The onset of lung injury, which appears to be caused by vascular disease, may level off or even decrease, according to the Centers for Disease Control and Prevention (CDC). And while the federal agency finally blames "most" black market THC products, it continues to use the nicotine vapor term "e-cigarettes" to describe the products that cause harm.
By last Tuesday (the last official update), 1,604 cases had been reported from 49 states (all except Alaska), the District of Columbia and the U.S. Virgin Islands. The CDC says that 34 people from 24 states have died.
The CDC's chief deputy director, Dr. Anne Schuchat, told reporters Friday that those who died ranged in age from 17 to 75, with an average age of 45, which compares with an average age of just 23 for those who survived their injuries. Schuchat said the "vast majority of patients" had a history of vaporizing THC products - 85 percent of those for whom the agency has data.
"Remember, these are self-reports," Zeller said. "It's the person saying, 'I only used the nicotine-containing products. "It raises the question of...actually, when they say I only used a nicotine-containing product". "Zeller notes that many of the victims live in states where cannabis products are illegal, and that many are also minors.
In other words, to avoid complications such as criminal charges or problems with parents, some cannabis users may distort the facts about what they have evaporated. And since patients are treated according to the health regulations of the states in which they live, there is no mandatory THC test on a broad front.
So far, there has been no case of lung injury related to a nicotine product.
CDC still uses the term "e-cigarettes."
The agency unfortunately calls the injuries EVALI, short for "e-cigarette or pest, product use Associated Lung Injury." The CDC seems committed to its misleading reporting and still adds the term "e-cigarette" to the outbreak, even though it itself acknowledges that most victims say they used illegal cannabis oil (or hash oil) cartridges (carts) and not nicotine vaporization products.
Cannabis oil presses do not call their products e-cigarettes. This is a name used only for nicotine weapons. The CDC's continued resistance to the use of terms recognizable by consumers of dangerous products may well be responsible for many of the recent injuries.
The initial reports of the outbreak were handled by the CDC's determined Anti-Vapor Bureau on Smoking and Health, and the entire bureau has continued to use that bureau's terminology ever since, encouraging potentially millions of cannabis oil pressers to continue using dangerous, untested hash oil samples, believing that "e-cigarettes" (nicotine products) were the way to avoid them.
The CDC appears to be using the outbreak of lung injury as a means to promote or at least enable local and national bans and restrictions on nicotine products. Seven states have since the outbreak banned aromatized vapor products, mostly in direct response to the lung injury or at least as a secondary cause. The Trump government has also proposed a federal taste ban, but the aromas in legal steam products have nothing to do with these injuries.
What causes lung damage?
According to the CDC, it is not certain exactly what is causing lung damage in the illegal oil samples. The agency appears to be looking for a new explanation that has not yet been implemented, or a combination of factors. They are testing the lung fluids of the victims and the FDA is checking the contents of products shipped by government agencies.
CDC appears to have ruled out the possibility that recently introduced cannabis oil thinners containing vitamin E acetate were responsible for all or most of the injuries, based at least in part on a Mayo Clinic study that looked at lung biopsies of some of the victims and found injuries not comparable to those of vitamin E acetate.
Vitamin E (tocopherol / tocopheryl) acetate, according to Zeller, has not been found in most FDA-tested patterns. Whether the CDC believes that the diluent plays any role at all in the outbreak – possibly in combination with other factors – is not certain.
Another early proposal was the fungicide myclobutanil, which can release hydrogen cyanide from the lung poison when heated. The use of myclobutanil on tobacco is prohibited.