Ask D’Mine: Medical Marijuana, Going Wheat-Free and Dairy-Free

Welcome back to our diabetes advice column Ask D’Mine, hosted by veteran type 1, diabetes author and community educator Wil Dubois.

Got questions about diabetes that you don’t know where to aim? We’re here for you. (Like it or not )

{Email us at AskDMine@diabetesmine.com}

btw, this week we’d like to congratulate Wil on his new gig writing for dLife. Take it away, Wil…

Austin from Oregon, type 1, writes: I’m an 18-year-old type 1 diabetic. I was wondering where it would be legal for me to get my medical cannabis card?

Wil@Ask D’Mine answers: Nowhere. Not yet. Probably not ever. At last count 16 states in the union have some sort of medical marijuana laws on the books, with ten more states moving forward on legislation. They couldn’t be more different from each other in the details of who can prescribe, who can receive, who can sell, and how to buy. But, my young friend, you won’t quality for any of them.

The medical pot states are: Alaska, Arizona, California (most counties), Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Jersey, New Mexico, Oregon, Road Island, Vermont, and Washington. Washington D.C. legalized last year, but their program is not fully up and running; and Delaware just passed legislation in May of this year, with a program planned to roll out by summer of 2012. Most of the states’ medical marijuana programs are run by state health departments, with several others overseen by state law enforcement. Some states will accept cards from other states, some don’t. Oh yeah, and many states have provisions for minors as well.

But as always, the Devil is in the Details. In sweeping terms most states allow properly certified clinicians (my boss at the clinic is one) to prescribe medical marijuana for cancer; glaucoma; HIV/AIDS; and severe chronic pain, seizures, or nausea. Some, but not all, states will also allow for hepatitis-C, migraines, and post traumatic stress disorder.

But not diabetes.

I couldn’t find pot approved for diabetes treatment anywhere. And frankly, I didn’t expect to, either. Diabetes doesn’t hurt, and most of the conditions covered by medical marijuana laws deal with painful conditions.

FYI, Colorado has a page of denied conditions that various stakeholders have tried, and failed, to add to the green-lighted list. The denied Colorado conditions specifically include diabetes mellitus types 1 & 2, along with diabetic retinopathy, and hypertension. Nope. Nope. Nope. And nope. Nice try.

While diabetes itself is painless, unless you’re talking about the metaphorical pain in the ass it can be, the same isn’t true of some of its possible long-term complications –especially neuropathy. But even coverage of this painful complication is far from universal. In my home state of New Mexico, peripheral neuropathy is a covered condition; but Washington state denied neuropathic pain coverage in the summer of 2010. On the other hand, Washington state is the only state I could find that allows marijuana coverage for some cases of chronic renal failure, and for hemodialysis induced nausea. Go figure.

So how popular is medical marijuana? I was amused to see on the Colorado program’s web site a notice in RED CAPITAL LETTERS that says: “due to the high volume of applications, the office of vital records will no longer review applications, issue receipts, or answer questions” at their windows. Ya gotta use the drop box or the post office….

OK, I guess that answers that question. But does marijuana really work as a medicine? Well, it depends on what you what to do with it. Here’s the straight dope on dope: extensive medical research has shown marijuana is an effective painkiller, and is effective as an anti-nausea drug. Its mellowing effect on agitated people is also well-documented, which is why some states will allow it to be prescribed towards the end of Alzheimer’s when “sundowning” becomes a problem.

Oh, and for those of you who don’t know (and don’t feel embarrassed ‘cause I didn’t know either), medical marijuana can be smoked, eaten, vaporized, or taken in pill form. Something for everyone.

One last important note about medical marijuana; just because it’s legal doesn’t mean it’s covered by your health insurance. Yep. Legal toke is still not FDA approved, so the suits at your insurance company have the perfect loophole to hang you with.

It’s cash pay all the way, baby.

Simone from North Carolina, type 1, writes: I was recently diagnosed with type 1 diabetes as an adult. Since my stomach’s been upset, the nutritionist advised me to eat a gluten-free, dairy-free diet. This seems really difficult to enforce. Is it really necessary to cut out wheat and dairy AND carbs?

Wil@Ask D’Mine answers: Welcome to the family! You should be receiving your glucometer and T-shirt in the mail any day now. So the first thing you need to know is, as if diabetes doesn’t suck enough on its own, it just has to bring all its friends over to party in your body! Here’s the deal: those of us with type 1 seem to be more prone to various gluten problems, like Celiac, and also to lactose intolerance.

Is it really necessary to cut out wheat, and dairy, and carbs? I dunno. You tell me. If you do decide to try a gluten-free, dairy-free diet, be aware that you’ll have to be totally “clean” of these substances for at least a month to see effects. Then you’ll have to gauge: Does your stomach feel better? If it does, your nutritionist is probably onto something. That said, I would be hesitant to assume that you had both conditions at the same time, so soon after diagnosis. And the problem with changing two things at once is that it makes it damn hard to know which one was the cause of the problem in the first place.

Maybe your stomach trouble is caused by the wheat. Maybe your stomach trouble is caused by dairy. Maybe it is caused by both. Or by neither. One thing’s for sure, thanks to today’s first question, we know you won’t be able to get a medical marijuana prescription for it!

If you feel better after cutting these foods out, you could add small amounts of wheat back in to your diet and see what happens. If your stomach goes topsy-turvy on you, you now know that wheat is a prime suspect. Let things settle down again for a bit and then try to add small amounts of dairy back in and again see what happens. Or vice-versa. Yep. You need to do a little science experiment on yourself here. Study cause and effect.

Would it be the pits to give up carbs? And dairy? And wheat? Oh, hell yeah. But the worst-case scenario, if it came to pass, would not be more than you can deal with. Never has our county had a greater variety of food options for those with odd-ball allergies and conditions. You’ll adapt. You’ll thrive.

You’ll do just fine.

Disclaimer: This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.