Vaping CBD carries unique risks
senior lifestyle correspondent
People like vaping because it’s a smokeless, convenient, and fast-acting way to consume pleasure-inducing chemicals including THC and nicotine. It’s also potentially quite dangerous—and that’s also true when it comes to vaping cannabidiol, the popular cannabis-derived compound known as CBD. In fact, thanks to a regulatory no-man’s-land, a consumer craze, and manufacturers who dilute extract with oils better suited for salad dressings, CBD vapes are uniquely risky.
As of Oct. 10, more than 1,200 cases of a mysterious vaping-related illness, and 26 related deaths had been reported to the US Centers for Disease Control and Prevention (CDC), which is advising consumers to “consider refraining” from vaping altogether. Of the 771 patients the CDC previously reported data on, the majority reported vaping THC and/or nicotine. Only about 17% reported having vaped a CBD product, but there is still good reason for CBD enthusiasts to take note—and even to be especially cautious.
“There’s no regulations.”
“There’s no regulations, there’s no one telling companies what to do,” says Jonathan Miller, general counsel for the trade group US Hemp Roundtable. “I don’t want to say it incentivizes bad behavior but it certainly doesn’t crack down on bad behavior.”
While no single brand, product, or ingredient has been identified as the cause of the 1,000-plus cases of vaping-associated pulmonary injury—first called VAPI and now renamed EVALI—we do know that many of the affected patients were vaping illicit, and therefore unregulated, THC products. Tests showed many of those contained vitamin E acetate, an oil derived from vitamin E—which is considered safe for skincare but not for inhalation.
We can’t reasonably expect dealers of illegal cannabis vapes would test their products for safety or share ingredient lists with customers. The thing is, consumers can’t necessarily expect that sort of testing or transparency from manufacturers of hemp-derived CBD vapes either—even if they’re buying them from vape shops, specialty stores, or websites that don’t appear to be breaking the law. The category is completely unregulated. And reckless players are not limited to labeling their products as THC. In September, the Associated Press tested 30 vape products marketed as CBD from brands that authorities had flagged as suspect, and found that 10 contained dangerous synthetic marijuana and many had little to no CBD at all.
While the US Food and Drug Administration (FDA) has been struggling to research and regulate both CBD and vaping separately, the agency has allowed manufacturers to flood the market with both types of products. In the FDA’s eyes, none of these products are legal, as they have not been evaluated or regulated for their safety. And where these two categories overlap in CBD vapes is a grey area that’s ripe for exploitation at the risk of consumers’ health. According to analysts at Cowen and Company, that grey area was worth an estimated $40 million in sales in 2018.
Meanwhile Miller, along with many others in the cannabis and hemp industries, is eager for lawmakers to create legal frameworks for their products. They point to the reported illnesses from black-market vapes as proof that a legal, regulated cannabis market is a safer one.
A brief legal primer
The difference between cannabis and industrial hemp in the eyes of US law is the content of THC, the intoxicating compound in cannabis: If a plant contains more than 0.3% THC by dry weight, it’s cannabis, and still considered federally illegal despite the many states with legalized recreational and medicinal use. If it’s less 0.3% THC by dry weight, it’s considered hemp, which is being incrementally regulated by government agencies. The 2018 Farm Bill removed industrial hemp from the Controlled Substances Act, essentially declassifying it as a dangerous controlled substance of no medical use, clarifying its status as an agricultural product, and making it legal under federal law under some circumstances.
In May of this year, the FDA held a public hearing where more than 100 stakeholders—patients, manufacturers, and researchers among them—testified about their experiences with CBD. Now, the industry is waiting for a timeline for regulation, which was expected this autumn, but has yet to appear. In the meantime, the FDA considers interstate sale of CBD as a food additive or nutritional supplement (ie., all those candies, canned sodas, and tinctures) to be illegal. But it’s not enforcing the law so long as operators in the estimated $590 million market for hemp-derived CBD adhere to the broader rules for the categories they fall in, whether that’s food, supplements, or cosmetics.
But here’s where it gets complicated, because the FDA hasn’t regulated vaping yet.
“You get kind of a double grey area here,” says Miller. “CBD is considered illegal by the FDA, and vaping is now viewed pretty hostilely by the FDA. It really is a great unknown … Without the FDA engaged formally, it makes it a lot tougher for consumers to figure out what’s a good product and what’s not.”
You might be safer with weed
If you’re in a state where weed is legal, you might be safer smoking (or vaping) it, by going to a licensed dispensary for a high CBD-strain or vape that’s subject to the same regulations that cannabis is. In states like California and Oregon, where cannabis is regulated by state agencies, products with THC are subject to testing for contaminants such as pesticides, heavy metals, solvents, and mold-related toxins. Again, hemp-derived CBD products are currently subject to … nothing.
“It’s the wild, wild west,” says Aaron Riley, the CEO of the Los Angeles-based cannabis testing lab CannaSafe, of the CBD landscape. Riley says that many of the CBD products CannaSafe tests would fail if they were subject to the same exacting standards as products containing THC—but they’re not. “You don’t have to get licensed. You don’t have to do any type of testing at all.”
Which isn’t to say that no one is testing CBD products. As the Hemp Roundtable’s Miller said, “some very well-meaning companies will try to promote the best practices.”
Some of those companies are those that come from the cannabis industry, and therefore have years of experience with extraction and testing.
The northern California-based company Bloom Farms—which has been in the cannabis extracts business since 2014—started selling hemp-derived CBD products online in January, and puts them through the same testing processes as their products with THC, which are under the strict purview of the California Bureau of Cannabis Control. Customers can also download a certificate of analysis from Bloom’s website that provides test results from a third-party lab, but that’s far from standard in the CBD space.
An oily situation
And of course, not all CBD vapes are created equal. Many extracts sold in vape pens and cartridges are diluted with other substances, such as medium-chain-triglyceride, or MCT, oils—fats that are frequently derived from natural sources such as coconut oil. While these are known to be safe to eat—and are often found in CBD tinctures—there’s little if any evidence that it’s safe to vape them, despite some manufacturers touting them as an all-natural ingredient.
“It’s totally horrifying to me,” says Katie Stem, an herbalist who cofounded the Oregon-based cannabis company Peak Extracts in 2014, and has researched plant medicine and chemistry at Oregon Health & Science University. “People should not be cutting [cannabis extracts] with any sort of culinary lipid.” Stem says that with an extraction process using carbon dioxide as a solvent, it’s possible to create a vape-able distillate containing only plant material, without any additives.
Quartz contacted two manufacturers of CBD vape pens that contain MCT oil, and neither has replied to our messages. Bloom Farms’ unflavored CBD vape contains no MCTs or other cutting agents. The company’s flavored CBD vape pens contain trace amounts of MCTs—less than 0.3% according to a company representative—and the company is currently phasing them out.
Neal Benowitz, a professor of medicine at the University of California, San Francisco, who has studied the pharmacology of e-cigarettes, says that CO2 extraction process is “pretty clean,” and the results are well-known.
“People have been vaping them for a long time, and haven’t had a problem,” he says. “That seems to be relatively safe, and that’s a solvent that dissolves them. The question now is, when you start messing with that process, what are you adding to it?”
Benowitz said the effects of vaping MCT oil, however, is an understudied area.
“I’m concerned about it,” he says. “But I don’t have any data.”
Stem speculates the tendency to mix cannabis extract with MCTs might come down to greed or ignorance, and a misunderstanding of the term “cannabis oil,” which is something of a misnomer since CBD and THC extracts are not fatty lipids at all.
“They think, ‘Oh, it’s an oil. I can mix it with another oil and that will thin it and it will make it easier to flow into our vape pen,’ and it’s not harmful because we’re already smoking oil. Well, no. Cannabis extract is not an oil,” says Stem.
Kathryn Melamed, a pulmonologist at University of California, Los Angeles, Medical Center who has seen patients affected by vaping, agrees that smoking oils can be dangerous, and notes that the vaping-related illness bears some resemblance to lipoid pneumonia—a direct reaction to lipids or oils in the lungs.
“While one type of substance—like vitamin E or maybe some other oil—can be ingested and metabolized through the gut, the lung just doesn’t have that ability,” she says. “So then it becomes much more dangerous, and a particle that the lung wants to try to fight and expel. And that’s the inflammatory response that you get.”
A regulatory no-man's land and a consumer craze have created a perfect storm of untested oils for vaping.
Everything You Need to Know About Vaping CBD Oil
Sean is a fact checker and researcher with experience in sociology and field research.
Vaping has been around for more than a decade now and is growing in popularity—especially among teens and young adults. One of the newest trends impacting this growing vape culture is the desire to vape cannabidiol (CBD) oil. In fact, using this oil in vape pens is becoming increasingly popular and the industry is expected to grow exponentially over the next few years according to the Brightfield Group, a firm that studies the CBD market.
Part of the draw to CBD oil in areas where marijuana has been legalized is the fact that it has been touted as helping treat a host of medical problems. Some of the medical issues people claim that the oil treats include epileptic seizures, anxiety, inflammation, and sleeplessness. However, there is very little evidence backing up these claims with the exception of treating epilepsy.
In fact, the Food and Drug Administration (FDA) has approved only one CBD-based medication, which is used to treat seizures associated with two severe forms of epilepsy. But, when it comes to CBD in general, they stress that it cannot be added to food, drinks, or dietary supplements. And although the FDA has warned manufacturers against making unproven health claims, it has not done much to stop the sale of CBD products.
What Is CBD Oil?
CBD oil is extracted from the flowers and buds of marijuana or hemp plants. Typically, it does not produce a “high” or intoxication because it contains very little, if any, tetrahydrocannabinol (THC). In fact, CBD oil is only permitted to contain less than 0.3% of THC. CBD oil is legal in states where medicinal or recreational marijuana is legal. Meanwhile, several other states have CBD-specific laws on the books even though marijuana is not yet legal there.
According to the FDA, it is currently illegal to market CBD by adding it to food or marketing it as a supplement. Despite these guidelines, they warn consumers that some CBD products are being marketed with unproven medical claims and are of unknown quality. They also caution consumers that CBD can harm the liver and may interact with other medications you are taking. And, it may even have a negative impact on male fertility.
Is Vaping CBD Oil Safe?
Generally speaking, vaping is an unsafe practice regardless of what substances are in the vape pen. And, CBD oil is no exception. In fact, the Centers for Disease Control and Prevention (CDC) has recently linked vaping products to an outbreak of nearly 3,000 lung illnesses that were so serious that even young people were being admitted to the hospital. Meanwhile, nearly 70 people have died from what is now being called EVALI (e-cigarette and vaping associated lung injury). And, the CDC believes thousands more may have admitted to the hospital with lung issues related to vaping.
Although the CDC has traced many of the EVALI hospitalizations back to vitamin E acetate, a substance used to dilute oils used in vaping, the risks of vaping CBD oil are not without risk, especially if the vape pens are obtained from illicit dealers, online sources, or friends. At least 26 of the EVALI cases were hospitalized after vaping CBD oil.
Additionally, numerous scientists, doctors, and researchers are concerned with the safety of inhaling CBD oil because little is known about the long-term effects. What’s more, when vaping devices are heated, a chemical reaction takes place in the vapor, which could pose additional risks to the lungs, especially in young people.
And despite the fact that the 2018 Farm Bill removed CBD from the definition of marijuana in the Controlled Substances Act, it is still subject to the same laws and regulations as other substances monitored by the FDA. Unfortunately, though, there is very little regulatory oversight of CBD oil in general—even though vaping is one of the most popular ways of using the oil. In fact, the FDA has not yet determined how to regulate CBD vaping products just yet.
But many people are hoping those regulations will happen soon. Even the CBD industry is concerned and asking for oversight. For instance, without more regulations, organizations like the U.S. Hemp Authority are unable to certify CBD oils as it does with CBD topicals, tinctures, and edibles. And, until that happens, consumers have very little way of knowing what they are getting when they purchase a CBD oil.
To make matters worse, this lack of certification has lead people to sell vaping liquid they claim contains CBD oil when it actually contains harmful chemicals, which is injuring and killing people in the process. To determine the extent to which this is occurring, the Associated Press (AP) commissioned a study to analyze the contents of nearly 30 oils claiming to contain CBD.
Their testing was completed by Flora Research Laboratories in Grants Pass, Oregon, which is licensed and inspected by the U.S. Drug Enforcement Administration. What they discovered is that 10 of the 30 vapes contained synthetic marijuana while others had no CBD oil at all. Additionally, eight oils had no detectable level of CBD while 14 were less than 0.3% CBD by weight. The other six ranged between 1.07% and 8.87% CBD by weight.
Because this testing was a such a small sample, the AP noted that their sampling is not representative of the entire CBD market. However, their testing does show just how risky it is to vape CBD oil when there is little to no regulation of the product. Vapers have no idea what they are getting when they take a puff.
A Word From Verywell
If you are considering vaping CBD oil as a way to address a medical concern, talk to your doctor first. The risks associated with vaping and CBD oil are significant and may not provide the benefits you want.
And if you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see Verywell’s National Helpline Database.
Vaping CBD oil is common, especially after claims about its medicinal properties. But, is it true? Sort out the facts about CBD oil and its safety.