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Vaping. Marijuana. An Update from Dr. Stephen Fries

by Dr. Stephen Fries
Pediatrics Department
Boulder Medical Center

As of summer of 2019, vaping is at epidemic level in high schools. The pressure to vape is enormous for teens; it is “cool.” Colorado has the highest percentage of vaping high school students in the country. However, more and more hazards are being reported through various public channels and there are word-of-mouth stories of problems.

Heavily reported are problems with vape pens exploding in pockets or purses, or while being vaped. These devices cause serious bodily injury to the victim. The pens that have exploded in victims’ faces have caused permanent serious injury and blindness.

The newest reports involved severe acute lung disease from vaping, mainly in men, the mean age being 23 years old. Colorado recently had its first case, and so far there have been six death nationwide due to lung illnesses related to e-cigarette use. We believe there is something in the way vape pens work that causes acute toxicity in some individuals, but so far there is no common cause among the patients who have acute lung damage.

I have spoken to a dentist who states the vape pens deposit chemical residue on the teeth. The residue is difficult to remove and trap bacteria under the chemicals, causing rapid decay. He said he filled 13 cavities in one patient who vapes, only to have the patient return to fill another 19 cavities.

According to the organization, Truth Initiative, one JUUL pod contains 20 cigarettes worth of nicotine. Nicotine is more addictive than opiates; once addicted, it is very difficult for a person to stop using. Also according to the Truth Initiative: “Early nicotine use can harm brain development, alter nerve cell functioning and increase the risk of young people smoking cigarettes. In fact, young people who use e-cigarettes are four times more likely to go on to smoke cigarettes than their peers who do not vape.”

It’s common sense that any product that is burned and inhaled into the lungs is damaging to the lungs. Unfortunately, vape pens are not regulated, especially those that burn marijuana and other THC oils.

Another look at cannabis from a medical perspective

Through the years, I have observed impacts of cannabis use on my patients and larger community. Here are a few updates:

  • Pesticide Use & Cannabis:  According to a 2019 Environmental Health Perspectives (EHP) report, toxic pesticide use on cannabis is questionable, as well. The EHP explains, “pesticide use in agriculture is regulated by the U.S. Environmental Protection Agency (EPA) and overseen by state and local governments. Yet because the federal government still considers cannabis an illegal drug, the EPA has not approved any pesticides for use on the plant, nor has the agency provided any indication of the level of residues on cannabis products—if any—that could be considered safe.” I have been told that marijuana growers use the cheapest insecticide they can find to prevent insect infestations in their crops, and these pesticides are not washed off before the marijuana is smoked – a harmful combination.
  • Cannabis Toxicity:  The medical community is also seeing more toxicity from marijuana due to the high THC content of cannabis sold in states like Colorado, where it is legal. Reports of acute and chronic psychosis (a thought disorder such as schizophrenia) are common. Teens and young adults present to emergency departments with hallucinations and paranoia, symptoms which sometimes become chronic or permanent.
  • Pernicious Vomiting: Another symptom that we are seeing is “pernicious vomiting”, which is excessive vomiting. In fact, the condition known as cannabinoid hyperemesis syndrome (CHS) is a condition that leads to repeated and severe bouts of vomiting.
  • Lung Health:  Because marijuana is usually smoked, years of smoking will cause chronic lung disease just like cigarettes. According to the American Lung Association, “Smoke is harmful to lung health. Whether from burning wood, tobacco or marijuana, toxins and carcinogens are released from the combustion of materials. Smoke from marijuana combustion has been shown to contain many of the same toxins, irritants and carcinogens as tobacco smoke. Beyond just what’s in the smoke alone, marijuana is typically smoked differently than tobacco. Marijuana smokers tend to inhale more deeply and hold their breath longer than cigarette smokers, which leads to a greater exposure per breath to tar.”