you or someone you care about experience significant lung symptoms related to vaping, visit a doctor. In its Advisory, the CDC recommended that those who use e-cigarette products refrain from purchasing them from the illicit market, in their words, “off the street.” According to the Ohio Medical Marijuana Control Program, although Ohio has a few cases, none are related to vape products sold by program licensees.

And that’s an important point. Is prohibition the real culprit behind the vaping crisis? Some legalization opponents are capitalizing on the crisis to urge shutdown of the new industry. Federal bans are already in the works for some e-cigarettes. But consensus holds that prohibition doesn’t work. At the federal level, it has handcuffed cannabis research for a half century, including inquiries into the causes of the vaping crisis, and has allowed unscrupulous actors to thrive at the expense of public safety.

So, in the final analysis, one factor can be gleaned from what we know so far about vaping: it is most dangerous when it is illegal.

Product review: Patches

For those with a bad case of arthritis, there may be a new kid on the block to assuage pain: THC patches. Transdermal patches attach to the skin and release THCA, a precursor of THC, over time. Skin absorbs the THCA and the compound in turn reduces pain and inflammation, with the added benefit of improving mood over a longer time period without the high of smoking or vaping. Patches can be discretely applied during the day or affixed to work their magic overnight. Body heat activates the patch to release the THCA.

Patches can be purchased from Ohio dispensaries (if you can find one in your area). They come in packages ranging from one to five to 14 per package at respective prices of around $10, $65 and $175. The biggest obstacle lies in opening the package, but once that difficult task (especially for arthritis patients) is accomplished, a new and welcome experience in the consumption of medical cannabis can be had.