Warning for paper blotters
The quantity of psychoactive substances in paper blotters prepared by someone else may vary wildly. There is not guarantee that even sheets are standardized. One way to get around this is to dissolve the blotters in alcohol and use volumetric liquid dosing with a microliter syringe to prepare new blotters. Make sure to use a clean syringe without any contamination.
- Buccal: Paper blotters
- Sublabial (under the lip): Paper blotters
- Sublingual: Paper blotters
Warning for the Vaping-Associated Pulmonary Injury (VAPI) outbreak
An outbreak of severe vaping-associated pulmonary injury (VAPI) starting in 2019 is ongoing among users of vaping products, almost exclusively in the United States. VALI can be severe and life-threatening. Symptoms can initially mimic common pulmonary diagnoses like pneumonia, but individuals typically do not respond to antibiotic therapy. Individuals usually present for care within a few days to weeks of symptom onset.
Electronic cigarette refers to the practice of inhaling an aerosol from an electronic cigarette device, which works by heating a liquid that can contain various substances, including nicotine, tetrahydrocannabinol (THC), flavoring, and additives (e.g. glycerin (sold as vegetable glycerine (VG)), propylene glycol (PG)). The long-term health impacts of vaping are unknown.
Vegetable glycerine (VG), and propylene glycol (PG)
Vegetable glycerine (VG) was long thought to be a safe option. However, the carcinogen formaldehyde is known as a product of propylene glycol and glycerol vapor degradation, these ingredients may also cause lung inflamation.
Vitamin E acetate
On September 5, 2019, the Food and Drug Administration (FDA) in the US announced that 10 out of 18, or 56% of the samples of vape liquids sent in by states, linked to recent vaping related lung disease outbreak in the United States, tested positive for vitamin E acetate which had been used as a thickening agent by illicit THC vape cartridge manufacturers. On November 8, 2019, the Centers for Disease Control and Prevention (CDC) identified vitamin E acetate as a very strong culprit of concern in the vaping-related illnesses, but has not ruled out other chemicals or toxicants as possible causes. The CDC's findings were based on fluid samples from the lungs of 29 patients with vaping-associated pulmonary injury, which provided direct evidence of vitamin E acetate at the primary site of injury in all the 29 lung fluid samples tested. Research suggests when vitamin E acetate is inhaled, it may interfere with normal lung functioning. A 2020 study found that vaped vitamin E acetate produced exceptionally toxic ketene gas, and carcinogenic alkenes and benzene.
- Dosage form (Wikipedia)
- 2019–2020 vaping lung illness outbreak (Wikipedia)
- Vaping-associated pulmonary injury (Wikipedia)
- Layden, Jennifer E.; Ghinai, Isaac; Pray, Ian; et al. (2019). "Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin — Preliminary Report". New England Journal of Medicine. 382 (10): 903–916. doi: . ISSN 0028-4793. PMID 31491072.
- "Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping". Centers for Disease Control and Prevention. 28 January 2020.Template:PD-notice
- Kelland, Kate (14 October 2019). "Vaping illness, deaths likely very rare beyond U.S., experts say". Reuters.
- "Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping". Centers for Disease Control and Prevention (CDC). 11 February 2020.Template:PD-notice
- Template:Cite report
- Gotts, Jeffrey E.; Jordt, Sven-Eric; McConnell, Rob; Tarran, Robert (2019). "What are the respiratory effects of e-cigarettes?". BMJ. 366: l5275. doi: . ISSN 0959-8138. PMID 31570493.
- Lestari, Kusuma S.; Humairo, Mika Vernicia; Agustina, Ukik (11 July 2018). "Formaldehyde Vapor Concentration in Electronic Cigarettes and Health Complaints of Electronic Cigarettes Smokers in Indonesia". Journal of Environmental and Public Health. 2018. doi:10.1155/2018/9013430. ISSN 1687-9805.
- "Vaping propylene glycol and vegetable glycerine may lead to lung inflammation". News-Medical.net (in English). 18 October 2019.
- Sun, Lena (September 6, 2019). "Contaminant found in marijuana vaping products linked to deadly lung illnesses, tests show". Washington Post (in English). Retrieved 2019-09-09. Unknown parameter
- "Three Companies Subpoenaed in Weed Vape Illness Investigation". Rolling Stone (in English). September 10, 2019. Unknown parameter
- "Transcript of CDC Telebriefing: Update on Lung Injury Associated with E-cigarette Use, or Vaping". Centers for Disease Control and Prevention. 8 November 2019.Template:PD-notice
- Wu, D; O'Shea, DF (24 March 2020). "Potential for release of pulmonary toxic ketene from vaping pyrolysis of vitamin E acetate". Proceedings of the National Academy of Sciences of the United States of America. 117 (12): 6349–6355. doi:10.1073/pnas.1920925117. PMID 32156732.