TOPEKA, Kan. — When I inquired about cannabis products at a vape shop on the west side of Kansas’ capital city, the employee asked me one question: “Do you have pain, or are you trying to get f— up?”
There were plenty of options for the latter — especially for someone with a sweet tooth. For the chocoholic: “Trips Ahoy” cookies, THC “Snickers,” and “Cookies ‘n’ Cream” flavored chocolate bars. For the candy lover: gummies made to look like Haribo, Nerds Rope, and Starbursts.
If I was the type of person who “got high before work,” I should try THC-O products, the employee explained.
All this was readily available for purchase, even though Kansas is one of just a handful of states in the nation without laws that allow some access to cannabis products. Kansas hasn’t enacted a medical marijuana program or even decriminalized weed. Even getting caught with a pipe or rolling papers can land you in jail.
To get around those laws, merchants are selling quasi-legal products containing slightly tweaked versions of marijuana to skirt the laws: products containing the chemicals Delta-8 THC, Delta-10 THC, THC-O, or HHC. Walk into almost any smoke shop in Topeka and you’ll see a wide variety on offer. There are disposable “marijuana” vapes in flavors like wedding cake, blackberry diesel and Hawaiian punch, pre-rolled joints, and even flower — green buds that look and smell almost exactly like traditional marijuana.
“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.”
The shops are operating in the open. One, a block from the state capitol, calls itself a dispensary and prominently displays a green cross outside — a common sign for medical marijuana. Another had a drive-thru window and a laminated sheet explaining the different highs produced by each different product. A third had a yard sign advertising “Legal THC.”
In just a few hours in October, STAT visited 10 shops openly selling the products in Topeka, which has a population of roughly 125,000.
The 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 in a state like Kansas could change the way it impacts the body. Already, there’s early research showing that at least one of the products being sold in Kansas produces a toxic gas when vaporized. Those same chemists hypothesize the same reaction likely played a role the spate of deaths from vaping products, commonly known as EVALI, in 2019. It’s also unclear whether these products actually contain what they say, because there’s virtually no regulation of the sellers.
“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.”
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.
It’s unclear how much longer the products STAT observed in Kansas will remain on the shelves. The Drug Enforcement Agency declared last week that one of the products being sold in Kansas, THC-O, is illegal under federal law. But for now, the products are still being sold. STAT was able to reach nine of the ten shops by phone. All confirmed they are still selling the same products.
The rise of these products, nearly all of which appear to be being shipped in from other states, has also angered Kansas 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.)
“They are being made by people who are trying to play the system,” said Kelly Rippel, the co-founder of Kansans for Hemp. “Why else would you want to get in a lab and try to [make these products]?”
Some of the compounds for sale in Kansas are well-known in the drug control world. The FDA has already warned about the risks of Delta-8 THC, for example. While it typically produces a milder high than traditional marijuana, regulators have warned that products with the chemical have still prompted more than 100 reports of adverse events like hallucinations and vomiting. The FDA has also warned Delta-8 products may contain dangerous byproducts left over from the manufacturing process, which typically involves adding a solvent and an acid to cannabidiol and boiling it.
Delta 8 products are becoming more rare in Topeka after the Kansas attorney general raided a number of stores selling them last year. Now shops have moved onto lesser-known varieties like Delta 10 THC, HHC, HHC-O and THC-O. At the shops STAT visited, HHC and HHC-O products were the most ubiquitous.
HHC-O, in particular, seems to produce stronger highs than marijuana.
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 is 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.”
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 to, STAT’s request to speak about HHC.
Raphael Mechoulam, the first scientist to discover and isolate Delta 9 THC in the 1960s, responded to our question about several of the compounds: “What are HHC and HHC-O?”
At least two stores were also selling THC-O, 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.
THC-O products are in a particularly precarious legal position. Last week, the DEA declared THC-O products are illegal federally because the compound does not occur naturally in hemp. The agency was not asked to weigh in on the legality of HHC but whether those products are eventually deemed illegal or not will likely come down to whether regulators believe it can be found naturally in the cannabis plant.
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, the spate of vaping-induced lung injuries that injured more than 2,800 people and killed more than 60.
Chemists say it’s abundantly clear to anyone with enough knowledge in organic chemistry to make these products that they would cause such a reaction.
“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.
Strongin has not run the same experiments on HHC-O, but hypothesized that it would also produce ketene gas when vaped. “For most any cannabinoid acetate derivatives, including HHC-O, the chemistry should be the same/similar in forming ketene,” he said.
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,” said Strongin said, whose study used a device to simulate vaping.
University of Kansas Medical Center’s Thornton, who runs the entire poison control system for the state, told STAT 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 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 one DEA-registered hemp testing lab in Kansas told STAT it was unable to test for the compounds now openly being sold in the state.
The products don’t appear to produce the types of serious adverse reactions like seizures, and psychosis that were seen with other synthetic “legal highs” like Spice or K2. That’s likely because those products weren’t actually derived from cannabis, but were plant matter sprayed with a variety of chemicals, some of which were far more potent than THC.
But the lack of scientific knowledge about the 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.”
Kruger said her 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.
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.
The rise of these products comes at a critical time for the nascent Kansas hemp industry, which is still working to position itself as a potential cash crop in the agricultural state.
Rippel, of Kansans for Hemp, told STAT 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 in rural Kansas, 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,” Rippel said.
STAT’s coverage of the commercial determinants of health is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.