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Sunday, November 10, 2019

Ex-Ranger says this could prevent another death like Tyler Skaggs’. Will MLB allow it?

The best answer to all that afflicted him in San Diego, Oakland, Arlington, Surprise, Round Rock, Scottsdale and everywhere else his career took him is being grown at his farm in the middle of New Mexico and at others like it throughout the country.

It’s an industrial hemp farm, and Blanks is an advocate of hemp-derived CBD as a treatment option in baseball.

“The platform enables me to speak about it because I’m not one of the tragedies,” he said. “I happened to come from this place and something bad happened. I feel it’s necessary for me to come forward and try to help people.”

RoyalsRetro (AG#1F) Posted: November 10, 2019 at 06:22 AM | 22 comment(s) Login to Bookmark
  Tags: drugs in sports

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   1. Rough Carrigan Posted: November 10, 2019 at 10:22 PM (#5900265)
No! That plant is evil!
People should only ingest industrially produced medicines recommended by their doctor after he's been threatened with losing his license if he recommends anything but big pharma products, and after he's been given free accommodations at a seminar in Hawaii. That's good science.
   2. Walt Davis Posted: November 11, 2019 at 02:07 AM (#5900285)
Define "allow." MLB is obviously not going to "legally allow" any treatment not OK'd by the Feds. But that's possibly beside the point -- MLB doesn't "legally allow" cocaine and doesn't generally test for it. Coke is a "drug of abuse" which can only be tested if there is "reasonable cause" (or whatever term they use in the JDA) and even then it doesn't result in a penalty as long as the player follows the treatment plan. Maybe "hemp-derived CBD" would count as a "drug of abuse." Maybe it wouldn't count as that either in which case there are no means for MLB to test for it. So unless CBD would trigger a (false?) PED/stimulant positive or is a known masking agent, there's not really anything for MLB to "allow." If it is somehow performance-enhancing (this seems unlikely to me) it would require a TUE which MLB couldn't allow unless it was an approved treatment (I assume). I'm not sure what MLB does with regard to substances that are known to trigger a genuinely false PED positive.
   3. snapper (history's 42nd greatest monster) Posted: November 11, 2019 at 09:03 AM (#5900292)
This guy is talking about CBD as a treatment for chronic pain. Is there any evidence Skaggs was using opioids for chronic pain? I haven't heard any.

From what I've read, Skaggs was using Opioids, Fentanyl, and booze to get high.

Edit: Of course for chronic pain, opiates work just fine, if they're under proper Dr's supervision. The issue with the Opioids crisis was over-prescription by unethical Drs. to people who were using for the wrong reason.
   4. jacksone (AKA It's OK...) Posted: November 11, 2019 at 09:31 AM (#5900296)

Edit: Of course for chronic pain, opiates work just fine, if they're under proper Dr's supervision. The issue with the Opioids crisis was over-prescription by unethical Drs. to people who were using for the wrong reason.


Even if you are using opiates under proper Dr supervision there is still the very real chance to get addicted to them. That very well could have been the start for Skaggs. Take some prescribed medicine for arm pain, decide you like it a lot, take more and more.
   5. snapper (history's 42nd greatest monster) Posted: November 11, 2019 at 09:40 AM (#5900299)
Even if you are using opiates under proper Dr supervision there is still the very real chance to get addicted to them. That very well could have been the start for Skaggs. Take some prescribed medicine for arm pain, decide you like it a lot, take more and more.

If he got addicted that quickly, he was likely using them outside of the prescribed amounts and or usage. I mean, yeah, some people will get addicted to anything. There's a small percentage of the population that are basically genetically doomed to addiction. Outside that group, addicts get that way by abusing drugs in the first place.

"Deciding you like it a lot" is not being addicted. It's making a choice to abuse. I like Bourbon a lot. If I decide to drink half a fifth a day, that's a choice.
   6. The Good Face Posted: November 11, 2019 at 11:29 AM (#5900325)
If he got addicted that quickly, he was likely using them outside of the prescribed amounts and or usage. I mean, yeah, some people will get addicted to anything. There's a small percentage of the population that are basically genetically doomed to addiction. Outside that group, addicts get that way by abusing drugs in the first place.

"Deciding you like it a lot" is not being addicted. It's making a choice to abuse. I like Bourbon a lot. If I decide to drink half a fifth a day, that's a choice.


The standard opioid crisis cycle goes as follows.

1. Have pain, get prescribed opiates.
2. Opiates work, pain managed.
3. Develop tolerance to opiates, need more drugs to manage pain.
4. Addiction kicks in, tolerance increases.
5. Doctor stops prescribing enough drugs to manage addiction.
6. Addict shifts to heroin/fentanyl once pills become too difficult to obtain.

But I find it difficult to believe an MLB pitcher who claimed arm pain would have any problem getting prescriptions for pain killers. Sounds like a case of a guy who got addicted after being prescribed them for pain, went looking for a bigger high, and wound up using fentanyl.
   7. JL72 Posted: November 11, 2019 at 11:55 AM (#5900333)
If he got addicted that quickly, he was likely using them outside of the prescribed amounts and or usage.


But isn't part of the point that use of CBD (or similar drugs) is less likely to result in addiction even when used outside the prescribed amounts and usage?

Yes, patients should use drugs in the manner prescribed. But knowing that, at least with opioids, can end up in some bad results when it does not occur, exploring alternatives makes sense.
   8. base ball chick Posted: November 11, 2019 at 12:15 PM (#5900340)
snapper

you really REALLY don't understand addiction

- CBD can have THC or no thc. the kind without THC is legal here in texas. it does seem to help a lot of people with pain. no idea if it helps ballplayers who are sore, tired and hurting for months because they don't get really any time to rest. but even if it was legal to use the CBD with small amounts of THC, better to overuse THAT than opoids. i doubt athletes would really overuse it because THC slows down your reflexes and we're talking about major league ball here

- it would also help if people got over their steroids hysteria and team physicians were allowed to give it to players to help heal their injuries. i mean, it IS useful medically that way

btw
doubt skaggs was addicted specifically to fentanyl - the dealers are selling fake oxycodone pills that has fentanyl in them

also
at this point we don't know if skaggs was actually addicted to opiods or just abusing them
   9. snapper (history's 42nd greatest monster) Posted: November 11, 2019 at 12:24 PM (#5900344)
snapper

you really REALLY don't understand addiction


I know lots of people who use and have used serious painkillers for months, years, and decades without addiction (including family members). One of those was also an alcoholic. I also know people who have problems abusing every substance under the sun (including family members).

If you don't have a specific genetic propensity to addiction, you generally don't get addicted through normal prescribed use. You may get addicted because you like the sensation and decide to take more to get your high, or to use the pills off label (e.g. snorting opioids).

Most addicts get addicted because they over use the substance in search of the "high" or some other sensation. I object to this current line of thought that addiction is just something that "happens to people".
   10. Cris E Posted: November 11, 2019 at 01:24 PM (#5900359)
If you can object to the "Just happens to people" sentiment then I can object to the "it's simply a choice" or "they just want to get high" line. It's clearly not that simple, and choosing to get in is not the same as choosing to get out. Addiction isn't regular use, it's use past the point of control to where it affects your well-being and can't be stopped. Addiction is where the choice part falls away and just leaves a person with only use.
   11. snapper (history's 42nd greatest monster) Posted: November 11, 2019 at 01:30 PM (#5900361)
If you can object to the "Just happens to people" sentiment then I can object to the "it's simply a choice" or "they just want to get high" line. It's clearly not that simple, and choosing to get in is not the same as choosing to get out. Addiction isn't regular use, it's use past the point of control to where it affects your well-being and can't be stopped. Addiction is where the choice part falls away and just leaves a person with only use.

Oh, I agree with you on what addiction is. It's is certainly real, and beyond the point of choice.

What I'm saying is that most people don't get to that state of addiction without a preceeding conscious choice to abuse the substance in some way.
   12. base ball chick Posted: November 11, 2019 at 03:48 PM (#5900385)
snapper (history's 42nd greatest monster) Posted: November 11, 2019 at 01:30 PM (#5900361)

If you can object to the "Just happens to people" sentiment then I can object to the "it's simply a choice" or "they just want to get high" line. It's clearly not that simple, and choosing to get in is not the same as choosing to get out. Addiction isn't regular use, it's use past the point of control to where it affects your well-being and can't be stopped. Addiction is where the choice part falls away and just leaves a person with only use.

Oh, I agree with you on what addiction is. It's is certainly real, and beyond the point of choice.

What I'm saying is that most people don't get to that state of addiction without a preceeding conscious choice to abuse the substance in some way


- oh yes they do
because those who took pills prescribed by a doctor (let's get the illegal use question out of the way) may not be using too much or to often to get high/low/whatevs but because they may have felt they needed more or more often to get the kind of pain control they wanted - maybe not what the prescriber had intended

i have a FB friend who had major serious abdominal surgery who could barely move or take care of himself after he went home he was in that much pain - and he decided to flush pills down the toilet after 2 days because he found himself reaching for the pills before it was time and was terrified that he could get addicted (he's a recovering alcoholic who has been sober for quite a while, so he knows addiction). and this was after 2 days when he actually NEEDED serious pain control
   13. snapper (history's 42nd greatest monster) Posted: November 11, 2019 at 04:04 PM (#5900389)
i have a FB friend who had major serious abdominal surgery who could barely move or take care of himself after he went home he was in that much pain - and he decided to flush pills down the toilet after 2 days because he found himself reaching for the pills before it was time and was terrified that he could get addicted (he's a recovering alcoholic who has been sober for quite a while, so he knows addiction). and this was after 2 days when he actually NEEDED serious pain control

But, that's not addiction, that's pain. I understand his fear because of his alcoholism, but taking the pills early because the pain is back is OK. All dosages are inexact. I mean they give the same pills with the "two every 4-6 hours" instructions to people of vastly differing weights.
   14. Der-K: at 10% emotional investment Posted: November 11, 2019 at 04:18 PM (#5900394)
I wish we had more and better studies on the efficacy of CBD and marijuana in medical contexts.
--
On opioids, my understanding is that the consensus in the medical community was that they were being over-prescribed and overused and now the pendulum has swung the other way, such that controls on getting them in many contexts have gotten too strict.
--
I know and have worked with people who are experts on both pain treatments (specifically) and more generally addiction - I, however, am decidedly not one of them. That said, one takeaway I've had in talking with them involves how these pathways can be surprisingly person-specific - one's propensity and triggers for addiction, how one's pain receptors respond to treatments, and so on. (I learned that last bit firsthand in an ambulance once as I apparently don't feel the analgesic effects of morphine.) I have to think that the future of this arena should be much more tailored to people's physiologies, if nothing else.
   15. base ball chick Posted: November 11, 2019 at 04:39 PM (#5900399)
snapper (history's 42nd greatest monster) Posted: November 11, 2019 at 04:04 PM (#5900389)

i have a FB friend who had major serious abdominal surgery who could barely move or take care of himself after he went home he was in that much pain - and he decided to flush pills down the toilet after 2 days because he found himself reaching for the pills before it was time and was terrified that he could get addicted (he's a recovering alcoholic who has been sober for quite a while, so he knows addiction). and this was after 2 days when he actually NEEDED serious pain control

But, that's not addiction, that's pain. I understand his fear because of his alcoholism, but taking the pills early because the pain is back is OK. All dosages are inexact. I mean they give the same pills with the "two every 4-6 hours" instructions to people of vastly differing weights


- according to him, he didn't think it was just pain making him reach for the pills. it doesn't take much - can even be one dose, to make someone turn into an addict

- i don't know why it has been decided that all adult humans of any age or size needs the exact same does of any medicine. or even given the same length of time.


Der-K: at 10% emotional investment Posted: November 11, 2019 at 04:18 PM (#5900394)
I wish we had more and better studies on the efficacy of CBD and marijuana in medical contexts.


- we don't because of all the silly hysteria about mary j wanna. it has been used by umpty people for who knows HOW long to treat all kinds of problems including sleep problems, nerve problems, pain. it's not arsenic or lead or something, but the demonization of this stuff is beyond idiotick

I know and have worked with people who are experts on both pain treatments (specifically) and more generally addiction - I, however, am decidedly not one of them. That said, one takeaway I've had in talking with them involves how these pathways can be surprisingly person-specific - one's propensity and triggers for addiction, how one's pain receptors respond to treatments, and so on. (I learned that last bit firsthand in an ambulance once as I apparently don't feel the analgesic effects of morphine.) I have to think that the future of this arena should be much more tailored to people's physiologies, if nothing else.


- of COURSE they should
because we are all genetically unique
it is well known that any particular person may do very well on ADD medicine X but the same dose of almost the exact same thing Y doesn't work or has bad side effects.
- also that some of the new beyond expensive meds to treat autoimmune stuff like rheumatoid arthritis works great on some people and does zero on others. it has to be genetic

- it's too bad that the govt has sinister motives for wanting anyone's DNA because in mah not so umble opinyin seems it would be a lot of help for doctors
   16. Der-K: at 10% emotional investment Posted: November 11, 2019 at 04:50 PM (#5900401)
bbc: yes and yes.
to pile on the second bit, the people who are a part of studies geared toward either broad populations or more individualized stuff are, let's say, not representative of the national or global populations.
   17. The Good Face Posted: November 11, 2019 at 04:57 PM (#5900406)
But, that's not addiction, that's pain. I understand his fear because of his alcoholism, but taking the pills early because the pain is back is OK.


I think the point is that for an alarming number of people, it's not OK. They follow the instructions their doctor gives them and wind up addicted. You can handwave with, "Well, those people obviously just have a genetic predisposition to addiction", but we're talking a lot of people here.
   18. depletion Posted: November 11, 2019 at 10:10 PM (#5900488)
Am I the only one who is bothered that Mr. Skaggs body is barely cold when "Ex-Ranger" is selling something that "could prevent another death like Tyler Skaggs"? Nothing against people who are trying to quantify the salient properties of CBD, but this sales pitch is not appropriate.
   19. base ball chick Posted: November 12, 2019 at 12:17 AM (#5900508)
sigh

he wasn't pimping his own stuff. theres TONS of it out there already

and you want him to wait until WHEN to bring up the issue of CBD use?
   20. Traderdave Posted: November 12, 2019 at 01:00 AM (#5900516)
For some weird reason opiates don't work well for me. In recent years I've been prescribed them twice: once for hernia surgery and once for root canal. Neither time did they do much more than aspirin, except they constipated the hell out of me. Both times I turned them back into the pharmacy and bought some CBD edibles, legal here in California. They worked.

Full disclosure, it took a lot. I ate approx 4X the normal dose, but surgery and root canals both hurt like hell, so maybe that's why it took a lot, but it worked. I'm no teetotaler re: cannabis. I've enjoyed the THC variety more than a few times, but I can tell you the CBD version really does have a legit health use.
   21. Bote Man Posted: November 12, 2019 at 02:17 AM (#5900521)
I've seen the point made (elsewhere) that we're supposed to accept that it's OK for billionaire teams to grind players into a mass of useless pulp through the rigors of play at the MLB level, but when the players seek relief from the inevitable pain that such activity brings we're supposed to scold them for not being strong enough. After rolling that thought around in my head for a bit I tend to agree that this is an unfair imbalance.

So instead of getting tied up in what's currently legal, maybe it's time to re-evaluate the entire approach to these issues. This, of course, will not happen because there is too much money at stake for entrenched interests who will go to great lengths to maintain the status quo.
   22. Walt Davis Posted: November 12, 2019 at 07:17 PM (#5900684)
I'm always happy to pile on billionaires but I don't totally buy #21.

1. Pitching is basically not something humans are really designed for so (nearly) all pitchers will have pain, most will eventually have a fairly serious injury. Barring a move to robo-pitchers, it's not clear there's any way to play baseball without that being true.

2. Teams don't really have incentive to grind their players into useless pulp.

3. There is an incentive to get as much value as possible out of the cheap years. However, with the possible (likely IMO) exception of the AAAA bullpen shuttle, teams' approach to that issue over the last 20-30 years has been to "baby" their pitchers with fewer innings, fewer pitches, fewer starts, not forcing them a 3rd time through the order. It's even true for relievers -- in 1989, 62 relievers threw 70+ innings, including 14 over 100; in 2019, 30 made it to 70 and only one guy topped 85 (Gaviglio in Tor at 95.2).

4. A potential solution to #3 is to make young players more expensive (probably a good idea for other reasons). But given the trend has been towards lighter workloads for pitchers in hopes of keeping them healthy longer, possibly making them more expensive will have the opposite effect of pushing teams to use them more since the value/$ ratio is otherwise going down.

5. But where I assume Bote and I agree is that the center of all of this should be legit medical care that places the health of the player as the top priority. I'm not certain that happens in scenarios where the choice is between some team benefit and the player's health. This could be handled by having an independent group providing medical care for all teams -- similar in that sense to how drug testing works. Since the independence of a group that makes a huge profit off of baseball is difficult to assure, set this up such that MLB pays for it but MLBPA chooses the contractor.

5a. It is a general comment on society that addiction (and the various paths to addiction) need to be viewed in public health (and sociological/psychological) terms, discussed more openly and de-stigmatized. With regard to baseball, this should be even more the concern of MLBPA than it should be of MLB (i.e. both should be working in this area but it should be of particular importance to the union).

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