There hasn’t been a single day in the last week where I didn’t have a patient stop me, call, message, text, or email with questions regarding the safety of cannabis vape oil. The news is on fire about vaping concerns after a rash of vaping related illnesses and a handful of confirmed deaths. The CDC recommended people avoid all nicotine and e-juice vape products, while the FDA told consumers to avoid THC containing vape products.

My response to all these questions - we just don’t know. But that also doesn’t mean we need to panic and throw away all our medicine. Instead, we need to get informed.

While cannabis has been used safely for thousands of years, vape oils and the associated technology is relatively new to the game. They are extremely popular due to the portability and discreetness and seem to be relatively safe when used with quality ingredients. Unfortunately, due to the current legal climate there have been no long term studies on the safety of these vape oils.

Current news reports about vaping related illness are thought to be linked primarily to the addition of (synthetically derived) Vitamin E Acetate, a toxic ingredient (when inhaled) illicit producers add to cartridges to stretch profits. Adding it to THC oil can make thinned cartridges appear to be a thick and pure oil. Of the 450+ hundred reported cases, to my knowledge only one has been linked to a legally purchase product (in Oregon) . According to FL MMTC’s, Vitamin E is not being used in Florida vape cartridges. This shows how important regulation and testing is for public safety (and how prohibition is detrimental to health). If you are using black market vape products - STOP. The risk is too great.

While legal products don’t seem to be the cause of current safety concerns, as patients it’s still important that we are conscious informed consumers of our cannabis medicine. Regardless of how many people have used vapes without ill effects, we truly have no idea the long term safety of cannabis vape oils. Every patient needs to take this into consideration when weighing delivery methods.

I’ve worked first hand with over a thousand patients in Florida’s program and others around the country through my private coaching practice. Through this experience I can tell you of countless patients who report experiencing irritation, burning, and excessive coughing with some vape oil products. I’ve experienced it myself with certain products and dispensaries. How much of this is normal and safe, and how much of this is something to be concerned about? We just really don’t know, but irritation & burning reactions surely isn’t a good sign.

Instead of listing Florida dispensaries and their ingredients (which change), below I’m going to breakdown what you should be aware of when choosing a vape product and the questions to ask. Don’t purchase unless you have considered these things.

Things to Be Aware of When Choosing a Florida Cannabis Vape Oil

Risk vs Benefit
All medications and treatments involve patients taking a look at the risks and benefits and making the decisions that are best for their personal circumstances. Being an educated, informed medical consumer making intentional health decisions works out well. Keep this is mind when considering a cannabis vape. For some of us, the harm of letting symptoms go untreated may be worse than any potential risk from a thoughtfully purchased and consumed vape product. For some of us it may be the reverse.
What type of terpenes are being used?
The process of creating distillate, the cannabis oil primarily used in vape cartridges, destroys the large majority of original terpenes. For both thinning and medicinal effect, terpenes are added back into THC oils. Terpenes are abundant in nature and can be sourced from both cannabis and other botanical/natural sources. While chemically a terpene sourced from cannabis is no different than a terpene sourced from fruit, many patients report differences in their tolerability and efficacy. I experience excessive nose & eye burning, irritation, and coughing with naturally/botanically derived terpenes, but not with cannabis terpenes. Some oils are not flavored back into the strain they were extracted from, meaning a product can be extracted from strain X and sold as strain B via terpene addition. The safety of inhaling various concentrations of these terpenes is also unknown.
Are there any cutting agents?
With the proper cartridge and device, cannabis oil (& terpenes) can be vaped without any other thinning agents added. Unfortunately, some dispensaries in Florida are still thinning cartridges with coconut derived MCT oil and many patients report irritation to MCT cut vapes. Like most of this, the overall safety of inhaled MCT oil is unknown. I personally think it’s an unnecessary risk to take, and until we have further information I prefer to avoid it. I know this thought is shared by many other cannabis professionals and physicians. Check ingredient lists - it should only say cannabis oil and terpenes.

Are lab results available?
Florida dispensaries are required to put their products through 3rd party testing. Ask to see these reports and check for potential contaminants. Many products have QR labels that can be scanned to directly pull up results. The amount of lab information available varies by MMTC. Keep this in mind when shopping.
What’s the quality of the cartridge and battery?
The safety of the associated cartridges and devices are also in question. A simple google search will find dozens of reports of lead and other contaminants being found in cartridge oil - even in legal, regulated markets. It is theorized that cheap Chinese manufactured cartridges leach lead and other heavy metals into the medicine, possibly exacerbated by heating devices. If you are going to use vape cartridges, be mindful not to burn your battery too hot and choose only quality tested and reputable cartridge/device brands.

My Personal Preference

Even prior to the recent alarming public safety concerns about vaping oils, I’ve been sticking to vaping and smoking cannabis flower when at all possible. Not only does it work best for me, I’m just not entirely comfortable with the uncertainty of vape products. However, I live with multiple chronic illness and have to leave the house, especially if I want to work. I haven’t done well on oral methods during the day, so I use vape pens when I can’t otherwise medicate with flower. I am extremely mindful about what products I use and put into my body - I stick with cannabis derived terpenes and no cutting agents. I’m also mindful not to vape products that have too strong of flavor as I have concerns about inhaling high concentrations of terpenes.