Sept. 6, 2023 – A product derived from cannabis, created in laboratories around the country, has led to thousands of calls nationwide to poison control centers and sent hundreds of people to emergency rooms with complaints of vomiting, hallucinations, not being able to stand, and even passing out.
And it’s widely available and legal.
The culprit is called delta-8 tetrahydrocannabinol or, more commonly, delta-8 THC. Last May, the FDA issued a consumer update warning of serious health risks linked to delta-8 after people took it, including unintentional exposures in children.
Commercially available delta-8 products are created in labs from cannabidiol (CBD) and a broad mixture of chemicals, such as pesticides, petroleum, and unknown ingredients. Because the FDA does not regulate CBD, delta-8 THC products are slipping under the radar in terms of oversight. As delta-8 products land on the shelves of local gas stations and convenience stores, what questions should consumers be asking before making a purchase?
What is Delta-8 THC?
Delta-8 THC is a cannabis plant ingredient and a “cousin” of delta-9 THC, which is the psychoactive component of cannabis – what gives users a "high." In its purest form, it can go head-to-head with delta-9; they bind to similar receptors in the body, and both produce a high. But unlike delta-9, delta-8 only occurs in trace amounts in the plant, which has limited the ability of manufacturers to use it commercially. This means that the delta-8 found in the neighborhood smoke shop is not the delta-8 found in nature.
The history behind the growth of the delta-8 market can be traced back to the 2018 Farm Bill. A clause let growers cultivate industrial hemp, which included extraction of CBD and other things in the plant that contain less than 0.3% THC. A glut of extracted CBD supply led to a cornucopia of altered products that use household and other chemicals to convert hemp-sourced cannabinoids into synthetic delta-8.
“They’re literally atoms that are rearranged into arrangements that were not created in nature,” said Chris Hudalla, PhD, an analytical chemist and founder and chief scientific officer of ProVerde Laboratories, a cannabis testing lab based in Milford, MA. “They don’t even have a name because they have never been seen before; we have no idea of their toxicity.”
Hudalla’s lab has tested close to 5,000 delta-8 samples, and 100% were contaminated, some with up to 30 types of unintentional secondary products of unknown toxicity.
“It’s a bit like Russian roulette: Every chemist has a different recipe, and every recipe creates a contaminant profile,” Hudalla said. “We literally know nothing about them. We don’t know if they cause birth defects … or whether they cause cancer.”
Ethan Russo MD, a neurologist and researcher who studies how drugs affect the mind and behavior, said that research done in the 1970s, and more recently by Johns Hopkins Cannabis Science Laboratory, has shown that delta-8 is about half as potent as delta-9, meaning that you need twice as much to get the same effects.
But a double dose comes with a host of potential issues, including overdose and a syndrome called cannabinoid hyperemesis, where long-term use might result in repeated, severe bouts of vomiting that can land people in the emergency room.
People who take delta-8 “may not notice toxicity immediately, but we have no idea what the long-term implications of having these products in your body could be,” said Russo, the founder and CEO of CReDO Science, an organization that consults with industry to help design and guide medicinal cannabis research and clinical trials.
Incidentally, the Biden administration recently proposed changing how cannabis is treated in the Controlled Substances Act. The administration calls for moving it from Schedule I status to Schedule III, a category that includes drugs like ketamine and certain steroids considered to have “moderate to low potential for physical and psychological dependence.”
The rescheduling would mean that scientists would have greater access to cannabis for research, potentially opening the door to later legalization of marijuana and, therefore, less consumer interest in delta-8.
Buyers' Regret: A Host of Dangerous Side Effects
The FDA relies on voluntary reports from consumers, patients, doctors, and other health professionals to monitor for side effects of some products like delta-8. Between December 2020 and February 2022, there were 104 reports of adverse reactions from delta-8. Poison control centers also documented over 2,300 calls about exposures to delta-8 THC over the same period.
But when researchers started to track the social media site Reddit for self-reported effects of delta-8 – reports that never reached the FDA – they discovered that the numbers were significantly higher and included more than 2,000 adverse events and more than 400 serious adverse events, finding:
- Over 40% were psychiatric/mood-related (for example, anxiety, delusions, panic attacks, or paranoia).
- Roughly 30% involved the lungs, chest, or throat (for example, a choking sensation, painful breathing, coughing, or throat tightness).
- 22% were general (for example, fatigue; feeling abnormal, with symptoms like heat and jitters; or having secretions).
- 17% were gut-related (for example, stomach pain/discomfort, diarrhea, gas, nausea, or vomiting).
- Almost 9% involved accidental overdose, and 7.5% reported an increase in blood pressure, heart rate, and weight.
Hudalla recalled the case of a young father who had been using delta-8 gummies for months but, one day, decided to double his intake.
“He passed out for a while, and when he woke up, he had a psychotic episode; he literally thought that he had murdered his two children who were sleeping upstairs,” Hudalla said.
Before You Buy
Until the FDA and states start to regulate synthetic delta-8, consumers can take a few steps to protect themselves.
- Do your homework. Learn how and where the products are made. Search the web for sources, and directly ask about key ingredients used to make the product and the reputation of the laboratory that produced it.
- Examine the label. A reputable product will have a certificate of analysis (COA), a document from an accredited laboratory that confirms that the product meets specific standards. This should contain the product name, the company ordering the testing, batch number, and date it was made.
- Limit your purchases to regulated dispensaries. This might be a deal-breaker for people intent on trying delta-8 products, since most of these are sold on the internet or in gas stations and convenience stores, and through illegal channels.
- Be mindful.
But even with a certificate, delta-8 makers do not have do not have a standard processes for potency testing.
“The big distinction between delta-8 and other THC isomer products is that there are no requirements for testing,” said Tracey Lancaster Miller, executive vice president of the Maryland-based Peake ReLeaf Dispensary.
Not only is potency unclear, but “it hasn’t been tested for contaminants, so you don’t know if there might be molds or heavy metals, or other types,” she said.
“These products should be prohibited,” Russo said. But “if they are going to be sold, they need to be properly analyzed with certificates of analysis, and they need proper and accurate labeling. Lack of information of danger does not equal safety.”