An Interesting Twist in the Medical Marijuana Debate

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Mike Dwyer

Mike Dwyer is a former writer and contributor at Ordinary Times.

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26 Responses

  1. Avatar Burt Likko says:

    Let me get three points out of the way first:

    • Marijuana should be as legal as tobacco and alcohol because its physiological effects on a human being are no more (and no less) profound than those legal, regulated, and tolerated substances. At minimum, it should be decriminalized.
    • Social anxiety disorder is real and impacts lots of people. It is different than being shy or suffering from stress, and those who have this medical issue benefit from medical treatment. I do not know, but do not doubt, that Mr. Diaz needs and benefits from medical treatment for the condition.
    • I do not know, but do not doubt, that marijuana effectively counteracts the effects of social anxiety disorder and should, in a rational world, be considered a reasonable and legal option for treatment of that medical condition.

    Okay. Now, in spite of all that:

    • Social anxiety disorder can be treated with an array of other medications whose legality is unquestioned and which would not have caused disqualification from professional MMA competition.
    • Diaz had and still has options other than mairjuana to address his psychological issue.
    • The added pressure of a camera crew and an imminent high-stakes fight did not compel him to spark up; he chose to use marijuana as a means of responding to that stress. This is so even if marijuana is the most effective possible treatment for his social anxiety disorder.
    • Diaz is obviously well aware that MMA hosts the bulk of its activities in Nevada, he cannot but be well aware that marijuana is not legal to use in Nevada, and he cannot but be well aware that as a professional athlete, he will be monitored for the use of illegal substances with risks to his career should he be discovered using them.
    • Despite all the foregoing, Diaz chose to use marijuana at risk and consequence to his career and livelihood. He would rather be suspended from his career for a year and forego the opportunity to make what Mike D. estimates are literally millions of dollars, rather than stop smoking marijuana. His jest about his career interfering with smoking, coupled with his actual behavior, suggests that marijuana smoking is more important to him than pursuing a career as a professional athlete.

    I’m not dialing back from my first three points. But as described here, Mr. Diaz is exhibiting the behavior and psychological patterns of an addict. While the susceptability of a human being to substance addiction is not a particularly strong argument for the criminalization and other irrational public policies adopted with regards to control of that substance, it certainly does not add luster to the efforts of those who would steer things in a more productive direction.

    I view the situation described in this post as highly analagous to a person who becomes addicted to prescription painkillers. There is a legitimate medical need for the substance, but the use has exceeded the therapeutic need and the behavior has now caused profound negative consequences. Addiction treatment and alternative means of addressing the still-existing medical are what is called for.

    An alcoholic would have been a terrible poster boy for the repeal of Prohibition. Similarly, if you (like me) are an advocate of the decriminalization and ultimate legalization of marijuana, you should consider that Mr. Diaz’s apparent addiction makes him a terrible poster boy for that cause. I wish Mr. Diaz well, and I hope for the sake of the political efforts to rationalize marijuana policy that he gets his treatment effectively and discreetly.Report

    • Avatar Mike Dwyer says:

      “But as described here, Mr. Diaz is exhibiting the behavior and psychological patterns of an addict.”

      I agree 100%. I’ve heard addiction defined as ‘continued use even when faced with adverse consequences’.Report

    • Avatar Burt Likko says:

      I should have called social anxiety disorder a “psychiatric” issue as it relates to brain chemistry rather than cognitive process. Apologies.Report

    • Avatar David says:

      I don’t think you are correct in describing him as an addict. It sounds more like he has a (legal) prescription for the substance. He does NOT have a legal prescription for the other substances he could use, and from the other news reports, they too are tested for and he cannot use them (Adderall) in the boxing league.

      In other words, he has a psychological condition (social anxiety disorder), diagnosed by a medical professional, he has medication which has been prescribed and presumably works best for his condition, the other medications he could take are also proscribed and tested for.

      He’s being put between a rock and a hard place. Either he medicates for his condition, or he suffers. To insist that someone with a medical condition is an “addict” for medicating for it is to push the limits of the definition of addiction to meaninglessness.

      With regard to the statement you quote, I see it as a comment that he is not allowed to take his prescribed medication prior to the fights. In other words, the unreasonable bounds of the league body <b>interfere with his physician-prescribed medication schedule</B>. Is this not an equally accurate depiction of the argument?Report

      • Avatar Mike Dwyer says:

        David,

        As Burt points out, there are other LEGAL drugs available to treat his problem. Using a banned substance and crossing his fingers is when the addictive behavior seems to rear its ugly head.Report

      • Avatar Burt Likko says:

        I would tend to suspect that the MMA would place a premium on its fighters having very clear minds when they step into the octagon. And there’s no dispute that marijuana interferes with one’s mental state, which is after all the point of using it recreationally. So I don’t feel comfortable conceding that MMA’s rule is unreasonable.

        I also don’t feel comfortable conceding that Diaz is between a rock and a hard place. One suspects that, as in the case of PGA Tour, Inc. v. Martin (2001) 532 U.S. 661, a genuine disability can and should be met with a reasonable accomodation, perhaps but maybe not necessarily a waiver of the substance use rules. (No, I have not invested any thought in the issue of what kind of accomodation other than a substance-use waiver might be.) But permitting someone to use a substance banned from use by both Federal and state law, even if the substance is legal in another state, is very unlikely to be a “reasonable” accomodation.

        As for Diaz’ status as an addict, of course neither of us can state that with certainty. That diagnosis would be between Diaz and his physicians. I said he “…is exhibiting the behavior and psychological patterns of an addict,” and called him an “apparent addict” (emphases added). I opined from there about the political impact of this situation on the larger effort to normalize marijuana policy.Report

        • Avatar DensityDuck says:

          “I would tend to suspect that the MMA would place a premium on its fighters having very clear minds when they step into the octagon.”

          I would tend to suspect that fighters using narcotic drugs before a fight would be a self-limiting problem.

          And you’re assuming that “social disorder” is an actual problem for him, and not just the excuse he uses to buy marijuana.  It’s pretty much a given that anyone in a marijuana “dispensary” is an entirely healthy person who found a doctor that was willing to diagnose them with “back pain” (of course, the examination costs $300 and the doctor doesn’t take insurance.)Report

          • Avatar Burt Likko says:

            I admit that I have similar sorts of preconceptions about users of marijuana dispensaries and doubts regarding the proliferation of new-sounding psychiatric conditions to describe old-fashioned personality flaws.

            But assuming that these are true would not be addressing the issue from a position of charity. Let us take Mr. Diaz at face value when he states he suffers from this psychiatric condition and further take him at face value when he states that medication with marijuana is an effective treatment for it. Doesn’t affect my position at all.Report

  2. Avatar James Hanley says:

    Mike,  a very interesting post.  I just want to address one point.

    What questions the issue raises revolve around whether or not other states should honor marijuana as a medicinal drug in testing.

    Burt partly answered this in noting that there are other treatments for anxiety disorder, but there’s also a relevant analogy, asthma medications.  Asthma is a life-threatening medical condition that is treatable by medication (to state the obvious), and a number of elite athletes suffer from exercise-induced asthma.  But asthma medications work by opening up the airways, so that the sufferer can breathe in more oxygen.  That can be used for non-medicinal purposes, too, to enhance performance.  Consequently, most asthma medications are banned by the International Olympic Committee.  Steroids are also used to treat asthma (I normally require about one steroid treatment a year), to reduce the inflammation of the airways, but of course steroids are also a performance enhancer, and also banned.

    So I’m very sympathetic with the fighter–just as I am with asthmatic athletes–and fully agree with Burt’s first three points.  But there’s precedent here, so I really think–at least as a practical matter-that the question you raise is easily answered.Report

    • Avatar Infuriating Pedant says:

      I know that it’s kind of nit-picky, but the steroids used to treat asthma are quite different than the steroids used to enhance athletic performance.

      The first are analogues of adrenal hormones (cortisone, adreneline), and the latter are analogues of testosterone.Report

      • Avatar James Hanley says:

        Good nitpick; it’s something I didn’t know.  Do you know if the asthma treatment steroids are different enough that they’re allowed by, for example, the IOC?  I was assuming they’re not, but perhaps I’m wrong.Report

        • Avatar Infuriating Pedant says:

          I would assume the the simple anti-imflammatory steroids (e.g. prednisone) would be allowed, since in the short term they do nothing with athletic performance, but in the long term diminish it.    But very often, rules–once a regime is put in place–no longer need logical rationales to continue existing (I think you’re libertarian, or at least libertarian-ish, so I presume you’d agree with this).

          So, simple answer:  I don’t know.   But, being an infuriating pedant, that won’t keep me from speculating…Report

          • Avatar James Hanley says:

            *grin*Report

          • Avatar Patrick Cahalan says:

            IIRC the problem with prednisone is that it trips the test, which is not precise enough to distinguish between one steroid and another.

            So, (again, IIRC), you can’t use medical steroids any more than performance-enhancing steroids and it’s not because they’re medical, it’s because the test flags them both, and thus it would be impossible to catch someone who was using performance-enhancing steroids without including the medical ones in the banned list.

            Thus concludeth the waving of the hands.Report

  3. Avatar Jaybird says:

    Remember the Ross Rebagliati kerfuffle at the olympics?

    From what I recall, he tested positive for an amount consistent with sitting near someone who was smoking it. When asked “why did you test positive?”, he answered something to the effect of “I sat near someone who was smoking it”. They took his gold medal away anyway.

    That said, I’d be interested in knowing why they don’t do periodic drug testing throughout training for all of these substances. I mean, it’s not okay if the guy uses steroids just during September and October and, by February, whatever remnants they leave are out of his system.

    If a football player talked about doing steroids all summer, got to the drug test place in September, winked at the camera, and came up negative… we’d all know what was up. If it’s illegal for use because it gives too much of an advantage to fighters who would otherwise get bored training, then why not test them while they’re training?Report

    • Avatar Mike Dwyer says:

      People have discussed year-round testing for UFC fighters but there are a lot of challenges. The fighters tend to be very transient. They move around from gym to gym, looking for sparring partners, etc. They are also spread all over the country. The only thing that would probably work is bi-annual meetings in Las Vegas (they already do one per year now). The fighters are not tested now at the yearly summit but they could start requiring it. Adding this to pre-fight testing would get most of them tested 5-6 times per year.Report

      • Avatar Andy Smith says:

        The short answer is that drug testing in most sports is a joke. Pro cycling, which I follow closely, has had many major stars sanctioned (the glaring and disappointing exception continues to be Lance Armstrong), in large part because they are more serious about testing. They test OOC (out of competition) as well as during races, and the penalties are relatively draconian (generally two years). This means the riders have to keep the testers constantly informed about their whereabouts, which has led to a lot of complaints, but there really doesn’t seem to be an alternative.

        Anyone who follows doping in sports knows that it’s pretty much endemic in all the major pro sports in the U.S.–MLB, NFL,NBA, MMA, boxing, etc–because the organizations that run or pretend to run these sports don’t want to do anything to stop the money train. Even pro cyclists, who are tested far more frequently, know how to dope to avoid positives. For every positive test there are probably ten false negatives.Report

  4. Avatar An Old Friend says:

    Marijuana is DEFINITELY a performance-enhancing drug. When I was in high school, I played baseball very seriously. I was a pitcher for one of the best high school baseball teams in the nation. This was an incredibly nerve-wracking experience. Depending on my mood, I could pitch really well or have some serious control problems or even break down entirely and just scream inside.

    It was around this time that I started experimenting with marijuana (for social reasons, nothing to do with baseball). I noticed a HUGE improvement in my pitching performance. One day after getting monstrously high the night before, I struck out nine batters in a row. Just effortlessly. This obviously couldn’t continue forever (or else I’d be in the big leagues now), but for a short time during my senior year in high school I was the best pitcher in the state.

    In college I thought the same rule might apply to other stuff, like writing papers. It didn’t, at least for me. Everything I wrote while high on marijuana read like complete crap the next day!Report

  5. Avatar Damon says:

     So let’s get down to the questions posed:  “What questions the issue raises revolve around whether or not other states should honor marijuana as a medicinal drug in testing.”  Simple.  I’m cool with the folks in each state to deciding.  It’s their state.  Additionally, the governing body for this sport can also make that decision-but I think it already has.

    “…but to penalize someone for legal marijuana use in another state seems to be an overreach.”  Pff.  He’s not being penalized for weed use in another state.  He’s being penalized for testing positive for weed prior to a fight in Nevada.  He chose to cross the state line.  He chose to smoke weed inside the time needed to fully metabolize the product and test clean.  He knew the rules.  He took a risk and it bit him in the ass.Report

    • Avatar Jesse Ewiak says:

      Also, if the NSAC decided that cough syrup was a drug you weren’t allowed to use, then guess what, you couldn’t drink cough syrup prior to a fight. Now, one may or may not think it’s a correct decision to use pot before a fight, but dem’s the rules. Follow them or find a job with a fighting organization that does stuff in non-commission states.Report

      • Avatar Will H. says:

        I tend to agree with Damon’s view, that this is a State issue.
        But the “dem’s the rules” thing made me think of something related, regarding broad statements of principles as a means of regulatory structure.
        I don’t see how that could be adjudicated. Any statement of principles is going to be whittled down to an enumerated list when it comes decision time.
        I think there’s a greater issue here of the form of what we know as “rules” and the manner in which those rules are used to arrive at decisions.
        Then again, if the sole purpose of the rules is to protect from liability, an enumerated list would do just fine.Report