HSA doctors on high alert for vaping, e-cigarette illnesses

CTMH Doctors Hospital Clinical Compounding Pharmacist Kevin Gipple works inside the hospital's compounding lab. He does not expect the US investigations into vaping or local developments surrounding e-cigarettes and THC to negatively impact the medical cannabis industry in Cayman. - Photo: Kevin Morales

The Health Services Authority has confirmed that its medical staff treated two e-cigarette users but stopped short of linking their symptoms with the use of those products.

Physicians have been placed on “high alert”, however, and are asking more direct questions of people using vaping and e-cigarette products, an HSA spokesperson told the Cayman Compass.

One of the patients had bleeding from the nostril and the other an “unusual and transient cough”.

“No other serious cardiorespiratory symptoms have been identified in persons vaping or using e-cigarettes,” the spokesperson said.

The US-based Center for Disease Control and Prevention and the Food and Drug Administration are investigating a rash of deaths and illnesses in that country believed to be associated with vaping. Seven deaths and 530 cases of lung injury have been reported from 38 states and one US territory as of Thursday, according to the CDC. Most patients reported a history of using e-cigarette products containing THC.

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The ongoing investigations prompted Cayman’s National Drug Council last week to issue a statement that, in part, urged the public to make informed decisions, including about any associated risks, when it comes to substance use of any kind.

“While we acknowledge there are positive impacts of the CBD component found in cannabis for medicinal purposes, we urge the public to be informed,” National Drug Council Director Joan West Dacres is quoted as saying in the statement. “It is well known that components of cannabis are addictive, affect the brain and have been linked to increased risk of mental health problems.

“Over the years, studies have provided significant evidence on the effects of alcohol and tobacco use, comparatively to date, there is insufficient conclusive evidence on the effects of medicinal cannabis use.”

Impact of medical cannabis in Cayman

CTMH Doctors Hospital and Cayman Pharmacy Group Clinical Compounding Pharmacist Kevin Gipple says he does not expect the US investigations to result in a shift of sentiment regarding medical cannabis in the Cayman Islands.

“If we’ve got a patient on a product and it’s working, they’re gonna continue it,” he said. “Time will tell, now that it’s all over the press and so on, but I wouldn’t I think so. You’ve got a product, it’s legal, it’s been working.”

While the US investigations centre on oils inhaled through a vaporiser, most medical cannabis prescriptions in Cayman are for products meant to be taken orally. Patients generally have been open to the idea of being prescribed products containing THC ever since amendments were made to the Misuse of Drugs Law (2017 Revision) that allowed for cannabis extracts and tinctures to be prescribed, Gipple said, adding that there has been some scepticism within the medical community.

“Certainly, some of the doctors said, ‘No, I don’t believe in it. It’s associated with smoking, it’s not FDA approved and the studies aren’t there’ – and they’re not,” he said.

One medical supplies industry insider, however, told the Cayman Compass that a recent search and seizure of THC vaping products at Doctors Express could negatively impact local medicinal cannabis stakeholders.

“These products are very popular right now,” the insider said, requesting to remain anonymous for fear of professional retribution. “People are looking for more natural ways to treat their illnesses.”

“Doctors Express has definitely set the cannabis industry back,” he added. “We were making strides to move forward, but Express has put the cart before the horse. They tried to go around the government and now they are going to have to pay the consequences.”

Statistics suggest CBD oil users in Cayman are not using it to get high, Gipple said. As of August 2018, there were 332 prescriptions written for medicinal cannabis. Of those, nearly 85% were written for oils featuring a lesser amount or no THC, the principal psychoactive compound found in cannabis.

“So that kind of shows people are interested in the medicinal qualities of it,” he said. He believes the number of prescriptions for medicinal cannabis is likely approaching 600.

As for those who may prefer to use a vape to inhale CBD oils, he cautions against finding similar products on the street following the Ministry of Health Chief Medical Officer’s cease and desist order.

“Sure, there’s potential,” he said. “I would hope they would go the other way and go to the oral because they still get the health benefit and they may get some euphoria from that too.”

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