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Dabbing has been gaining popularity among young people in recent years due to its ability to deliver a high concentration of tetrahydrocannabinol. When produced illegally, it is usually contaminated by toxic substances and associated with multiple health hazards. We present the case of a 66-year-old woman who developed hypersensitivity pneumonitis after dabbing butane hash oil for the first time and was successfully treated with corticosteroids with complete resolution of her symptoms. This case report emphasizes the respiratory complications associated with using a noxious substance like butane hash oil and gives physicians an insight into the diagnosis and management of dabbing-induced hypersensitivity pneumonitis.

Highly potent cannabis concentrates obtained by butane or by supercritical carbon dioxide-extraction are gaining popularity. These extracts called butane hash oil (BHO) with Δ9-tetrahydrocannabinolic acid A (THCA) contents above 60% are consumed by flash vaporization on a glowing titanium nail, followed by inhalation of the resulting vapor through a water pipe in a single puff — a technique referred to as “dabbing”. We herein investigated the decarboxylation rate of THCA during artificial smoking of cannabis plant material and simulated dabbing, and the lung availability of Δ9-tetrahydrocannabinol (THC) which we define as the recovery of THC in the smoke and vapor condensates. Preliminary smoking and dabbing experiments were performed using an apparatus built in-house. Due to availability of cannabidiol (CBD)-rich hemp in Switzerland, we included a sample of CBD flowers in our experiments and investigated the decarboxylation and recovery of cannabidiolic acid (CBDA) and CBD, respectively. Decarboxylation of THCA and CBDA during combustion of the plant material and vaporization of the BHO, respectively, was complete. The high recovery of total THC (75.5%) by dabbing cannot be achieved by smoking marijuana. Lung availability ranged from 12% for mixed cannabis material with a rather low THC content, to approximately 19–27% for marijuana flowers, similar for THC in marijuana as for CBD in CBD-rich marijuana. In reality, when smoking a joint, further losses in recovery must be assumed by additional sidestream smoke. The rather high lung availability of THC via dabbing can explain the increased psychoactive and adverse effects associated with this new trend of cannabis consumption.

Through the potency monitoring program at the University of Mississippi supported by National Institute on Drug Abuse (NIDA), a total of 18108 samples of cannabis preparations have been analyzed over the last decade, using a validated GC/FID method. The samples are classified as sinsemilla, marijuana, ditchweed, hashish, and hash oil (now referred to as cannabis concentrate). The number of samples received over the last 5 years has decreased dramatically due to the legalization of marijuana either for medical or for recreational purposes in many US states. The results showed that the mean Δ9-THC concentration has increased dramatically over the last 10 years, from 8.9% in 2008 to 17.1% in 2017. The mean Δ9-THC:CBD ratio also rose substantially from 23 in 2008 to 104 in 2017. There was also marked increase in the proportion of hash oil samples (concentrates) seized (0.5-4.7%) and their mean Δ9-THC concentration (6.7-55.7%) from 2008 to 2017. Other potency monitoring programs are also present in several European countries such as The Netherlands, United Kingdom, France, and Italy. These programs have also documented increases in Δ9-THC concentrations and Δ9-THC:CBD ratios in cannabis. These trends in the last decade suggest that cannabis is becoming an increasingly harmful product in the USA and Europe.

Whether eosinophilic pneumonitis represents a true manifestation of e-cigarette, or vaping, product use-associated lung injury remains uncertain, and this ambiguity stems from a lack of histopathological data. We present a previously healthy young woman whose asthma-like symptoms and histopathologic finding of eosinophilic pneumonitis were caused by inhalation of vaporized cannabis hash oil concentrates. This report provides compelling evidence that eosinophilic pneumonitis can result from cannabis hash oil inhalation.

“Dabbing” is the inhalation of concentrated marijuana, usually in butane solvent. This case report illustrates a previously healthy 25-year-old caucasian male with a 10-year history of cannabis butane hash oil (BHO) use. The patient presented with dyspnea and cough. The evaluation included a chest x-ray, basic laboratory investigations, computerized tomography angiogram of the chest and echocardiogram. Patient was diagnosed with acute lung injury mimicking atypical pneumonia. He was treated with steroids and had clinically improved and advised to stop dabbing. Further studies are needed to elucidate the full spectrum of the adverse effects of dabbing.

The use of marijuana concentrates has escalated in recent years with butane extracts appearing particularly popular. The administration of butane hash oil, colloquially referred to as “dabbing,” is distinct from traditional flower cannabis usage due to the THC content of samples and the presence of impurities such as unpurged butane. While this may confer heightened risk to the user, additional significant concerns are tied to fires and explosions. Using butane as a solvent in amateur “blasting” methods may result in a flammable vapor pooling in enclosed spaces and igniting when exposed to a spark. As research on butane extract users, amateur production techniques, health risks, and legality is in its infancy, we explored existing studies on the topic to create a review of substantiated knowledge related to THC extracted using butane. The resulting assessment centers on three areas: 1) dab users including both recreational users and medical marijuana patients; 2) butane extraction techniques including illicit amateur open methods and the safer closed-loop system employed in medicinal/recreational states; and 3) risks, both related to fires and legality. We follow the presentation of this material with a summary of the (mis)information reaching the public in print and online sources so that public educational campaigns can focus on dispelling the inaccuracies and false notions of safety that may be tied to amateur production., Video abstract

In 2000, Colorado voters decriminalized marijuana for medical use; however, because marijuana use remained illegal under federal law, the number of users was low.[1][1] In 2009, President Obama instructed federal officials not to enforce marijuana laws that were in conflict with state laws, and the

High-potency cannabis concentrates are increasingly popular in the United States, and there is concern that use of high-potency cannabis might increase risk for cannabis-related problems. However, little is known about the potential negative consequences of concentrate use. This study reports on associations between past-year use of a high-potency cannabis concentrate, known as butane hash oil (BHO), and cannabis-related problems.A sample of 821 college students were recruited to complete a survey about their health and behavior. Participants who had used cannabis in the past year (33%, n=273) completed questions about their cannabis use, including their use of BHO and cannabis-related problems in eight domains: physical dependence, impaired control, academic-occupational problems, social-interpersonal problems, self-care problems, self-perception, risk behavior, and blackouts.Approximately 44% (n=121) of past-year cannabis users had used BHO in the past year. More frequent BHO use was associated with higher levels of physical dependence (RR=1.8, p0.001), impaired control (RR=1.3, p0.001), cannabis-related academic/occupational problems (RR=1.5, p=0.004), poor self-care (RR=1.3, p=0.002), and cannabis-related risk behavior (RR=1.2, p=0.001). After accounting for sociodemographic factors, age of onset of cannabis use, sensation seeking, overall frequency of cannabis use, and frequency of other substance use, BHO use was still associated with higher levels of physical dependence (RR=1.2, p=0.014).BHO use is associated with greater physiological dependence on cannabis, even after accounting for potential confounders. Longitudinal research is needed to determine if cannabis users with higher levels of physiological dependence seek out BHO and/or if BHO use increases risk for physiological dependence.

Inhalable, noncombustible cannabis products are playing a central role in the expansion of the medical and recreational use of cannabis. In particular, the practice of "dabbing" with butane hash oil has emerged with great popularity in states that have legalized cannabis. Despite their growing popularity, the degradation product profiles of these new products have not been extensively investigated. The study herein focuses on the chemistry of myrcene and other common terpenes found in cannabis extracts. Methacrolein, benzene, and several other products of concern to human health were formed under the conditions that simulated real-world dabbing. The terpene degradation products observed are consistent with those reported in the atmospheric chemistry literature.

BackgroundRecent reports suggest an increase in use of extremely potent cannabis concentrates such as Butane Hash Oil (BHO) in some developed countries. The aims of this study were to examine the characteristics of BHO users and the effect profiles of BHO.DesignAnonymous online survey in over 20 countries in 2014 and 2015. Participants aged 18 years or older were recruited through onward promotion and online social networks. The overall sample size was 181,870. In this sample, 46% (N = 83,867) reported using some form of cannabis in the past year, and 3% reported BHO use (n = 5922).MeasurementsParticipants reported their use of 7 types of cannabis in the past 12 months, the source of their cannabis, reasons for use, use of other illegal substances, and lifetime diagnosis for depression, anxiety and psychosis. Participants were asked to rate subjective effects of BHO and high potency herbal cannabis.FindingsParticipants who reported a lifetime diagnosis of depression (OR = 1.15, p = 0.003), anxiety (OR = 1.72, p < 0.001), and a larger number of substance use (OR = 1.29, p < 0.001) were more likely to use BHO than only using high potency herbal cannabis. BHO users also reported stronger negative effects and less positive effects when using BHO than high potency herbal cannabis (p ConclusionMental health problems and other illicit drug use were associated with use of BHO. BHO was reported to have stronger negative and weaker positive effects than high potency herbal cannabis.

Aims: Media reports suggest increasing popularity of marijuana concentrates (“dabs”; “earwax”; “budder”; “shatter; “butane hash oil”) that are typically vaporized and inhaled via a bong, vaporizer or electronic cigarette. However, data on the epidemiology of marijuana concentrate use remain limited. This study aims to explore Twitter data on marijuana concentrate use in the U.S. and identify differences across regions of the country with varying cannabis legalization policies. Methods: Tweets were collected between October 20 and December 20, 2014, using Twitter's streaming API. Twitter data filtering framework was available through the eDrugTrends platform. Raw and adjusted percentages of dabs-related tweets per state were calculated. A permutation test was used to examine differences in the adjusted percentages of dabs-related tweets among U.S. states with different cannabis legalization policies. Results: eDrugTrends collected a total of 125,255 tweets. Almost 22% (n = 27,018) of these tweets contained identifiable state-level geolocation information. Dabs-related tweet volume for each state was adjusted using a general sample of tweets to account for different levels of overall tweeting activity for each state. Adjusted percentages of dabs-related tweets were highest in states that allowed recreational and/or medicinal cannabis use and lowest in states that have not passed medical cannabis use laws. The differences were statistically significant. Conclusions: Twitter data suggest greater popularity of dabs in the states that legalized recreational and/or medical use of cannabis. The study provides new information on the epidemiology of marijuana concentrate use and contributes to the emerging field of social media analysis for drug abuse research.

BACKGROUND AND OBJECTIVES: Electronic cigarette (e-cigarette) use is increasing rapidly among high school (HS) students. Of concern, e-cigarettes can be used to vaporize cannabis, although use rates among adolescents are unknown. We evaluated lifetime rates of using e-cigarettes to vaporize cannabis among all lifetime e-cigarette users (27.9%), all lifetime cannabis users (29.2%), and lifetime users of both e-cigarettes and cannabis (18.8%); common means of vaporizing cannabis including hash oil, wax infused with Δ-9-tetrahydrocannabinol (THC), and dried cannabis; and demographic predictors of using e-cigarettes to vaporize cannabis. METHODS: In the spring of 2014, 3847 Connecticut HS students completed an anonymous survey assessing e-cigarette and cannabis use. RESULTS: Vaporizing cannabis using e-cigarettes was common among lifetime e-cigarette users, lifetime cannabis users, and lifetime dual users (e-cigarette 18.0%, cannabis 18.4%, dual users 26.5%). Students reported using e-cigarettes to vaporize hash oil (e-cigarette 15.4%, cannabis 15.5%, dual users 22.9%) and wax infused with THC (e-cigarette 10.0%, cannabis 10.2%, dual users 14.8%) and using portable electronic vaporizers to vaporize dried cannabis leaves (e-cigarette 19.6%, lifetime cannabis 23.1%, lifetime dual users 29.1%). Binary logistic regression indicated that male students (odds ratio [OR] = 2.05), younger students (OR = 0.64), lifetime e-cigarette users (OR = 5.27), and lifetime cannabis users (OR = 40.89) were most likely to vaporize cannabis using e-cigarettes. Rates also differed by HS attended. CONCLUSIONS: Rates of vaporizing cannabis using e-cigarettes were high. These findings raise concerns about the lack of e-cigarette regulations and the potential use of e-cigarettes for purposes other than vaping nicotine.

While marijuana remains the most widely used illicit drug in the United States1 and is the subject of countless medical, psychological, and sociological studies,2 its potential harms are not fully ...

The practice of "dabbing" has seen an apparent upswing in popularity in recent months within American drug subcultures. "Dabbing" refers to the use of butane-extracted marijuana products that offer users much higher tetrahydrocannabinol content than flower cannabis through a single dosage process. Though considerably more potent than most marijuana strains in their traditional form, these butane hash oil products and the practice of dabbing are underexplored in the empirical literature, especially in prohibition states. A mixed-methods evaluation of a federally funded treatment program for drug-involved offenders identified a small sample (n = 6) of butane hash oil users and generated focus group interview data on the nature of butane hash oil, the practice of dabbing, and its effects. Findings inform discussion of additional research needed on butane hash oil and its implications for the ongoing marijuana legalization debate, including the diversity of users, routes of administration, and differences between retail/medical and prohibition states.

The recreational smoking of marijuana, or cannabis, has become widespread, especially among adolescents. Because of its lack of acute life-threatening effects, marijuana has often been considered to be a “soft drug”. This perception may have to be revised in face of recent evidence that use of this substance may have longlasting, residual effects on immune function. THC is the major psychoactive component in marijuana and is concentrated primarily in the flowering tops of the plant Cannabis sativa, which may contain 1–6% THC total weight. However, the percentage by weight of THC may reach 8% in hashish and exceed 50% in hash oil. THC and other cannabinoids that are native to cannabis are referred to as phytocannabinoids. These share with other phytocannabinoids the property of being lipophilic and following smoking, are stored in the liver, lung, spleen, and especially in neutral fat. It has been estimated that THC has a half-life of 8 days in fat and that it may take up to 1 month for complete elimination. This persistence in bodily tissues suggests that THC exerts residual effects following an episode of smoking marijuana. THC also exerts a wide range of effects on immune function, most of which are suppressive [1]. Most of the data that have linked THC to immune suppression have been obtained through studies using various immune cell subpopulations in culture or in animal models. These results must be interpreted with the caveats that effects have been attributed to THC under conditions that are divorced from the potential interactive effects with other cannabinoids that are found natively in marijuana. Also, a potential confound in attributing a specific effect of THC on the immune system is that individuals who use marijuana in a recreational mode may also partake in other substances that have an immune-suppressing potential. In addition, individuals who use marijuana for therapeutic purposes may already have underlying health conditions that render them immunocompromised or susceptible to infection. Nevertheless, the preponderance of the scientific data indicates that THC has a diverse effect on the immune system and dampens the antibody response of humans and animals, suppresses the activities of T lymphocytes, inhibits NK cytolytic activity, and abolishes the functional activities of macrophages [1]. Salient among these is that THC has been reported to promote a shift in Th cell differentiation from that of a Th1-type proinflammatory to that of a Th2-type anti-inflammatory mode. Such a perturbation in the cytokine homeostatic balance could place a host at greater susceptibility to infection with a variety of microbial agents. Many of the effects of THC have been attributed to the activation of two serpentine, seventransmembrane, G-inhibitory proteincoupled receptors [2]. The first of these, CBR1, is found principally in the CNS and accounts for the psychoactive properties of THC. The second of these, CBR2, is found primarily in cells of the immune system and is linked to a variety of immune-suppressive activities attributed to THC. Recent studies suggest that exposure to marijuana may have effects that extend beyond the acute level. It has been suggested that exposure to marijuana during adolescence represents a particularly vulnerable time window for the deleterious effects of THC that may have long-term effects. For example, Rubino et al. [3] and Tomasiewicz et al. [4] indicated that adolescent exposure to marijuana components affected neuropsychological function in adulthood. Lombard et al. [5] reported that perinatal exposure to THC had a profound effect on the mouse fetus, as evidenced by a decrease in thymic cellularity on Gestational Days 16, 17, and 18 and Postgestational Day 1, which was accompanied by marked alterations in certain T cell subpopulations. These outcomes were reversed by antagonists that targeted the CBR1 or CBR2, suggesting

The University of Mississippi has a contract with the National Institute on Drug Abuse (NIDA) to carry out a variety of research activities dealing with cannabis, including the Potency Monitoring (PM) program, which provides analytical potency data on cannabis preparations con- fiscated in the United States. This report provides data on 46,211 samples seized and analyzed by gas chromatography-flame ionization detection (GC-FID) during 1993-2008. The data showed an upward trend in the mean D 9 -tetrahydrocannabinol (D 9 -THC) content of all confiscated cannabis preparations, which increased from 3.4% in 1993 to 8.8% in 2008. Hashish potencies did not increase consistently during this period; however, the mean yearly potency varied from 2.5-9.2% (1993-2003) to 12.0-29.3% (2004-2008). Hash oil potencies also varied considerably during this period (16.8 € 16.3%). The increase in cannabis preparation potency is mainly due to the increase in the potency of nondomestic versus domestic samples.

Butane hash oil (BHO), also known as "amber," "dab," "glass," "honey," "shatter," or "wax," is a potent marijuana concentrate, containing up to 90 % tetrahydrocannabinol (THC). BHO is easily manufactured using highly volatile butane as a solvent. Our objective was to characterize hydrocarbon burns associated with BHO manufacture in Colorado. This was a cross-sectional study utilizing the National Burn Repository to capture all hydrocarbon burns reported to the local burn center from January 1st, 2008, through August 31st, 2014. We abstracted demographic and clinical variables from medical records for patients admitted for hydrocarbon burns associated with butane hash oil extraction. Twenty-nine cases of BHO burns were admitted to the local burn center during the study period. Zero cases presented prior to medical liberalization, 19 (61.3 %) during medical liberalization (Oct 2009-Dec 2013), and 12 (38.7 %) in 2014 since legalization. The majority of cases were Caucasian (72.4 %) males (89.7 %). Median age was 26 (range 15-58). The median total-body-surface-area (TBSA) burn size was 10 % (TBSA range 1-90 %). Median length of hospital admission was 10 days. Six required intubation for airway protection (21 %). Nineteen required skin grafting, eight wound care only, one required surgical fracture repair, and one required surgical debridement. Hydrocarbon burns associated with hash oil production have increased since the liberalization of marijuana policy in Colorado. A combination of public health messaging, standardization of manufacturing processes, and worker safety regulations are needed to decrease the risks associated with BHO production.

* Abbreviations: BHO — : butane hash oil THC — : tetrahydrocannabinol The practice now known as “dabbing” appears to be quickly proliferating as a fashionable way to use marijuana in the United States.1 Dabbing is the inhalation of a concentrated tetrahydrocannabinol (THC) product created through butane extraction. The use of butane hash oil (BHO) products and the modification of cannabis more generally are not new phenomena, but dabbing has recently moved from relative obscurity to the headlines, leaving cannabis aficionados, adolescents, and parents curious about its effects. Physicians and other health care professionals need to be prepared for discussions about the effects of dabbing to minimize potential harms, particularly because recent marijuana policy changes likely has facilitated youth access to “dabs.” BHO is made from cannabis and in many instances may be used to salvage less potent portions of the plant.2 Because BHO production is uncomplicated, requires few resources, and is the subject of countless instructional videos on social media Web sites, recreational users have created BHO at home in a process colloquially called “blasting.” Blasting involves passing butane through a steel or glass tube packed with dried cannabis trimmings. THC and other hydrophobic compounds in the vegetation’s trichomes dissolve within the butane; the butane–THC solution leaves the tube through a filter and is collected in a dish or tray. Because butane is very volatile, it evaporates (or is purged within a vacuum oven), leaving crystalized resins that can have a THC concentration approaching 80%. This product can take many forms depending on heat, pressure, humidity, and other factors. The form most challenging to produce … Address correspondence to John M. Stogner, PhD, Department of Criminal Justice and Criminology, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223. E-mail: johnstogner{at}uncc.edu

A new method for administering cannabinoids, called butane hash oil ("dabs"), is gaining popularity among marijuana users. Despite press reports that suggest that "dabbing" is riskier than smoking flower cannabis, no data address whether dabs users experience more problems from use than those who prefer flower cannabis. OBJECTIVE: The present study aimed to gather preliminary information on dabs users and test whether dabs use is associated with more problems than using flower cannabis. METHOD: Participants (n=357) reported on their history of cannabis use, their experience with hash oil and the process of "dabbing," reasons for choosing "dabs" over other methods, and any problems related to both flower cannabis and butane hash oil. RESULTS: Analyses revealed that using "dabs" created no more problems or accidents than using flower cannabis. Participants did report that "dabs" led to higher tolerance and withdrawal (as defined by the participants), suggesting that the practice might be more likely to lead to symptoms of addiction or dependence. CONCLUSIONS: The use of butane hash oil has spread outside of the medical marijuana community, and users view it as significantly more dangerous than other forms of cannabis use. Language: en

The cannabis plant (Cannabis sativa L.) and products thereof (such as marijuana, hashish and hash oil) have a long history of use both as a medicinal agent and intoxicant. Over the last few years there have been an active debate regarding the medicinal aspects of cannabis. Currently cannabis products are classified as Schedule I drugs under the Drug Enforcement Administration (DEA) Controlled Substances act, which means that the drug is only available for human use as an investigational drug. In addition to the social aspects of the use of the drug and its abuse potential, the issue of approving it as a medicine is further complicated by the complexity of the chemical make up of the plant. This manuscript discusses the chemical constituents of the plant with particular emphasis on the cannabinoids as the class of compounds responsible for the drug’s psychological properties.

The analysis of 35,312 cannabis preparations confiscated in the USA over a period of 18 years for delta-9-tetrahy-drocannabinol (Δ9-THC) and other major cannabinoids is reported. Samples were identified as cannabis, hashish, or hash oil. Cannabis samples were further subdivided into marijuana (loose material, kilobricks and buds), sinsemilla, Thai sticks and ditchweed. The data showed that more than 82% of all confiscated samples were in the marijuana category for every year except 1980 (61%) and 1981 (75%). The potency (concentration of Δ9-THC) of marijuana samples rose from less than 1.5% in 1980 to approximately 3.3% in 1983 and 1984, then fluctuated around 3% till 1992. Since 1992, the potency of confiscated marijuana samples has continuously risen, going from 3.1% in 1992 to 4.2% in 1997. The average concentration of Δ9-THC in all cannabis samples showed a gradual rise from 3% in 1991 to 4.47% in 1997. Hashish and hash oil, on the other hand, showed no specific potency trends. Other major cannabinoids [cannabidiol (CBD), cannabinol (CBN), and cannabichromene (CBC)] showed no significant change in their concentration over the years.

Hash oil samples were analyzed for pollen before and after filtration through 12 different household fabrics, to determine to what extent such samples can be shown to have come from the same source despite having undergone these different treatments. Unfiltered hash oil samples extracted from the same batch of cannabis leaf material showed similar pollen values. An unstirred portion of the extraction solution showed differences in some pollen values to those of stirred samples, suggesting differential rates of pollen settling. However, the presence of some of the same uncommon pollen types in unstirred and stirred samples suggests a common source. Of 12 filter fabrics, ten (a bath towel, two tea towels, a bedsheet, two pillowcases, three stockings and a t-shirt) had a minor effect on the pollen content of the hash oil by slightly reducing the frequencies of some of the larger sized pollen types. Only two of the fabrics had a major effect on the pollen content of the hash oil. The nappy markedly reduced the proportion of the larger sized pollen types resulting in a marked increase in the proportion of some smaller pollen types whereas the calico filtered out virtually all pollen. Illicit hash oil samples recovered from different people or places may therefore in many cases be compared to determine a common source despite samples from the same batch having undergone different filtration treatments and despite differential settling rates of pollen. Also, hash oil samples may be compared to samples of untreated cannabis leaf material to establish a common source.

The chemical analysis of 2169 Cannabis preparations confiscated in the United States over a ten-year period is discussed. Samples are categorized according to physical appearance and potency trends are noted. The appearance of sinsemilla and buds, more potent forms of marijuana, and their effects on overall potency are emphasized along with discussion on domestically grown marijuana.