Tuesday, February 3, 2009

Michael Phelps, Marijuana, Drug Use and Ambivalence

A reader asked me to comment on Michael Phelps and wanted to know what I thought about him being caught smoking marijuana. At first I was reluctant to do so. So many people have already weighed in on this issue. But the reader pressed me, saying he really wanted my opinion on this matter so I thought I would share a few thoughts.

The most striking thing to me about his marijuana smoking has been the mixed public reaction which has ranged from excoriating him to an attitude of leniency. I believe that this ambivalence reflects America's ambivalence about marijuana itself. Is marijuana addictive? Is it a "harmeless" drug or a gateway drug to more serious drug abuse? Should it be legalized? Should marijuana be allowed for medical purposes? As a society we have not yet come to terms with marijuana and how and if it should be used.

I believe that all discussion about marijuana should be taken in the broader context that the two most commonly used, dangerous and destructive drugs are both legal, alcohol and nicotine. The harm caused by these drugs far outweighs all the harm created by all other drugs combined. I think we forget this in the often passionate debate over marijuana.

So what is the truth? What do we need to know in order to have more informed opinions on marijuana? In no particular order I will indicate some of the facts that are clear. Marijuana is an addictive drug. While most people who use try marijuana or use occassionaly do not become addicted there is a group of people who are highly addicted and whose lives are torn apart by marijuana use. At Cottonwood I see patients whose use of marijuana has been casual despite their addictions to other drugs and I also see patients who are addicted to marijuana alone and have been unable to function effectively in life due to this addiction. While most people who use marijuana do not go on to other drug abuse there are hardly any other drug users who have not used tobacco and marijuana first. Tobacco though is the main "gateway" drug. Marijuana is no longer the main drug of abuse among teens after tobacco and alcohol. Prescription pain pill use has overtaken marijuana use among youth and is increasing while marijuana use has been decreasing. The marijuana used to today is much more potent and has much higher content of THC (the active drug) than the marijuana used in the 1960' and 70's. Chronic marijuana use can lead to psychosis in a subset of people who may be more genetically prone to developing a psychotic disorder. Marijuana is currently calssified by the Federal Drug Enforcement Agency as a schedule I drug, a drug that has no medicinal use. We know however that it does have medicinal use and can be particularly effective for the nausea often induced by chemotherapeutic treatments for cancer. Medical use of marijuana has been legalized in several states including our own Arizona but the Federal government restrictions overide state law.

So I don't have the answer to the question of marijuana use but I do think we should base our opinions upon the knowledge we have rather than just uninformed opinions.
As for Michael Phelps? My thought for the day is

"Let him who is without sin cast the first stone".

Jesus of Nazareth

2 comments:

  1. Dr. Seymour,
    Thank you for this post. It was very informative. According to the news this evening, Michael Phelps has been suspended for three months by USA Swimming and Kellogs will not renew his contract. So much for the first stone!

    ReplyDelete
  2. There will probably be more stones to come.

    ReplyDelete

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