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Fabian Castillo suffered from disabling anxiety when his uncle handed him a marijuana vape pen one day last December.
"It will help calm you down," said Castillo, his uncle said.
In the following months, the vape worked as advertised. Castillo, who had just graduated from high school in Southern California, found himself calmer and more productive.
At the time, he did not know what he was using, what he now believes, was a vape bootleg pen filled with a mixture of toxic chemicals.
But on August 2, Castillo's breathing became laborious. Her mother took her to the emergency room where, according to her, an x-ray revealed severe lung damage.
"I could not breathe, I could not speak, I could literally not even move my hands," said Castillo, 19.
He spent the next nine days in a medically induced coma. Eight weeks later, he is still struggling to breathe deeply.
The growing popularity of vaping products – both legal and imitation – is fueling a public health crisis that has upset the medical community.
A dozen people have died of mysterious lung diseases associated with retention pens, and another 805 have been hospitalized in 46 states, according to federal health officials.
"We are dealing with a new epidemic," said Dr. Melodi Pirzada, a pediatric respirologist at NYU Winthrop Hospital in Long Island, New York State.
The Centers for Disease Control and Prevention predict that most patients reported using vapors containing THC, the psychoactive ingredient in marijuana. Some state health officials have indicated that vitamin E acetate, a solvent used to "cut" cannabis for use in spray pens, could be responsible for the outbreak.
But no substance or product has yet been associated with any cases of vapor-related lung disease, says the CDC, leaving the medical community struggling with an explosive health crisis of unknown cause.
At the same time, the FDA is struggling to control what has quickly become a billion-dollar industry with a booming black market, experts say
The result: Americans have access to an amazing assortment of THC spray pens with no way of knowing what they actually contain.
Seeking answers, NBC News commissioned one of the country's largest cannabis testing centers to test a sample of THC cartridges – 18 in total – obtained from legal clinics and unauthorized resellers.
The results were deeply troubling.
Of the three purchased from California's forensic clinics, the CannaSafe testing company has not found any heavy metals, pesticides or residual solvents such as vitamin E.
However, 13 of the remaining 15 samples from black market THC cartridges contained vitamin E.
CannaSafe has also tested 10 unregulated cartridges for pesticides. All ten tested positive.
The products all contained myclobutanil, a fungicide that can be turned into hydrogen cyanide when burned.
"You certainly do not want to smoke cyanide," said Antonio Frazier, vice president of operations at CannaSafe. "I do not think anyone would buy a cart labeled cyanide hydrogen on it."
Pirzada described the existence of myclobutanil as "very disturbing". "It's going to have a very toxic effect on the lungs," she said.
The New York pulmonologist also expressed concern about the presence of vitamin E, also known to cause significant lung injury by inhalation, in THC blends. "It should not be inhaled into your lungs," she says.
Pirzada treated four patients, all adolescents, with pulmonary lesions related to vaping. She stated that the tests conducted on the same vaping mixture as that used by one of her patients had highlighted the presence of vitamin E.
The 18-year-old boy arrived at the hospital with symptoms resembling pneumonia. But within 48 hours, Pirzada said, his health deteriorated rapidly and he was placed under a fan.
He spent five days in intensive care before he could breathe alone and recover thanks to the steroids. "He needed very important support to keep him alive," Pirzada said.
These patients flock to the country's hospitals. During the summer, an 18-year-old girl arrived at UCLA Health with severe cough, fever, nausea and labored breathing. In less than 48 hours, her lung function deteriorated to the point that doctors sent her to the intensive care unit and connected her to a respirator.
The teenager, who said he has been vaping tobacco and potted products every day for the past two years, has finally improved and was released from the hospital.
"She got very sick very quickly," said Kathryn Melamed, a pulmonologist who saved the life of this teenager.
Less than 15 miles from UCLA Health is a 12-block area of downtown Los Angeles filled with vape shops. Stores sell empty cartridges and packaging, allowing anyone with access to THC and a solvent such as vitamin E to easily produce their own vape bootleg products.
California has legalized marijuana for recreational purposes for adults over 21 in 2016.
David Downs, head of Leafly's California office, an online publication dedicated to the cannabis industry, said that downtown Los Angeles was the final destination of a supply chain in the US. from China.
"It all starts in China, where you can buy empty cartridges for the THC market and the nicotine market, as well as additives, flavorings and thickeners added to these cartridges along with the oil. of THC, "said Downs.
"It's a very deep, mature and advanced industry that starts in China and ends in our own backyard."
Downs said that anyone who buys bootleg tapes is putting himself in danger.
"I said," Listen, if you buy a fake Gucci handbag, it will not cause you a lung injury, but if you buy a fake vape cartridge, it's possible that it will happen. "
FED Acting Commissioner Ned Sharpless on Wednesday told a US congressional committee that investigators were working to identify dangerous products and "follow the supply chain." to the source".
"The FDA does not pursue any action related to the personal use of vaping products, we are interested in suppliers," said Sharpless to the House Energy and Commerce Subcommittee, which exercises oversight over the FDA.
"But to be clear, if we determined that a person manufactures or distributes illicit, adulterated, vaping products that cause illness and death for personal gain, we will consider this a criminal act."
The American Vaping Association insists that the outbreak is related to THC oils and their imitations.
One of the stores visited by NBC News in Los Angeles sold packages for Dank Vapes Gorilla Glue, the same vape brand used by Castillo before landing at the hospital's ICU. The product is in no way associated with Gorilla Glue, the company that produces super-glue and other adhesives.
An aspiring singer, Castillo has not yet regained his health. Whenever he tries to take a deep breath, he has the impression of descending a staircase. Castillo also faces a strange sensation that lets him feel as if he is falling and causing a body contraction.
He stated that he was expressing himself to deter others from putting their lives at risk by using vows.
"Everything was paused because I decided to vape," Castillo said. "I thought it was safe."
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