title: Butane Hash Oil Burns: A 7-Year Perspective on a Growing Problem.
abstract: With the legalization of marijuana in four states, and decriminalization in many others, marijuana is becoming easier to obtain. The authors have experienced an increase in burn injuries related to the production of butane hash oil (BHO; a concentrated tetrahydrocannabinol product produced by the distillation of marijuana plant products with pressurized butane). This article updates our experience and highlights the increasing public health problem associated with these burns. Charts of patients who presented to the burn center with suspicion of BHO-related injuries between January 2007 and December 2014 were examined. Data collected included demographics, injury characteristics, treatment utilized, and outcomes. Charts of 101 patients were identified as having BHO-related burn injury. The mean age of these patients was 30.5 ± 10.6 years (mean ± standard deviation, range: 2-55 years) and 93.1% were male. Patients sustained a mean of 26.8 ± 24.1% TBSA burn with 14.3 ± 25.1% third degree burns. Three patients died as the result of their injuries. Patients required a mean of 12 ± 48.4 ventilator days, and 27.1 ± 59.4 days in the hospital. The number of patients presenting with these burns increased over the past 7 years. BHO burns occur most commonly in February (12 patients), on Wednesday (19 patients), and between 18:00 and 06:00 (58 patients). There has been a sharp increase in the number of patients presenting with burn-associated BHO production in the region over the past 7 years. The authors as burn care providers need to increase public awareness of this issue and aid in the development of legislation to help prevent these burns before it becomes a public health crisis.
authors.affiliation: From the *Shriners Hospitals for Children Northern California, Sacramento; †Firefighters Regional Burn Center at University of California, Davis; and ‡Department of Surgery, University of California, Davis.
authors.forename: Kathleen S
authors.initials: KS
authors.lastname: Romanowski
authors.forename: Alura
authors.initials: A
authors.lastname: Barsun
authors.forename: Peter
authors.initials: P
authors.lastname: Kwan
authors.forename: Esther H
authors.initials: EH
authors.lastname: Teo
authors.forename: Tina L
authors.initials: TL
authors.lastname: Palmieri
authors.forename: Soman
authors.initials: S
authors.lastname: Sen
authors.forename: Pirko
authors.initials: P
authors.lastname: Maguina
authors.forename: David G
authors.initials: DG
authors.lastname: Greenhalgh
mesh_terms: D000328:Adult; D002057:Burns, Chemical / Q000453:epidemiology / Q000209:etiology*; D002059:Burns, Inhalation / Q000453:epidemiology* / Q000209:etiology; D002073:Butanes / Q000009:adverse effects; D002188:Cannabis / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D064086:Medical Marijuana / Q000600:supply & distribution*; D020380:Needs Assessment; D010938:Plant Oils / Q000009:adverse effects*; D011634:Public Health; D012189:Retrospective Studies; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D002073:Butanes; D064086:Medical Marijuana; D010938:Plant Oils