SCOTT SIMON, HOST:
The Centers for Disease Control say most of the cases of respiratory illness from vaping are linked to products containing THC, the psychoactive ingredient in cannabis. People have gotten sick even in states where marijuana sales are legal and where marijuana must undergo some quality testing. Will Stone brings us the story of a man who got sick in Washington State, where recreational pot has been sold since 2014.
WILL STONE, BYLINE: About two years ago, Charles Wilcoxen turned to vaping marijuana, believing it would be better than smoking it.
CHARLES WILCOXEN: I felt that vaping was a safer alternative. It was - I truly believed that.
STONE: Wilcoxen would buy the vape cartridges from Washington's legal marijuana shops, where they're tested for things like mold. The 44-year-old is an Army veteran and runner, and he was in good health until one day last month. After vaping, Wilcoxen became sick very quickly. He started wheezing. Soon he was nauseous and running a fever.
WILCOXEN: I felt miserable. You know, it was, like, flu-like symptoms.
STONE: After a few days he began to wonder, could it be the vape?
WILCOXEN: And I used the same device, same cartridges that I'd been using in the past.
STONE: The next day, he woke up and could barely breathe.
WILCOXEN: Literally I would take five steps and have to hunch over and try to catch my breath.
STONE: Wilcoxen ended up spending three days in the hospital. Doctors found buildup in his lungs and sent it for tests.
WILCOXEN: It all came back positive results for lipoid pneumonia, which was indicative for - from the vaping. You know, it's where it came from.
STONE: Lipoid pneumonia, the same respiratory condition identified in some others who have fallen ill after vaping. Wilcoxen decided to sue. He's going after six companies. All have a role in manufacturing or distributing the vaping device or the cartridges that contain a liquid form of THC, the psychoactive ingredient in marijuana. Public health agencies have traced many cases of vaping illnesses back to THC products, some bought on the black market.
Testing has shown those illicit THC cartridges can contain cutting agents like vitamin E acetate, which isn't safe to inhale. But Wilcoxen says he only went to state-licensed stores. Washington requires that labs test marijuana for potency and certain contaminants, but not other chemicals added to the liquid THC.
SHANNON STEVENS: There is no requirement to test for any sort of cutting agent.
STONE: Shannon Stevens is laboratory director for Confidence Analytics, which has a state license to test cannabis products in Washington.
STEVENS: I would be surprised to learn that an illegal product in our retail stores had been identified as having been cut like this, but I definitely wouldn't exclude the possibility.
STONE: Like other states, Washington is trying to identify what harmful chemicals might be in vaping products. In the meantime, the state has passed a four-month emergency ban on flavored vaping products. It applies to both nicotine and THC. Dr. Kathy Lofy is the state health officer for Washington.
KATHY LOFY: While we don't yet know exactly what's causing severe lung injury, we did like the option of banning flavors because we know that, you know, youth are very attracted to the flavors.
STONE: But the state's public health leaders acknowledged that prohibiting flavors won't necessarily stop the current outbreak of illnesses. Ziva Cooper directs the UCLA Cannabis Research Initiative.
ZIVA COOPER: There is this risk when you ban something that people will be driven to the black market.
STONE: Even in states where cannabis is regulated, Cooper says the market is fraught with problems. People are walking into stores and buying neatly packaged products that look legit.
COOPER: They think that they can trust what's on the labels. But the truth is is that the labels don't necessarily accurately portray what's actually in the products.
STONE: For now, the Centers for Disease Control and Prevention is keeping warnings about vaping brought. At a recent congressional hearing, CDC's deputy director Dr. Anne Schuchat said while most cases are linked to the black market, her agency doesn't yet have a clear picture of the risks where marijuana is legal.
ANNE SCHUCHAT: Whether the substances that are in products that are completely unregulated by the states are riskier than the products that are regulated by the states, I don't think we have good data either way.
STONE: Until more is known, those who vape need to realize that no matter where they, live the safety regulations vary. And testing, even in states where pot is legal, has not necessarily caught up with whatever might be causing the current outbreak of illness. For NPR News, I'm Will Stone in Seattle.
SIMON: And that story comes to us from NPR's reporting partnership with Kaiser Health News.
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