July 22, 2023. We just got back from CHAMPS in Las Vegas.  One of the leading trade shows for the smoke shop industry, featuring manufacturers, distributors, glass artists and more.  We were overwhelmed by the shear magnitude of vendors selling all sorts of products containing Kratom to THC and everything else in between, even dosed whipped cream in a can. 

When we inquired about the products at one of the vendor booths, we were asked “Do you have pain, or are you trying to get f***ed up?”

There were plenty of options for the latter. We found Delta 3, Delta 6, Delta 8, Delta 9, Delta 10, Delta 11, PHC, HHC, HHC-O, HHC-P, HXC-P, Hydroxy 9, THC-A, THC-B, THC-H, THC-M, THC-P, THC-JD, THC-V, THC-x, H4 and many now being combined together. If that’s not enough for you, synthesized mushrooms are popping up everywhere. And it’s unclear whether any of these products actually contain what they say, because there’s virtually no regulation of the sellers.   

This trend is concerning to public health officials, who fear that the minor changes made to the chemical structure of cannabis to technically make it legal, could change the way it impacts the body.  

Earlier this year, if you were the type of person who “got high before work,” you were told to try THC-O products. THC-O is a synthetic substance typically made by acetylating Delta 8-THC. THC-O is also known to be significantly stronger than marijuana; it is commonly referred to as the “spiritual cannabinoid” because of its psychoactive effects. But now it’s being replaced with other products. Why?

Chemists have raised serious concerns about THC-O, warning that the lab processes used to make it might produce dangerous and potentially deadly byproducts. Recently published research from two labs found that THC-O produces the poisonous gas ketene when vaped. Those same researchers have argued that the acetylation of vitamin E likely played a role in the so-called EVALI outbreak in 2019, the spate of vaping-induced lung injuries that injured more than 2,800 people and killed more than 60.

THC-O products are in a particularly precarious legal position. Earlier this year in February 2023, the DEA declared THC-O products are federally illegal because the compound does not occur naturally in hemp.  

To get around these laws, however, merchants are selling quasi-legal products containing slightly tweaked versions of marijuana to skirt the laws: products containing all sorts of chemicals.  It’s unclear whether these products actually contain what they say, because there’s virtually no regulation of the sellers.  Chemists say it’s abundantly clear to anyone with enough knowledge in organic chemistry to make these products. “The substructure of the vitamin E acetate molecule and the substructure of the THC-O acetate are identical, and any chemist that would be able to make that stuff … would have recognized that,” said Robert Strongin, a Portland State University chemistry professor, who conducted studies on THC-O.  However, products with THC-O are still being sold and consumed. 

“There are new synthetic variants cropping up every week,” said Christopher J. Hudalla, the chief scientific officer of the cannabis testing facility ProVerde Laboratories, who raised numerous concerns about these products.  “It is a bit similar to Mr. Potato Head. You have a base potato, to which different attributes can be added: different eyes, glasses, mustaches, arms, legs, hats, etc. There is almost an unlimited number of permutations or combinations of those attributes that can be applied to your base potato.”    They are being made by people who are trying to play the system. Why else would you want to get in a lab and try to make these products?

“These are simply products that don’t have any quality control to them. They may have what they say in it, they may not — they may have more, they may have less — you just don’t know,” said Stephen Thornton, the medical director of the poison control center at The University of Kansas Health System. “It’s very much a ‘buyer beware’ kind of market.”

Whether all of these products are eventually deemed illegal or not will likely come down to whether regulators believe it can be found naturally in the cannabis plant.

There’s some scientific debate over whether HHC is naturally occurring in the cannabis plant in very small doses, but experts agree that HHC-O is not. HHC-O, seems to produce stronger highs than marijuana.   It’s created by chemically altering the original HHC compound through a process called acetylation. The process makes it easier for the resulting substance to more easily cross the blood-brain barrier. HHC-O as a result is much stronger than pure HHC; one video on YouTube described HHC-O as “HHC to the billionth power” and said the acetylation process was used to “get as high as humanly possible.”

Although the same THC-O experiments have not been done on HHC-O, it’s hypothesized that it would also produce ketene gas when vaped. There’s little evidence yet, however, that these products are landing people in the emergency room.  Strongin said it’s not clear yet how much ketene gas might get into the lungs if people vape THC-O or HHC-O, or whether there might be long term cumulative effects from it. Overall, scientists know very little about ketene toxicology, he argued.  “No one wants to use human subjects, or even animal subjects, to study ketene.”

University of Kansas Medical Center’s Thornton, who runs the entire poison control system for the state of Kansas, said he hasn’t seen many cases at all of people calling the hotline because of these products.  Thornton cautioned that medical toxicologists might not be seeing warning signs because of the limited tools they have to track adverse events from various cannabis products. Most often these cases won’t be caught unless a person self-reports using them.  “It’s very hard to know exactly how big of an issue this is — other than you drive around and you see … the amount of these things being advertised,” Thornton said. “You know they’re making money and people are buying it.”

While many manufacturers hire their own third party labs to confirm the contents and strengths of their products, there’s no regulator checking these results — and some experts question the validity of those tests.  The one DEA-registered hemp testing lab in Kansas said it was unable to test for the compounds now openly being sold in the state.

“The testing to determine the presence and amount of all these compounds is exceptionally difficult,” said Michelle Peace, a forensic toxicology expert at Virginia Commonwealth University who has studied these compounds. “Only a few labs can do this testing well, yet there are a lot of labs who say they can do it. I would not trust a single certificate of analysis with all of these new compounds. The unregulated cannabis industry moves too quickly for labs to do this testing right and well.”

The lack of scientific knowledge about these products has made even those who take a “harm reduction” approach toward drugs struggling to provide sound advice, according to Jessica Kruger, an associate professor at the University at Buffalo who has studied the use of Delta 8 cannabis products.

“We have to know more in order to provide guidance,” Kruger said. “It really puts us folks in a really hard predicament. … I don’t want to give recommendations that could actually harm people, but I also want to provide users with information so they can reduce harm.”

These products often involve use of potentially harmful chemicals to create the concentrations claimed in the marketplace. 

• Some manufacturers may use potentially unsafe household chemicals in this chemical synthesis process. Additional chemicals may be used to change the color of the final product. The final products may have potentially harmful by-products (contaminants) due to the chemicals used in the process, and there is uncertainty with respect to other potential contaminants that may be present or produced depending on the composition of the starting raw material. If consumed or inhaled, these chemicals, including some used to make (synthesize) by-products created during synthesis, can be harmful.
• Manufacturing of these products may occur in uncontrolled or unsanitary settings, which may lead to the presence of unsafe contaminants or other potentially harmful substances. 
• The FDA has warned that some of these products may contain dangerous byproducts left over from the manufacturing process, which typically involves adding a solvent and an acid to CBD (cannabidiol) and boiling it.
• There’s virtually no scientific research looking at the impacts of these substances on the body, and several major universities with cannabis research programs declined, or did not respond.

States around the nation, including those with legal marijuana, have struggled to contend with the rise of these “legal high products.” 

• Colorado, arguably the most marijuana-friendly state in the nation, set up a task force to figure out how to regulate them.   
• In Washington, where marijuana is legal, regulators have raised concerns about the “impact of a product that is generally unregulated competing with a tightly regulated state cannabis marketplace.” 
• The Nevada legislature passed a bill in 2021 banning all of these products, five years after Nevada voters opted to legalize marijuana.  
• In New York, July 19, 2023, the state Cannabis Control Board voted to ban any hemp-derived product that contains more than 1 milligram of THC, the intoxicating chemical in cannabis, per serving.
• Florida is cracking down on companies marketing weed edibles in kid-friendly packaging.  

The rise of these products, nearly all of which are being shipped nationwide, has also angered hemp farmers, who are trying to establish themselves as legitimate business owners who follow the law. (Hemp is federally legal so long as it does not contain more than 0.3% THC, the intoxicating compound in marijuana.)

Hemp farmers say the rise of these quasi-legal products are bad for both their business and their reputation. Hemp farmers are just beginning to be recognized in America as farmers of legitimate crops, like those who produce corn or soybeans. Much of that recognition came from advocacy efforts to explain that the cannabis plant has more uses than just getting people high — and that farmers can produce industrial hemp that isn’t intoxicating at all. Those efforts led to a 2018 federal law legalizing hemp, so long as it only contained trace amounts of THC, the primary psychoactive chemical in marijuana. But now, companies are trying to claim both that their products are legal hemp, and that they get people high — despite the industry’s previous claims that hemp is not intoxicating.

“It’s confusing a lot of people,” said Jonathan Miller, the general counsel for the lobbying group the U.S. Hemp Roundtable.

Miller added that not only are these intoxicating products squeezing non-intoxicating products out of the market, but they’re prompting state legislators to overcorrect and begin more closely regulating legal hemp products. Miller pointed to bills recently introduced in Virginia and Washington state that limit the amount of hemp-derived compounds that can be placed in products, even if they’re not intoxicating.

Rippel, of Kansans for Hemp, said that the rise of legal high products caused a “misnomer in people’s minds about what hemp is.”

“Hemp can also mean — and should mean — all of the agricultural aspects: food, fuel, fiber, shelter. Those are the things that we need people to be focusing on, because those are going to be the longest term sustainable economic drivers,” Rippel said.

Rippel hopes Kansas will soon legalize medical marijuana, developing a regulatory infrastructure to ensure consumers can access safe products and help crack down on those trying to skirt the law. The legislature is considering multiple bills on the subject this session.

Something has to happen – lawmakers don’t really have a choice but to put something in place that will at least try to rein in some of what these manufacturers are trying to do.  Until that happens, our general advice is start with a low dose, start slow, and know where your product is coming from — and don’t buy it from a gas station or from a random internet site.