Dad, You Have to Inhale

marijuana cancer patientsMy wife calls them “hand-me-ups”…  things we inherit from our kids.  My ex-fashionable shirt that my son wore in college.Our semi-vegetarian diet my daughter adopted in high school. The dog at my feet that came visiting for the weekend, three years ago.

Our lives are enhanced and modified by the most unexpected of teachers, our children. The mentoring of our progeny keeps those of graying years at least partially youthful.  Still, I was astonished to hear this week, the words, “Dad, you need to starting doing drugs.”

The “dad” being addressed is 93 years old and has advancing cancer. He is tired, nauseas, anxious and sleeps poorly.  Though he likely has a number of months to live, he has become withdrawn.  Despite my usual medical brew, his incapacitating symptoms are without palliation.

Dad is miserable.  Enter his daughter with the solution.  The “drug” she is talking about is the treatment de jour, marijuana.

How did this happen?  We raise our kids to be good, honest, mature citizens; we drive them to soccer, suffer through years of homework (do you remember dioramas?), and do the whole college obsessive-compulsive tour thing.  In addition, above all, we beg our offspring to stay away from pot, pills and addictive mind-altering potions.

Now they turn on us, pushing ganja in our time of need. How did we go wrong?  Actually, it is we that missed a great opportunity.

50% of Americans have inhaled marijuana at some point in their lives.  More than 25 million of our neighbors have used it within the last year.  Those that imbibe are of a decidedly younger demographic.  The oldest citizens, especially those of the Greatest Generation, are much less likely to have experience with cannabis.

Fortunately, once again, youth presents the solution.

New Jersey’s Medical Marijuana (NJ MMP) program has been active and growing now for almost two years, making the drug available for select patients (see below).   A handful of doctors, of whom I am one, have been dispensing prescriptions for 1/4oz bags.

Having never partaken myself, this has been a learning experience as much as any other medical therapy I have administered.  As I have become familiar with its use, so have a wide range of patients, and its popularity is increasing. Recently, I saw a 35yo melanoma patient, a 48yo woman with Crohns, a 60yo multiple sclerosis sufferer and an 88yo church-going, right-wing-voting, DAR-attending, great-grandmother and they are all now are rolling and toking.

Marijuana is one of the safest drugs a doctor can order.  In the entire world literature, there has never been a documented death by overdose.  Its most common side affects are the same as its affects; it makes some people sleepy and dopy.

While it may increase the risk of heart problems, especially in the elderly, it does not punch holes in the stomach like aspirin, rot the liver like Tylenol, wipe out the immune system like chemotherapy or any of a myriad list of toxicities that horrifies us all when we read the average medicine’s packaging material.

Smoking itself can irritate those with lung issues, but especially short-term use in patients with serious disease is unlikely to cause permanent pulmonary damage.  We do need access to better oral forms, such as oil, for those with emphysema and for use in very sick children.

On other hand, marijuana really works. I do not know of another drug or treatment that produces such consistent benefit and patient satisfaction.  Every other medicine that I have prescribed for any problem, be it pain, nausea, depression or health conditions like hypertension, diabetes or heart disease, is much more likely than marijuana to have serious side effects.

My patients report significant improvement in nausea, energy, anxiety, sleep and even pain from illness.  They are able to function, eat and be social.   While not a treatment for disease itself, for many patients it provides excellent symptom relief.  In the words of the stoner’s of old, “This is good s**t.”

So, based the research of one doctor and a couple dozen patients, the medical marijuana experiment is a success.  It significantly helps certain patients to feel stronger, happier and I suppose, younger.  Another gift, a hand-me-up, from our children.

Nonetheless, in the words of one frustrated son whose father refused to do more than hold the precisely rolled joint, “Dad, you have got to inhale.”

James C. Salwitz, MD is a medical oncologist in private practice for 25 years, and a clinical professor at Robert Wood Johnson Medical School. He frequently lectures at the Medical School and in the community on topics related to cancer care, Hospice and Palliative Medicine. Dr. Salwitz blogs at Sunrise Rounds in order to help provide an understanding of cancer.

2 replies »

  1. Yes it’s true that medical marijuana has a lot of benefits if used in the right dosage and with the help of a medical expert. But on the other hand it has also its side effects due to long term use. It can affect our health and brain associated with thinking, memory, pleasure, coordination and time perception which are very dangerous. It can also affects our attention, judgment and balance. I think nobody can even tell how long a person can take marijuana to experience these side effects. Maybe a person suffering from a medical condition doesn’t even care what are the side effects as long as it gives a certain relief or even undergo better addiction treatment rehab.

  2. Had medical marijuana been available when my father, a WWII sailor with a 120 pack-year cig history, been diagnosed with metastatic lung cancer, I would no doubt have prescribed or obtained some to help his symptoms and side effects.

    That being said, how many people who express a need for “medical marijuana” actually have advanced cancer? 1%? 0.01%? The people that I see in the media, and a few in my ER practice, claim various reasons that I would consider to be rather questionable. Back pain ? -really? headaches ?- gimme a break. Did I somehow miss the epidemiological pandemic of glaucoma? Does this generally well-managed malady now affect 50% of our nation’s population?

    Medical MJ may indeed be safe, and may have some legitimate medical indications, for those whose symptoms are not sufficiently alleviated by current allopathic medicine. But this definition would also apply to acupuncture, hypnosis, and possibly homeopathic remedies. But none of these are currently under the control of brutal, horrific drug cartels that murder thousands every year to get their product to market. None of these destroy the environment with chemicals dumped into water supplies, as with illicit high-yield pot farms.

    Further, if you think we have a problem in this country with people abusing Oxycontin and hydrocodone via drug diversion, theft, and addiction, then wait until every nurse practitioner in America can write a prescription for marijuana.