Saad Metla had smoked marijuana recreationally before, but when he started vaping THC, it was initially for medicinal purposes.
The Syracuse University psychology senior has undergone over 25 major limb-lengthening surgeries due to a medical condition known as knock knees, and has been prescribed opioids for most of his life as a result. In high school, Metla developed a dependency on painkillers that had become so severe by his sophomore year of college that he decided to cut them out entirely. Still in need of medication, he turned to vaping THC in 2015.
“I had a couple friends who were dealers and they were telling me, ‘Hey check this out, it’s a concentrated form of THC … it’s powerful and the high is a little more intense,’” he recalled being told when first introduced to the then-novel e-cigarette.
Metla says he enjoys THC vapes for the extra intensity, and like many others, for its ashless, almost smokeless and mostly odorless convenience. Now, whether he’s using marijuana medicinally or recreationally, he says he prefers vaping over other forms of administration.
Vapeable marijuana products hit the market around a decade ago and represent one of the fastest growing segments of the multibillion-dollar cannabis industry. It’s also changed the way people are consuming marijuana.
A NewsHouse survey of more than 300 college students indicated that vape pens rival joints, bongs and edibles as the preferred way for students at SU and state colleges to consume marijuana.
With the health risks of vaping tobacco or other products continuing to draw attention, researchers are trying to determine connections between vaping THC and the mysterious lung illness, now known as EVALI.
As of December 2019, the Centers for Disease Control and Protection reported 2,506 cases of hospitalized EVALI across all 50 states and two U.S. territories, and 54 deaths across 27 states and the District of Columbia. While nicotine vapes and regulated THC vapes have been tied to a handful of cases, illicit THC vapes were linked to 80 percent of all EVALI cases.
Dr. Jeanna Marraffa, assistant clinical director and toxicologist at the Upstate New York Poison Center, said in November her office has treated more than 100 patients for the lung illness and that tracing vape products to their original source can be problematic.
“Even though you think you know where it’s coming from, what’s in it, we have no idea,” Marraffa said.
The federal government has poured millions of dollars into researching vapes, but marijuana’s classification as a Schedule I substance has restricted research on THC. The result is a massive knowledge gap that researchers and public health officials are rushing to fill amid the current vaping crisis. Though researchers have determined vitamin E acetate – a thickening agent added to THC vape liquids that’s been found in the lung samples of most EVALI patients – as a primary culprit, it’s unclear what else could be causing these outbreaks.
“We know that vitamin E acetate is there, but there are still other questions: Is that the only culprit? Is there something else that’s happening concurrently? Is there a chemical reaction that’s happening?” Marraffa said.
New York state, where recreational marijuana remains illegal, has been affected by the EVALI outbreak more than most other states, with 254 cases and one death related to the new illness as of March 31, according to the NYS Department of Health.
Marraffa, a co-author of one of the first EVALI patient treatment guides, said the Upstate New York Poison Center began receiving a whirlwind of cases in September when the outbreak was peaking around the nation. The Upstate toxicologist has since been collaborating with state and federal health officials on a near-daily basis but admits she didn’t expect the crisis to persist so long.