5 ms·

None of these cutting agents are approved for human inhalation and no studies will be done. From an epidemiological perspective these cases are tightly clustere

None of these cutting agents are approved for human inhalation and no studies will be done. From an epidemiological perspective these cases are tightly clustered both temporally and location wise which really limits the possibilities. Common cutting agents in the licensed market are PEG200, PEG300, and MCT oil. None are those are proven safe from what I know. In the black market the initial cutting agent was PEG600. Then TrueTerpenes came out with Viscosity ( https://trueterpenes.com/products/diluent/viscosity-extract-liquifier/ https://trueterpenes.com/products/diluent/viscosity-extract-... ). Initially they said it was all terpenes (simple alcohols found in cannabis responsible for some effects and flavor) to sell it. It later came out that it was "mineral oil" but the reality is no one knows exactly what it is but it's a petroleum-based product of some kind. There was backlash against TrueTerpenes for this but selling mineral oil at $1500/liter (price point for cutting agents) is profitable. Some reports have described the symptoms as consistent with lipid pneumonia. Next FloraPlex released their thickening agent. Then HoneyCutt. I started hearing stories of people selling 0% THC epoxies to unsuspecting buyers as distillate starting a few months ago. Now there are people making their own thickening agents. Is it a theory? Yes. I'm normally scientifically conservative but I'd place a friendly wager on this one.

shkkmo 7y ago
I would agree that your guess is probably better than mine and I would be disinclined to bet against you. I hope the CDC has access to all this information so they can evaluate this as a potential cause. My issue was only that you followed a bunch of informative facts with an untested theory that was not differentiated from the facts that preceded it.
- cannaceo 7y ago
  My apologies, I didn't mean to come off as abrasive. Yes, I see your point about the presentation of facts.
  - shkkmo 7y ago
    I didn't find you abrasive and I appreciate you sharing your information and insights with us.
kortex 7y ago
I perform with and breath fire as a hobby. The single biggest risk to firebreathers isn't burns, but chemical pneumonitis, due to fuel inhalation (basically synthetic mineral oil with chain lengths 12-18). Took one look at that xray and thought, "yup, chemical pneumonitis" [1]. Also known as lipoid pneumonia. In my research, one finding that stuck out [2] was that natural oils (triglycerides, saturated or unsaturated) are more pro-inflammatory than straight-chain mineral oils. MCT oil would absolutely cause acute inflammation and in severe cases, collapse of alveoli. However, the long chains, longer than C14, have half-lives measured in months to years. The effects of these is harder to know, but excessive exposure causes essentially COPD. Edit: oh look, here's an article specifically pointing out lipoid pneumonia [2]. I actually disagree with their thesis, that vegetable glycerine is causing the inflammation. I would bet it's more likely to be one of these thickeners, or a carrier agent for a flavor, causing the inflammation. I know people who go through over an ounce per day of VG solution that aren't getting chemical pneumonitis, but inhalation of sub-milliliter amounts of oils has sent friends of mine to the hospital. Basically, if it's not air, it doesn't belong in your lungs. However, the degree and character of the damage done depends on the chemical composition. Shorter molecules, molecules with more hydrophilic nature (alcohols, polyols, ketones, acids), biologically active molecules, are more acutely inflammatory, but usually the body can deal with them. Longer molecules, biologically inert ones, are less acutely reactive to the immune system, but can cause disruption of membranes and long term toxicity. Unsaturated fatty acids are especially bad because they can be oxidized directly into inflammatory signal chemicals. [4] [1] https://en.wikipedia.org/wiki/Chemical_pneumonitis https://en.wikipedia.org/wiki/Chemical_pneumonitis [2] pdf - https://www.ajronline.org/doi/pdf/10.2214/AJR.09.3040 https://www.ajronline.org/doi/pdf/10.2214/AJR.09.3040 "Mineral oil (a mixture of inert, long-chain, saturated hydrocarbons obtained from petroleum) and vegetable-based oils tend to cause minimal to mild inflammatory reactions (Fig. 3). The intraalveolar oils can coalesce in the alveoli and become encapsulated by fibrous tissue, resulting in a nodule or mass (paraffinoma) (Fig. 4). Conversely, animal fats are hydrolyzed by lung lipases into free fatty acids that trigger a severe inflammatory reaction that manifests as focal edema and intraalveolar hemorrhage [5]. " [3] html - https://casereports.bmj.com/content/2018/bcr-2018-224350 https://casereports.bmj.com/content/2018/bcr-2018-224350 [4] https://www.frontiersin.org/articles/10.3389/fimmu.2014.00483/full https://www.frontiersin.org/articles/10.3389/fimmu.2014.0048... "unsaturated fatty acids can be oxidized in a tightly regulated and specific manner to generate either potent pro-inflammatory or pro-resolving lipid mediators. "
mayniac 7y ago
Why aren't propylene glycol or glycerine used as cutting agents?
- kortex 7y ago
  Scientific wild-ass guess: Polyols (ethylene glycol, propylene glycol, glycerine) are very hydrophilic. It would be trivial to detect presence in oil concentrates - just shake with a known quantity of distilled water. The polyols will be pulled into the water layer and increase the volume. It's not quantitative but if you know the 'ol in question you can calibrate a curve and get within a few percent of actual with just graduated cylinders.
- heavyset_go 7y ago
  They decrease viscosity, making it obvious that a product was diluted.
- cannaceo 7y ago
  THC oil doesn't mix with glycerine. You can mix it with propylene glycol if you are using other diluents as well.
lonelappde 7y ago
Is "approved for human inhalation" a thing? Don't regular cigarettes have tar that people inhale?
- kortex 7y ago
  The only thing I know of approved for deliberate human inhalation are things like inhaler and nebulizer based drugs. Those are usually carried in a fluorcarbon (HFA-134a aka 1,1,1,2-tetrafluoroethylene in Ventolin inhaler, which just evaporates) or saline in the case of nebulizers. Theatrical fog causes "irritation of mucous membranes such as the eyes and the respiratory tract associated with extended peak exposure to theatrical fog. " Another study "also found long-term exposure to smoke and fog was associated with both short-term and long-term respiratory problems such as chest tightness and wheezing". Cigarettes are terrible, but vaping ain't vitamins. https://en.wikipedia.org/wiki/Fog_machine#Adverse_health_effects https://en.wikipedia.org/wiki/Fog_machine#Adverse_health_eff...
  - idDriven 7y ago
    The only instances I could find of respiratory irritation requiring medical intervention related to fog machine use where involving oil based fog machines, or mixed-use but have so far been unable to find case reports of Glycol or Glycerin based fogs alone. Not all theatrical fog is the same as vaping as far as I am aware. If you have any articles specifically dealing with the components used for vaping I would be interested to read them. Vaping does not use oil.
  - cwkoss 7y ago
    Vitamin vapes are a product that is actually being sold now, I know someone who has tried one.

shkkmo 7y ago

I would agree that your guess is probably better than mine and I would be disinclined to bet against you. I hope the CDC has access to all this information so they can evaluate this as a potential cause. My issue was only that you followed a bunch of informative facts with an untested theory that was not differentiated from the facts that preceded it.

cannaceo 7y ago
My apologies, I didn't mean to come off as abrasive. Yes, I see your point about the presentation of facts.
- shkkmo 7y ago
  I didn't find you abrasive and I appreciate you sharing your information and insights with us.

kortex 7y ago

I perform with and breath fire as a hobby. The single biggest risk to firebreathers isn't burns, but chemical pneumonitis, due to fuel inhalation (basically synthetic mineral oil with chain lengths 12-18). Took one look at that xray and thought, "yup, chemical pneumonitis" [1]. Also known as lipoid pneumonia. In my research, one finding that stuck out [2] was that natural oils (triglycerides, saturated or unsaturated) are more pro-inflammatory than straight-chain mineral oils. MCT oil would absolutely cause acute inflammation and in severe cases, collapse of alveoli. However, the long chains, longer than C14, have half-lives measured in months to years. The effects of these is harder to know, but excessive exposure causes essentially COPD. Edit: oh look, here's an article specifically pointing out lipoid pneumonia [2]. I actually disagree with their thesis, that vegetable glycerine is causing the inflammation. I would bet it's more likely to be one of these thickeners, or a carrier agent for a flavor, causing the inflammation. I know people who go through over an ounce per day of VG solution that aren't getting chemical pneumonitis, but inhalation of sub-milliliter amounts of oils has sent friends of mine to the hospital. Basically, if it's not air, it doesn't belong in your lungs. However, the degree and character of the damage done depends on the chemical composition. Shorter molecules, molecules with more hydrophilic nature (alcohols, polyols, ketones, acids), biologically active molecules, are more acutely inflammatory, but usually the body can deal with them. Longer molecules, biologically inert ones, are less acutely reactive to the immune system, but can cause disruption of membranes and long term toxicity. Unsaturated fatty acids are especially bad because they can be oxidized directly into inflammatory signal chemicals. [4] [1] https://en.wikipedia.org/wiki/Chemical_pneumonitis https://en.wikipedia.org/wiki/Chemical_pneumonitis [2] pdf - https://www.ajronline.org/doi/pdf/10.2214/AJR.09.3040 https://www.ajronline.org/doi/pdf/10.2214/AJR.09.3040 "Mineral oil (a mixture of inert, long-chain, saturated hydrocarbons obtained from petroleum) and vegetable-based oils tend to cause minimal to mild inflammatory reactions (Fig. 3). The intraalveolar oils can coalesce in the alveoli and become encapsulated by fibrous tissue, resulting in a nodule or mass (paraffinoma) (Fig. 4). Conversely, animal fats are hydrolyzed by lung lipases into free fatty acids that trigger a severe inflammatory reaction that manifests as focal edema and intraalveolar hemorrhage [5]. " [3] html - https://casereports.bmj.com/content/2018/bcr-2018-224350 https://casereports.bmj.com/content/2018/bcr-2018-224350 [4] https://www.frontiersin.org/articles/10.3389/fimmu.2014.00483/full https://www.frontiersin.org/articles/10.3389/fimmu.2014.0048... "unsaturated fatty acids can be oxidized in a tightly regulated and specific manner to generate either potent pro-inflammatory or pro-resolving lipid mediators. "

mayniac 7y ago

Why aren't propylene glycol or glycerine used as cutting agents?

kortex 7y ago
Scientific wild-ass guess: Polyols (ethylene glycol, propylene glycol, glycerine) are very hydrophilic. It would be trivial to detect presence in oil concentrates - just shake with a known quantity of distilled water. The polyols will be pulled into the water layer and increase the volume. It's not quantitative but if you know the 'ol in question you can calibrate a curve and get within a few percent of actual with just graduated cylinders.
heavyset_go 7y ago
They decrease viscosity, making it obvious that a product was diluted.
cannaceo 7y ago
THC oil doesn't mix with glycerine. You can mix it with propylene glycol if you are using other diluents as well.

lonelappde 7y ago

Is "approved for human inhalation" a thing? Don't regular cigarettes have tar that people inhale?

kortex 7y ago
The only thing I know of approved for deliberate human inhalation are things like inhaler and nebulizer based drugs. Those are usually carried in a fluorcarbon (HFA-134a aka 1,1,1,2-tetrafluoroethylene in Ventolin inhaler, which just evaporates) or saline in the case of nebulizers. Theatrical fog causes "irritation of mucous membranes such as the eyes and the respiratory tract associated with extended peak exposure to theatrical fog. " Another study "also found long-term exposure to smoke and fog was associated with both short-term and long-term respiratory problems such as chest tightness and wheezing". Cigarettes are terrible, but vaping ain't vitamins. https://en.wikipedia.org/wiki/Fog_machine#Adverse_health_effects https://en.wikipedia.org/wiki/Fog_machine#Adverse_health_eff...
- idDriven 7y ago
  The only instances I could find of respiratory irritation requiring medical intervention related to fog machine use where involving oil based fog machines, or mixed-use but have so far been unable to find case reports of Glycol or Glycerin based fogs alone. Not all theatrical fog is the same as vaping as far as I am aware. If you have any articles specifically dealing with the components used for vaping I would be interested to read them. Vaping does not use oil.
- cwkoss 7y ago
  Vitamin vapes are a product that is actually being sold now, I know someone who has tried one.