Some New York doctors suspect drug dealers selling contaminated THC oils are causing mysterious vaping-related lung injuries, but the secretive world of illicit marijuana use is hindering their investigation.
New York’s 34 lung injuries are mostly ages 17 to 30 and started showing up at emergency rooms in July after vaping of tetrahydrocannabinol, known as THC, the psychoactive element of marijuana, doctors said.
Some of them were also vaping nicotine, but the probe has narrowed in on cannabis use as the culprit, doctors and state health officials said. It’s part of 215 vaping injuries being investigated across the country, prompting federal officials to issue alerts against vaping nicotine or marijuana until a cause is determined.
Many of the otherwise healthy young men and women in New York complained of pneumonia-like symptoms with shortness of breath, fever and coughs. But some were also vomiting, and one was coughing up blood, doctors said.
Close to a dozen required week-long stays at intensive care units and several remain hospitalized. Many of the 34 patients recovered after receiving supplemental oxygen or steroids, doctors said.
Health officials noted the youngest patient was 15 and the oldest was 46.
What were they doing?
Most of the youths’ stories suggested they used vaping devices commonly called e-cigarettes to get high on illicit THC products, rather than drugs sold in states that legalized marijuana for recreational or medical use, according to doctors and health officials.
New Yorkers' tales of using black-market marijuana oils and THC vape cartridges were often elusive, however, due to fears of legal trouble and general distrust of authority in the drug using community, doctors said.
“Getting a detailed accurate history with this age group is very difficult because they don’t want their parents to know they’re doing it,” said Dr. Timothy Collins, whose team treated two vaping injuries at Vassar Brothers Medical Center in Poughkeepsie.
Beyond keeping loved ones in the dark, their silence is facilitating the flow of potentially dangerous THC products being sold everywhere from shady street corners and music festivals to school hallways in New York.
It’s forcing health officials and doctors to solve a medical mystery without key clues, such as the e-cigarette devices involved in each case, sources of THC and patients’ true vaping habits.
Some of the youths still kept many THC vaping details secret after their lungs temporarily failed.
“Even after having just been intubated on a ventilator, he still didn’t seem to understand the significance of the illness that he had been through,” said Dr. Jamie Wooldridge, recalling her talk with a 16-year-old at Oishei Children’s Hospital Buffalo.
Alert: New York announces investigation of vaping-related injuries
Drugs: How NY drug dealers are selling illicit THC oils
Further, some of the tight-lipped patients aren’t providing samples of the THC products, which can be tested for contaminants that some doctors believe sickened people.
Identifying any labeling or branding also helps track the injuries through shadowy drug smuggling networks, doctors said.
“Just like they would bring a tick or a spider that bit them into the hospital, we encourage them to bring in the cartridges or whatever they’re vaping,” said Dr. Daniel Croft, who has treated 11 vaping injuries at University of Rochester Medical Center’s Strong Memorial Hospital.
Meanwhile, public health officials in 25 states continued to investigate severe pulmonary diseases linked to vaping. Two suspected vaping-related deaths have been reported, including one in Oregon that involved marijuana oil bought at a state-sanctioned recreational pot shop.
What New York doctors are finding
While authorities emphasized vaping nicotine remains a potential factor, investigators are trying to unravel the dark web of illicit marijuana sales in the race to contain the spate of vaping injuries.
Some public health officials and doctors have started finding potential links between the cases.
Some of the vaping injury patients in Rochester and across the country, for instance, described recent changes in black-market THC, such as drug dealers offering deep discounts and thicker oils that should raise alarms of potential additives and contaminants, Croft said.
“At least a few of the (patients) were indicating the counterfeits may be using some kind of thickener to try to fool users,” he said.
In Rochester, doctors also found some patients reported using THC products labeled Dake Vapes and Naked 100 Lava Flow, Croft said, urging people to be cautious about using any brands due to rampant deception in the pot marketplace.
“A few folks had given brand names, but with the counterfeits slapping a label on is common, so I don’t know how much stock I have in that,” Croft said.
Further, testing done by New York health officials returned some evidence that black-market cannabis oils containing a vitamin E-based additive are sickening people.
About 12 vaping injury samples from across the state had high levels of vitamin E acetate, which isn’t found in medical marijuana sold through New York’s state-licensed businesses, according to Jill Montag, a Department of Health spokeswoman.
Many of the cases in Rochester also involved the older vaping devices with larger tanks and batteries as opposed to the newer models, Croft said, but several patients also described using knock-offs of the newer designs mimicking the Juul brand.
More: NY AG subpoenas financial advisers, banking institutions tied to Sacklers, Purdue, opioids
More: New York marijuana: Will New York allow for smokable medical pot?
New York lung injuries
Of the vaping injury cases in New York, 13 were in western New York and six were in New York City. Westchester County, Dutchess County and the Capital Region each have four cases. And one case was also on Long Island, Montag said Wednesday.
Yet some doctors treating the patients suggested the epidemic’s toll is likely higher due to delays in identifying the threat across the country, as well as the inherent complexity involved in diagnosing lung illnesses.
“I don’t think the awareness was there around vaping risks,” said Dr. David Pierce, chief medical officer at Buffalo General Medical Center.
“You end up kind of in this position where you’re treating them for pneumonia as well as trying to give them anti-inflammatory care due to an injury from God knows what chemicals that could be in the vaping cartridges,” he said.
Some of the more severe illnesses required running fiber-optic scopes into the lungs to scan for infections, Croft said.
“It does appear to be more of this acute inflammation of the lungs rather than an acute infection, but some of them are so sick that we have to cover them for infection,” he said.
Differences in the vaping stories told to doctors by the injured New Yorkers have also complicated efforts to track down a cause.
Some of the lung injuries hit almost immediately after heavy vaping sessions, for instance, and others developed over days and weeks. Several involved people taking other drugs, smoking cigarettes and manipulating the vaping devices.
“When you’re vaping, it becomes a vehicle for you to add anything to it,” said Dr. Mohammed Aziz, who treated a patient referred through Guthrie Corning Hospital.
Recoveries from the injuries have also varied as the cases are monitored for future lung problems, such as irritant-induced asthma, and doctors urge patients to quit vaping.
“Their lungs need time to heal. They really should not be inhaling any substance into their lungs other than fresh air,” Croft said.
While some of the injured people described being scared enough to quit vaping cold turkey, others seemed less receptive to the risk of future lung complications, doctors said.
One of the patients in Rochester returned to the hospital two days after being released, complaining of coughs and shortness of breath after smoking a cigarette. And a similarly unconvinced teen prompted a dire warning from his doctor in Buffalo.
“I told him if he uses one of these devices again he takes his own life into his hands,” Wooldridge said.
The Associated Press contributed to this report.
More: What to know about CBD laws, New York’s CBD food and beverage ban, FDA warnings on CBD risk
More: Back-to-school vaccines: What to know now that religious exemptions are banned in NY