Friday, April 16, 2021

The Mechanics of Vaping and Its Medical Impact on Your Health

Is it a suitable delivery mechanism for Marijuana?

With the growth and impending legislative changes to the status of marijuana within the US, I have been watching with interest, both the medical claims made relating to its efficacy and the proposed delivery mechanisms for getting the product to its endpoint. It’s a massive and profitable business for large companies that are investing heavily in product development and many focus on delivery systems that rely on a vapor-based carrier. Is this potentially harmful to the lungs?

Aurora Cannabis

Aurora is a publically traded company on the NYSE and is a constituent of the S&P/TSX Composite Index. According to its latest press release,

Aurora is a global leader in the cannabis industry serving both the medical and consumer markets. Headquartered in Edmonton, Alberta, Aurora is a pioneer in global cannabis dedicated to helping people improve their lives. The Company’s brand portfolio includes Aurora, Aurora Drift, San Rafael ’71, Daily Special, AltaVie, MedReleaf, CanniMed, Whistler, and Reliva CBD. Providing customers with innovative, high-quality cannabis products,

The infographic below will provide you a sense of the money involved in these companies and the value of the markets from the sale of CBD and recreational marijuana.

Image Source: Aurora Cannabis
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Marijuana is having its moment and in the ensuing gold rush to monetize the market, companies will develop new and innovative treatments, many of which will rely on the “vape” as the delivery mechanism of choice. According to Aurora;

“For the period, our core revenue strength in medical and consumer was complemented by initial rollouts in vape products and concentrates.

The question this article seeks to address, is exactly how safe is vaping? Set aside for the moment the fact that most research centers around nicotine-based vaping products. What medical literature exists to support the fact that the delivery of a now sanctioned “medical treatment” (let’s call it what it is, marijuana isn’t being legalized because it takes the edge off on a Friday night) via inhaled vapor is a good idea?

Your lungs are the designated target for Vapes, and in case you weren’t aware of this, our lungs aren’t the most spectacularly robust organ we possess. While they are able, over time to affect minor repairs, serious damage is irreversible. There is no reset or repair button for our lungs. Damage can be permanent and the impact on our health extends beyond the essential ability to draw breath.

Our lungs are the frontline of the body’s immune system. Every breath you take exposes the body to a potential infection. The condition of your lungs dramatically impacts the efficacy of your body’s immune response, for instance, to Covid. Compromising the proper functioning of your lungs by coating them in goo (vape oils) or keeping them in a constant state of irritation, can and often does, cost you your life. Healthy lungs are critical to a properly functioning immune system,

Image courtesy of Additude Mag

How A Vape works

Most of us are familiar with nebulizers. These medical products deliver a targeted and soothing dose of medication directly to your lungs. Vapes utilize the same mechanism with a few tweaks. Vaping involves heating a substance and inhaling the resulting fumes. Vaping devices (typically a vape pen or a mod — an enhanced vape pen — that may look like a flash drive) heat up a liquid (called vape juice or e-liquid) until it turns into a vapor that you inhale.

The delivery system is similar to a nebulizer, which people with asthma or other lung conditions may use. A nebulizer turns liquid medicine into a mist that patients breathe in. It’s a very effective way of delivering medicine directly to the lungs. What happens though, when you introduce other ingredients that aren’t medicines to the lungs, using a vapor-borne delivery mechanism?

What the research says

There isn’t currently enough research to form an accurate picture. We’ve had generations of data with which to analyze the effects of the toxins inhaled via smoking, and while can conclusively link smoking to lung damage, the same cannot yet be said for vaping. Not if we intend to use the term conclusively. There is however more than enough emerging clinical evidence to suggest vaping has serious medical consequences.

If you were merely inhaling good old vaporized water (steam), there wouldn’t be any issues, but that not how a Vape works. It relies on carrier oils and certain chemicals to hold the product being delivered, be it THC(the chemical in marijuana that causes psychological effects) or nicotine, and an industry favorite for carrier oils is Vitamin E.

In Michigan in late 2019, the state agency expanded a recall involving more than 20 different kinds of marijuana-related products sold in the state. The state instituted emergency rules last November to do more product testing after a wave of hospitalizations and deaths from vaping-related lung injuries. According to the CDC, more than 2,000 people had been hospitalized, and 60 people killed from the injuries associated with the presence of Vitamin E Acetate in vaping products.

Aside from the data, which we will examine below, common sense dictates that coating your lungs in any form of oil would reduce their ability to absorb air. You don’t need a medical degree to work that one out. Oil serves as a barrier, pop a few drops in your bath water and watch it do its thing. Dr. Norman Edelman, Senior Scientific Advisor to the American Lung Association. has this to say on carrier oils.

“There are some aerosolized products (or vapes) that contain ‘essential oils’ which are promoted as being healthy but inhaling any kind of oil or other lipid [oils] can be dangerous,”

This isn’t merely conjecture. Clinicians are observing the effects first hand. Johns Hopkins lung cancer surgeon Stephen Broderick. describes first hand what they are observing in patients.

“In the last 24 to 36 months, I’ve seen an explosive uptick of patients who vape. With tobacco, we have six decades of rigorous studies to show which of the 7,000 chemicals inhaled during smoking impact the lungs. But with vaping, we simply don’t know the short- or long-term effects yet and which e-cigarette components are to blame.”

So have they identified any early culprits so far? The carrier oils seem the most likely candidate. Unlike nebulizers that bathe lung tissue with a therapeutic mist, vaping coats the lungs with potentially harmful chemicals.

Broderick suggests that;

“We think that some of the vaporized elements of the oil are getting deep down into the lungs and causing an inflammatory response,”

The carrier oil at the center of the invention is vitamin E. It’s often used as a thickening and delivery agent in e-liquid. While it’s safe when taken orally as a supplement or used on the skin, it’s likely an irritant when inhaled. It’s been found in the lungs of people with severe, vaping-related damage. The likelihood of other oils (MCT) posing the same risk is also supported by early research, it’s simply that the use of vitamin E was favored within the industry. MCT is now replacing it, but recent research suggests the danger remains.

Before we’re accused of picking on the carrier oils, there are also less likely candidates, which, depending on their inclusion in the formulations, also pose risks.

  • Diacetyl: This food additive, used to flavor e-cigarettes, is known to damage small passageways in the lungs.
  • Acrolein: Most often used as a weed killer, this chemical can also damage the lungs.
  • Formaldehyde: This toxic chemical can cause lung disease and contribute to heart disease. Check to ensure any Vape pen you use is set to operate at below 230’C (450’F), preferably below 180’C. The PEG used in Vape oil formulations can degrade at higher temperatures into formaldehyde and acetaldehyde.
Image Courtesy of Bon Appetit

Diacetyl

Let’s examine diacetyl, as its inclusion in vapes is interesting, given what we know about it. Diacetyl is a food additive used to simulate butter flavor in microwave popcorn. Yummy if eaten, diacetyl isn’t meant to be inhaled (there are now emerging concerns about eating it) and we know this for a fact. There is a medical lung condition associated with the product called “popcorn lung”.

Its medical name is bronchiolitis obliterans (BO), a rare condition that results from damage of the lungs’ small airways. BO was initially discovered when popcorn factory workers started getting sick. The culprit was found to be diacetyl. Inhaling diacetyl causes inflammation and can lead to permanent scarring in the smallest branches of the airways — popcorn lung — which makes breathing difficult.

There is no lasting treatment for popcorn lung. The fact the FDA allows for the inclusion and sale of products for inhalation that contain diacetyl is worrying and needs to be addressed. Any Vape fluid that contains diacetyl should be studiously avoided and as an aside, there are over 6000 micrograms of diacetyl in every pack of cigarettes.

Other potential health hazards to consider include developing Exogenous lipoid pneumonia, an uncommon (but on the increase) condition resulting from aspirating or inhaling fatlike material, such as mineral oil found in laxatives, vapes, lip balms and various aerosolized industrial materials. These substances elicit a foreign body reaction in your lungs and proliferative fibrosis in the lung tissue.

Because symptoms are absent or nonspecific and the roentgenographic findings simulate other diseases, exogenous lipoid pneumonia is often unrecognized.

Making responsible choices

Consumers (that’s you and I) cannot rely on businesses and manufacturers to look out for our best interests, particularly where our health is concerned. Business is driven by profit and often with complete disregard for the consequences. Corporate history is littered with telling examples. We have to assume responsibility for our own wellbeing and health.

Enough evidence exists to suggest vaping poses a significant risk to your lungs. If you are reverting to it for your health and to ingest or inhale ingredients that are purported to help you, please think twice. You can approach companies directly to request a full ingredient list of the formulations they sell you.

Vaping now falls under the regulatory oversight of the FDA and they have access to these ingredient lists, should the company involved not be forthcoming.

There are other routes for getting CBD, THC, and marijuana into your system. Ones that do not pose a real and imminent risk to your lungs and your health and you should consider these as the preferred route of administration.

In today’s pandemic society where you rely on a functioning immune system to maintain your health, why risk it? And if you are a modern-day “Cheech and Chong” ensconced safely in your Wall street offices, please consider the health of the public in the development of your marijuana products. It’s the ethical thing to do. It’s the right thing to do.

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PATIENT ADVISORY

Medika Life has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by Medika Life

This article lives here: Alternate HealthThe Mechanics of Vaping and Its Medical Impact on Your Health
Dr Robert Turnerhttps://cre8tive.media
Robert is a Founder of Medika Life. He is a published author and owner of Cre8tive Digital Media. He lives between the Philippines and the UK. and is an outspoken advocate for human rights. Access to basic healthcare and eradicating racial and gender bias in medicine are key motivators behind the Medika website and reflect Robert's passion for accessible medical care globally.

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