Can You Die From Vaping CBD?

How safe is vaping CBD? In the United States, doctors have recently reported several deaths and instances of serious lung illnesses related to vaping. This has made CBD users agonise on the possible dangers of vaping. So, can you actually die from vaping CBD?

CBD vape

In vaping, the electronic device—which runs on a battery—is filled with a liquid, in this case, a special form of CBD. The device heats the liquid, turning it into vapour (hence the term vaping). The vapour is then inhaled and enters the body through the lungs.

Vaping is probably the most powerful way of taking in CBD. Through inhaling, CBD enters the bloodstream immediately, rather than being filtered and broken down through the digestive system.

Furthermore, vaping increases the bioavailability of CBD in the body, because it allows CBD to bypass any obstacles such as the digestive system, mouth, or skin. This means that a greater proportion of CBD enters the circulation and achieves a greater impact on the body.

Can you die from vaping?

It reads like a medical thriller but it’s a real — and worrying — story. Throughout the summer of 2019, several US hospitals reported admitting young people with shortness of breath and symptoms that looked like lung failure. The common thread among all patients was that they had been vaping either e-cigarettes or marijuana.

As of October 10, over 1,200 people had developed lung illnesses. Twenty-six related deaths had been reported to the US Center for Disease Control and Prevention (CDC). However, no such cases have been reported outside of the US so far.

So, what caused all these deaths? And why were they limited to the US?

Researchers across US hospitals and the medical community rushed to examine whether there was a specific brand or type of vapour that caused vaping-associated pulmonary injury—first called VAPI and now renamed EVALI. However, the people who were hospitalised had not vaped the same product or brand.

While only about 17% of them reported having vaped a CBD product, most people had vaped nicotine along with marijuana (which contains THC, the hallucinogenic component). Some others had taken only marijuana or only nicotine.

Tests run in the hospitals showed that there were no bacteria, infections, viruses, or other pathogens causing the shortness of breath and the lung collapse.

Experts are still not sure what provoked these lung illnesses. However, researchers have reviewed and researched various possible causes.

What are the dangers of vape pens?

While there’s every indication that CBD oil may benefit you, CBD vape products may well harm you.

Several factors come into play when vaping CBD, from the thinning agents used in the oils, the metals in the coils of the actual devices, and bad quality products, especially synthetic marijuana. All of these have been linked to health troubles.

CBD oils contain much more than just CBD

The growing consensus is that in the case of CBD (and THC, which in the UK remains illegal) it is not the actual CBD or THC that are causing the lung failures but rather the solvents and other compounds used to deliver the oil.

During the vaping process, high temperatures dissolve and vaporise the various solvents and oils. As the temperature drops, tiny oil drops are left behind and enter the lungs as the person inhales. This can cause a build-up of oil in the lungs, which the lungs are not able to cope with. Interestingly, research showed that some patients who were hospitalised suffered from lipoid pneumonia. The process seems to be as follows, from what we know at the moment:

• the unburnt oils enter the lungs;

• the lungs cannot process these droplets, which end up piling up on the lung tissues;

• as these droplets stack up, the lungs perceive them as intruders and start an immune protection process by developing an inflammation around them.

This inflammation, called lipoid because it is built around the oils, leads to lipoid pneumonia.

Inhaling thinning agents

Cannabis extract is a rather thick product that needs to be thinned in order to be heated in an electronic device. Some producers and manufacturers have used polyethylene glycol or propylene glycol as thinning agents. These, however, can split into carcinogenic compounds when they are heated at high temperatures.

The medical community has been looking into whether these thinning agents may have built up in the lungs, causing them to shut down.

There are some suggestions that vegetable glycerine (VG) is better as a thinning agent, but the results are still inconclusive.

Neal Benowitz, a professor of medicine at the University of California, San Francisco, speculates that the tendency to mix cannabis extract with other oils like MCT (commonly derived from coconut oil) might come down to a simple misunderstanding. The term “cannabis oil” is actually something of a misnomer since cannabis extracts are not fatty lipids at all:

People 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.

Inhaling something is different from eating it: vaping vitamin E

Our lungs are meant to breathe in air. People sometimes assume that if they can eat something, then it is fine to also inhale it. The reality is that while we can eat a lot of things, it is imprudent to inhale them. For instance, some CBD oils contain vitamin E. Vitamin E is often included in CBD oils as a supplement.

While we can—and should—eat vitamin E, our lungs are not capable of processing it. Several lung failure cases in New York have vitamin E acetate as a common factor in the various substances that people vaped.

Kathryn Melamed, a pulmonologist at University of California, Los Angeles, Medical Center explains in a related Quartz feature:

“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. 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.”

What is popcorn lung from vaping?

The term “popcorn lung” refers to bronchiolitis obliterans, a serious and irreversible lung disease. It affects the smallest airways in your lungs, resulting in coughing and shortness of breath.

The name comes from diacetyl, a buttery-flavoured chemical that was commonly found in microwave popcorn. It first affected workers at the factories that produced microwave popcorn, thus leading to the discovery of the dangers of diacetyl and its removal from popcorn products.

However, some e-cigarette companies add diacetyl to their products to complement flavourings such as vanilla, maple, coconut, etc. Recent studies have found that over 75% percent of flavoured e-cigarettes and refill liquids tested positive for diacetyl.

Diacetyl causes “popcorn lung” by irritating your alveoli. These are tiny air sacs in your lungs that carry oxygen to cells in the rest of your body. Exposure to diacetyl can scar the alveoli, causing inflammation or narrowing. This makes it difficult for them to deliver oxygen to your blood.

Unfortunately, while there are treatments to help alleviate the symptoms or slow the progression of the disease, there is no cure for popcorn lung. If left untreated, “popcorn lung” can be fatal.

Pre-existing respiratory problems

Other substances commonly used as thinning agents, like propylene glycol or polyethylene glycol, can be carcinogenic. One additional problem is that they exacerbate existing respiratory problems such as asthma or other allergic reactions.

Any person with pre-existing respiratory problems vaping products containing propylene glycol or polyethylene glycol, will be inhaling substances that aggravate their pulmonary problems.

Coils in the heating devices

A 2018 study conducted by the Johns Hopkins University found that tiny particles of metals (notably chromium and nickel) from the heating coils used to heat the oils, can end up in the vape inhaled.

Researchers are now wondering whether heavy vaping users have tiny particles of heavy metals building up in their lungs.

Ultimately, it is a lack of regulation

The most worrisome finding around the outbreak of lung illnesses is the complete lack of regulation around vaping products, especially CBD.

More troubling is the finding that many vaping products that were tested by researchers did not contain what they claimed to contain or included substances that were not clearly mentioned on the label.

The industry is under-regulated and there is no central testing authority that can certify all the CBD products that enter the market. Therefore, untrustworthy manufacturers can make unsubstantiated claims about their products.

Testing CBD vape kits

Random tests of vaping products have produced some unsettling results. For instance, there are CBD products that contain different dosages of CBD than the ones claimed. A 2017 study published in the Journal of the American Medical Association found that 70% of CBD products were mislabelled, either with regards to the content of CBD or to the existence (or not) of other compounds.

The aforementioned study discovered that there were CBD products that contained THC although they did not mention it on the label. The levels of THC were such that they could cause intoxication.

Other reviews have shown the existence of synthetic cannabinoids in products that claimed to contain only pure phyto-CBD. Synthetic CBD is cheaper than phyto-CBD, hence the substitution, but it is also dangerous.

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.

All in all, the CBD market, and consequently the vaping industry, is still under-regulated.

Can you vape any CBD oil?

CBD oils meant for vaping are specifically formulated. Despite what you might think, not all CBD oil can be vaped. CBD oil is thicker and contains compounds, such as coconut oil, which are perfectly fine to be ingested—but can be lethal if inhaled.

You should never vape things that are not supposed to be vaped. Only use CBD juices that have been specifically formulated to be vaped.

CBD oil should be used for oral consumption and CBD juices should be used in pens for vaping. Don’t mix product types and consumption methods.

CBD juices (or vape oils) contain ingredients that are considered safer for inhalation.

Which vapes are dangerous?

Vaping CBD may be helpful because its effects are felt immediately throughout the body. People experiencing acute pain or intense inflammation may benefit from the possible anti-inflammatory qualities of CBD in the smallest possible amount of time (click here for a list of reported benefits of CBD).

Anyone worried about the latest information regarding vaping can minimize danger by researching thoroughly brands and manufacturers. Call them to ask about their production techniques. Always ask for lab tests from the manufacturer. Read the labels carefully and make sure you are only buying pure phyto-CBD, without any THC or other unknown components.

Also, ask friends and people knowledgeable in the CBD market about their experience. Organically grown hemp is always better because hemp plants tend to absorb all heavy metals and pesticides from the ground. Ask about the provenance of the hemp used to produce CBD.

Inhaling CBD is more potent

You should always remember that inhaling CBD is more potent than ingesting it.

This means that you should adapt your dosage; one puff of CBD vape gives your body 1 to 2 mg of CBD (for tips on choosing the right CBD dosage for you, click here). Bearing in mind that the bioavailability of vaped CBD in the body is higher, you should start with a lower dosage and increase it slowly.

Also, remember that the way your body manages and processes CBD depends on age, weight, physical exercise, CBD tolerance, metabolism, and other factors.

Although there is no known CBD overdose, inhaling too much could cause side-effects such as nausea, dry mouth, low blood pressure and fatigue (click here for a list of commonly reported CBD side-effects). It is also safer for your lungs to inhale as little as necessary. 

Conclusion: how safe are CBD Vapes?

Until there is greater control over the whole CBD industry, vaping CBD needs to be undertaken cautiously.

The growing consensus so far is that lung problems caused by vaping are not due to the CBD itself but are a consequence of the way CBD is prepared and delivered in its oil format.

Following some essential safety rules could reduce dangers from vaping. Asking for your doctor’s advice can also limit your exposure to some dangers, especially if you are on any form of medication.

Lastly, remember that there is no definitive research regarding CBD and its potential health benefits, let alone about vaping CBD. Researchers are still determining what impact vaping can have on people’s lungs in the long term. Remembering that the benefits of CBD are still researched and reviewed will protect you from fraudulent claims.

To learn more about how to choose your CBD producer, click here!