# Toxicity and health effects of delta-8, delta-9, and delta-10-tetrahydrocannabinol and unregulated cannabinoids in vaping products

## TL;DR

This paper reviews the health risks of hemp-derived cannabinoids like delta-8, delta-9, and delta-10 THC, highlighting their toxicity and the need for regulation.

## Contribution

The paper provides a comprehensive review of the pharmacology, toxicity, and health risks of unregulated hemp-derived cannabinoids.

## Key findings

- Hemp-derived cannabinoids are linked to pulmonary toxicity and health crises like EVALI and CHS.
- THC and CBD affect health via CB1/CB2 receptors and NF-κB pathways.
- Regulatory oversight is urgently needed to address the risks of unregulated cannabinoid products.

## Abstract

Hemp-derived cannabinoids (CBDs) such as Δ8- and Δ10-tetrahydrocannabinol (THC) in cannabis e-cigarettes have been growing in popularity among youth, causing great concern for their health effects. Previous novel lung injury outbreaks, such as E-cigarette or Vaping Use-Associated Lung Injury (EVALI), were associated with the rising use of e-cigarettes and vaping products. Toxicological studies have revealed that chronic exposure to cannabis vapor can cause adverse brain and pulmonary effects. Hemp products are classified as cannabis and set a limit of no more than 0.3 % Δ9-THC, while products containing more than 0.3 % are defined as ‘marijuana.’ This has led to the proliferation of hemp-derived intoxicating cannabinoids, such as Δ8- and Δ10-THC, in addition to cannabidiol (CBD), cannabinol (CBN), cannabigerol (CBG), and Δ9-THC appearing in combination products. CBD frequently serves as a significant component of hemp-derived formulations, making it a central consideration for toxicological and regulatory evaluation as well. This phenomenon poses significant health risks to youth because these newer THC isomers and products are currently unregulated and not well-researched, yet they are still widely available. Therefore, we have examined the pharmacology, toxicity, potential therapeutic uses and possible health risks of several THC and hemp-derived cannabinoids. This review draws insightful highlights to the public health consequences of secondary exposures to CBD and THC, and their molecular mechanisms of action. It underscores the urgency for a regulatory oversight over unregulated cannabinoid markets to prevent toxicity of vaping-related health crises and other rapidly emerging cannabis health disorders, like the cannabinoid hyperemesis syndrome (CHS).

•Hemp-derived cannabinoids (Δ8-, Δ9, Δ10-, CBD) contribute to emerging toxicological health risks.•Cannabis vaping is associated with pulmonary toxicity such as EVALI and CHS.•THC and CBD both exert effects via CB1/CB2 receptors and NF-κB pathways.•There is an urgent need for regulations based on toxicity of cannabinoids.

Hemp-derived cannabinoids (Δ8-, Δ9, Δ10-, CBD) contribute to emerging toxicological health risks.

Cannabis vaping is associated with pulmonary toxicity such as EVALI and CHS.

THC and CBD both exert effects via CB1/CB2 receptors and NF-κB pathways.

There is an urgent need for regulations based on toxicity of cannabinoids.