Up in smoke? Medical marijuana and ET

I live in a state that approved medical marijuana, and, within weeks of legalization, clinics sprang up where you could pay a doctor $100 up front, get a "diagnosis," and smoke your dope legally. It was something of a debacle. People were getting authorization cards for everything from migraines to back pain to PMS. For a term or two, I had students wafting enough dope smoke into my classroom to give everybody a contact high. I had no idea there were so many suffering college students ...

It's been 30 years since I had a toke, but I honestly see nothing wrong with legalizing recreational use of marijuana and taxing it like liquor. But I'm also pretty leery of using marijuana as a treatment for ET, especially after doing some looking around on the Internet.

Google "essential thrombocytosis" and "marijuana," and you'll be inundated with lots of hits (no pun intended) for sites that make a lot of wild claims about cures and symptom management that look like they're designed to prey on desperate people. But there is some reliable info, and here's what I found:

Back in 2011, the MPNforum ran this essay by David Ensee about using marijuana to help with his polycythemia vera. Ensee started toking occasionally after meeting with a friend who fired up a joint for old times' sake. Ensee writes:

While exercise is actually my first line of defense for all [of my symptoms], some days I don’t have the energy to even begin. A couple of puffs leads to almost immediate relaxation, lowers the perception of body aches, and allows the mind to freely float away from congested thoughts about living with a chronic disease.

Ensee pretty much just reports on his experiences, and doesn't try to persuade anybody to go the alternative medication route. But he believes there should be more study on marijuana's possible benefits. I agree.

The National Institutes of Health (NIH), which has a good fact sheet on cancer and marijuana that is updated frequently, shows that hard scientific data on the medical benefits of marijuana is slim. Because marijuana is still highly restricted by the federal government actual human tests have been small, limited, and inconclusive. So, while the recreational aspect may be helpful to some like Ensee, is it really going to help you? And with what symptoms?

Illinois allows medical use of marijuana for some ailments. Last year the state's Medical Cannabis Advisory Board rejected marijuana for essential thrombocytosis:

“If a condition didn’t get approved it was because either we couldn’t find the medical rationale or the scientific evidence to justify it,” said Leslie Mendoza Temple, a physician and chair of the advisory board. “Or the condition was too broad — such as anxiety. There are many different kinds of anxiety. Everyone can have anxiety because it’s an emotional state. We needed more specificity.”

The main argument for using medical marijuana for your ET is that it might relieve anxiety and pain or discomfort associated with some chemotherapies. Whether it does this better than other meds is unknown. Marijuana might be best applied as a relatively short-acting recreational drug that could offer relief during a trying time, as Ensee suggests.

But there are a lot of con's or at least cautions to consider. It's unclear whether oral, vaped or smoked marijuana is the best delivery system (it does seem to make a difference for some people). Reliable dosing is another problem. Dispensary operators may not do a great job helping patients pick out the marijuana blend that contains the right amounts of THC and CBD (two types of cannabinoids) to address specific symptoms. You're relying on people whose pharmacological training doesn't go much beyond reading High Times. And most patients who use medical marijuana report they have to experiment a bit to find what works for them (though some may see the experimentation as a "pro.") Finally, THC can be unpredictable when it comes to reducing anxiety. Think of your last "paranoid attack."

Bottom line: Talk to your doctor before you decide to use any alternative medication. More human studies with marijuana are being conducted, and if your doc knows you're using marijuana, you can be alerted in case adverse indications are discovered.

Meantime, if you need a few non-medicated laughs, here's Cheech and Chong. Be sensible! Be well!