Health & Medicine

Hash-oil burns are exploding danger

An explosion caused by the illegal manufacture of butane hash oil destroyed a Walnut Creek apartment building in October 2014. At UC Davis Medical Center and Shriners Hospitals for Children, Northern California, injuries from butane hash-oil explosions account for 8 to 10 percent of severe burn cases, a larger percentage than from car wrecks and house fires combined, said Dr. David Greenhalgh, chief burn surgeon at both hospitals. “It’s kind of an epidemic for us,” Greenhalgh said.
An explosion caused by the illegal manufacture of butane hash oil destroyed a Walnut Creek apartment building in October 2014. At UC Davis Medical Center and Shriners Hospitals for Children, Northern California, injuries from butane hash-oil explosions account for 8 to 10 percent of severe burn cases, a larger percentage than from car wrecks and house fires combined, said Dr. David Greenhalgh, chief burn surgeon at both hospitals. “It’s kind of an epidemic for us,” Greenhalgh said. Contra Costa County Fire Protection District

On her cellphone, Tracey Clark keeps snapshots of her two sons dressed as groomsmen at a family friend’s wedding last fall. The younger boy, 13, smiles under a mop of curly brown hair. His older brother, 15, is clean cut and handsome.

Flipping ahead in her phone’s photo gallery, Clark shares pictures of her boys taken two months later, when they’re almost unrecognizable. In November, the teens landed in intensive care at Shriners Hospitals for Children in Sacramento, enveloped in gauze, breathing tubes in their throats, their faces raw and red from the massive third-degree burns suffered in a fire, which prosecutors say was caused by an illegal hash-oil lab at their uncle’s duplex in Butte County.

The two, who investigators believe innocently walked into their uncle’s workspace just before it exploded in flames, suffered burns over 40 to 60 percent of their bodies.

“I was scared they were going to die,” said Clark, a phlebotomist with the American Red Cross who lives in Pittsburg. “I thought, ‘This isn’t real. This isn’t happening.’”

Similar scenes have played out throughout California in recent years as intense fires from the illegal manufacture of butane hash oil – cheap and easy to make but extremely volatile – have exploded.

At two of Northern California’s major burn treatment centers – UC Davis Medical Center in Sacramento and Shriners Hospitals for Children, Northern California – injuries from butane hash-oil explosions account for 8 to 10 percent of severe burn cases, a larger percentage than from car wrecks and house fires combined, said Dr. David Greenhalgh, chief burn surgeon at both hospitals.

“It’s kind of an epidemic for us,” Greenhalgh said. There have been times when half of the 12 beds in UC Davis’ burn unit were filled with patients injured in hash-oil explosions, he said.

Between 2007 and 2014, 101 patients with suspected or confirmed burns from butane fires were admitted to the two hospitals, most of them in the past three years, according to Greenhalgh. Most were adults, but six of the admitted patients were under 18, some as young as 2 or 3 years old.

The case of the two teens, who were released from Shriners earlier this year after months in intensive care and multiple surgeries and skin grafts, was especially troubling because of their ages and the extent of their injuries, Greenhalgh said.

The Sacramento Bee is not naming them at the family’s request and because they are the juvenile victims of an alleged crime.

Statewide, illegal manufacturing of hash oil has become a public health menace on a par with illegal methamphetamine labs in prior decades, according to some law enforcement officials.

While federal and state statistics on butane hash-oil explosions are not readily available, there are numerous reports of arrests and fires at the local level.

In Butte County, for instance, prosecutors said 31 illegal hash-oil operations were uncovered in 2014. “We’re already on track to exceed that this year,” District Attorney Michael Ramsey said. The numbers are similar to the annual count of meth labs the county was breaking up in the 1980s and ’90s, he said.

“What we see now is a reprise of that (but) with more unsophisticated manufacturers,” Ramsey said. “They look on the Internet, order up the supplies – and blow themselves up.”

Ramsey’s office is prosecuting the teens’ uncle, 30-year-old Brandon Qassem, on seven felony charges, including possession of marijuana for sale, child endangerment and recklessly causing a fire that resulted in great bodily injury. Badly burned in the fire, Qassem is not incarcerated pending his trial because Butte County jailers are unable to cope with his medical needs, Ramsey said.

His wife, Angela Qassem, who is charged with two felonies, including child endangerment, told investigators that she and her husband were unemployed and making butane hash oil to sell to medical marijuana dispensaries, the district attorney said.

Easy to make, hard to control

Butane hash oil, a highly concentrated form of cannabis, is illegal to manufacture but is legal to sell under California’s medical marijuana law, meaning dispensaries must get their supply from illicit operations, according to law enforcement officials. The substance is sold in different forms to smoke and also used to make cookies and candies.

Hash oil’s concentration of THC, the active substance in marijuana, can reach 85 percent compared with a marijuana bud’s typical concentration of about 25 percent, said Vic Massenkoff, an investigator with the Contra Costa County Fire Protection District and one of the state’s leading experts on butane hash-oil fires.

Hash oil, made from discarded marijuana trimmings, sells for $800 to $1,300 per pound wholesale and can have a retail street value of $22,000 per pound, he said.

The lucrative market is helping to drive hash-oil production, while the wide availability of online videos and inexpensive supplies is compounding the number of tragic fires, said law enforcement and medical professionals.

Massenkoff delivers training sessions to law enforcement groups and firefighters on the dangers of butane hash oil, also called BHO or honey oil.

The key ingredient is compressed butane, which comes in canisters about the size of a 16-ounce beer can that drugmakers can easily purchase in bulk.

On Amazon, for example, a simple query for “BHO” pulls up the essential supplies a hash-oil maker would need, including a $40 case of 12 cans of “5x Power Butane Super Refined Fuel Gas,” which Massenkoff said is a favorite brand of hash-oil makers. There was also a large glass extraction tube for $37, a book called “How to Make BHO” and nonstick silicone mats for making dabs, the small potent drops of hash oil popular with smokers.

Typically, a hash oil maker crams a tall tube with marijuana and shoots the liquid butane through it. The butane acts as a solvent to extract and concentrate the THC-containing compounds, which drip into a glass container, usually Pyrex. It’s then set on a bath of warm water or a hot plate to help vaporize the butane, leaving behind the pure hash oil.

The biggest danger comes from the vaporized butane – invisible, odorless and heavier than air – that sinks to the floor and collects in enclosed spaces.

“These folks are standing in a cloud of clear, odorless butane,” with the substance absorbing into their clothing, Massenkoff said.

While many online videos carry warnings to avoid fires by only making hash oil outdoors, most manufacturing is done indoors because it’s illegal.

Almost any ignition source, from a spark of static electricity to a water heater’s pilot light, can turn the butane into an explosive inferno.

Curbs on butane buying?

Lawmakers are looking at ways to regulate the sale of butane. A bill introduced in February by Assemblywoman Catharine Baker, R-Dublin, would prohibit any individual from buying more than 400 milliliters of butane in a month and impose reporting requirements on retailers.

Similar limits on the cold medicine pseudoephedrine, a key ingredient of methamphetamine, are credited with curbing meth production in California in recent years. The law now requires purchasers to show their driver’s license to buy a single box.

Similar restrictions are needed for butane, said Massenkoff, who has written to Amazon asking the company to stop selling butane canisters in bulk.

Doctors and emergency crews have become better at identifying the causes of hash-oil burns, Greenhalgh said. Patients are predominantly young men who tend to be burned in groups of two and three while making the oil, he said.

Those whose clothes catch on fire can suffer third-degree burns over much of their bodies, including their faces. With massive burns the body swells, shutting off the airway, and an untreated patient would typically die in a few hours, the doctor said.

The body needs huge amounts of calories to heal from major burns, but such badly injured patients have a hard time getting enough nutrition through their feeding tubes and the body begins to break down muscle and weaken further, he said.

“These are big burns,” Greenhalgh said.

Hospital stays of months are common in the worst cases, including long stints in intensive care. There’s a constant risk of infection, multiple skin grafts, months or years of painful recovery, and scarring and disfigurement. Medical bills can run into the millions of dollars, though many patients are uninsured, the doctor said.

Clark, the Contra Costa teens’ mother and a widow, is sharing her family’s story to warn people of the human cost from illicit manufacturing of butane hash oil.

The horrific burns have changed daily life for Clark and her sons.

The boys are schooled at home while they recover. Once a day, Clark changes her younger son’s dressings on his raw back. He’s had 10 skin-graft operations and still must undergo reconstructive surgery on his face. She also must massage her older son each day to loosen the tight areas where his skin is healing from five operations.

It could be a year or more before her sons will be able to resume a normal life. Although some might consider their faces burned beyond recognition, their mother said, “I can tell it’s them.”

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