Butane hash oil production burns surged in Colorado after marijuana liberalization | Research

The takeaway

Burns from homemade butane hash oil extraction increased sharply in Colorado following marijuana liberalization, with 29 cases admitted to a single burn center.

Read this if you're interested in safety risks associated with cannabis concentrate production.

29 BHO burn cases; zero before liberalization, 12 in 2014 alone

What the researchers found

Researchers documented all hydrocarbon burns related to butane hash oil (BHO) extraction admitted to a Colorado burn center from 2008 through 2014. Zero cases presented before medical marijuana liberalization. During the medical liberalization period (2009-2013), 19 cases were admitted. After recreational legalization in 2014, 12 cases were admitted in just 8 months.

The typical patient was a young white male (median age 26). Burns were often severe: median burn size was 10% of total body surface area, median hospital stay was 10 days, 21% required intubation for airway protection, and 19 patients needed skin grafting.

BHO, which can contain up to 90% THC, is manufactured by passing highly volatile butane through cannabis plant material. The process creates explosion risk in enclosed spaces.

Why it matters

This study documented an unintended public health consequence of marijuana liberalization: increased burn injuries from amateur production of concentrated cannabis products. It highlights the need for safety regulations and public education as cannabis markets evolve.

The numbers in context

29 total BHO burn cases. Zero before liberalization, 19 during medical era, 12 in 2014 alone. 89.7% male, 72.4% Caucasian. Median age 26. Median 10% TBSA burns. Median 10-day hospitalization. 21% intubated. 19 required skin grafts. BHO contains up to 90% THC.

How the study worked

Cross-sectional study using the National Burn Repository to capture all hydrocarbon burns at a Colorado burn center from January 2008 through August 2014. Medical records were reviewed for cases specifically associated with BHO extraction.

What this study cannot tell us

Single burn center in one state limits generalizability. The study cannot determine whether these injuries would have occurred without liberalization or represent new behavior. Some BHO-related burns may have been treated at other facilities.

How to read the evidence

Cross-sectional study from a single burn center documenting a temporal trend. Cannot prove causation between liberalization and injuries.

When this study was published

Published in 2015 using data through August 2014. Regulations around BHO production have evolved since.

The bigger picture

Cannabis concentrate production represents a harm that did not exist at scale before legalization. As legal markets develop, regulating manufacturing processes and educating the public about explosion risks from solvent-based extraction at home are public health priorities.

Questions still open

Have commercial regulations reduced amateur BHO production injuries? Do states that legalized later show similar patterns? What public health messaging is most effective at preventing amateur extraction attempts?

Common questions

What is butane hash oil?

BHO is a concentrated cannabis product containing up to 90% THC, made by using highly volatile butane as a solvent to extract cannabinoids from plant material. Amateur production in enclosed spaces can cause explosions and severe burns.

Did marijuana legalization cause these burn injuries?

The study documented a temporal association: zero BHO burns before liberalization and 29 cases after. It cannot prove direct causation, but the timing strongly suggests that increased cannabis access led to more amateur extraction attempts.

Read the original research

Butane Hash Oil Burns Associated with Marijuana Liberalization in Colorado.

Journal of medical toxicology : official journal of the American College of Medical Toxicology, 11(4), 422-5

View on PubMed ↗Publisher’s paper ↗

Citation

Bell, Cameron; Slim, Jessica; Flaten, Hanna K; Lindberg, Gordon; Arek, Wiktor; Monte, Andrew A. (2015). Butane Hash Oil Burns Associated with Marijuana Liberalization in Colorado.. Journal of medical toxicology : official journal of the American College of Medical Toxicology, 11(4), 422-5. https://doi.org/10.1007/s13181-015-0501-0