This story is part of a partnership between MedPage Today and VICE News.
If the Brandon Coats court case had turned out differently, Dr. Margaret Gedde's medical marijuana patients would have been talking about it.
But he lost. So they said nothing.
It was what they all feared anyway, Gedde said.
Coats, a 34-year-old quadriplegic whose doctor prescribed medical marijuana to stop his muscle spasms, recently lost his wrongful termination suit against Dish Network, which fired him in 2010 for testing positive for THC, the chemical in marijuana. Medical and recreational marijuana are both legal in Colorado, where Coats lives and works, but it's against Dish's national company policy. He said he was using it off-duty, but it didn't matter.
The muscle spasms are hard to describe, Coats said, because he can't exactly feel them. Since a car accident left him confined to a wheelchair in his teens, he can't feel pain in his limbs the way he used to, but that doesn't make the spasms any less miserable, he told VICE News.
"I'm trying to sit at my desk and work, and every muscle in my body is bouncing," he told VICE News. "It's just debilitating because instead of me trying to do what I'm doing, I'm fighting my body. I'm trying to hold onto my chair so I don't fall out."
He said he tried pharmaceutical drugs to quell the spasms, which are caused by the disconnect between his brain and his body, but they didn't work. His job in technical support at Dish was getting harder and harder to do, so his doctor, who declined to be interviewed by VICE News, suggested he try medical marijuana in 2009. He's been using it off-duty ever since, and says it's helped.
The following year, however, Coats failed a random drug test, and despite explaining the situation to his employer, he was fired.
The wrongful termination suit went to Colorado Supreme Court, but Coats lost on Monday.
"We are pleased with the outcome of the court's decision," Dish Network said in a statement to VICE News. "As a national employer, DISH remains committed to a drug-free workplace and compliance with federal law."
"Surefire Loser of a Legal Argument"
Coats is the seventh or eighth person to sue his employer for wrongful termination over medical marijuana, said Kabrina Krebel Chang, a clinical associate professor of business law and ethics at the Questrom School of Business at Boston University.
"Every person who has sued — who lost their job because of medical marijuana pursuant to state law — has lost," she said, adding that most of them have argued disability discrimination. "Mr. Coats is quadriplegic. He has a very obvious disability, but he didn't use his disability as argument because it's a surefire loser of a legal argument."
Coats' lawyer was the first to argue that he was wrongfully terminated because he was engaging in "lawful activity" while off-duty, Krebel Chang said. The same argument could have been made for someone smoking pot for nonmedical reasons in Colorado.
"It's an interesting argument," Krebel Chang said. "Unfortunately the court didn't agree with it."
Brandon Coats prepares to take questions after the Colorado Supreme Court ruled against him on Monday, June 15, 2015. (Photo by Brennan Linsley/AP)
"Where Cases Like This Get Murky"
Although 23 states have legalized medical marijuana, only eight of them include built-in protections for Coats' very situation, Krebel Chang said.
"States like Arizona or Minnesota have laws that say if you fail your company drug test because you tested positive for THC and you are a licensed medical marijuana user, the employer can't act on that failed drug test," she said, adding that this is assuming the employee didn't arrive at work under the influence of marijuana. "It certainly gives the patient a ton more protection."
There have not been any lawsuits for wrongful termination related to medical marijuana in these states, she said.
Colorado, despite its pot-friendly reputation, doesn't have these protections in its medical marijuana law. In states without these protections, the common winning argument has been simple: Marijuana is illegal under federal law.
"Businesses don't have to change anything if they don't want to because it's still illegal under federal law," Krebel Chang said.
In one case in Oregon, the lawyer stressed that a doctor "prescribed" medical marijuana and the patient shouldn't be punished by her employer for it, but state laws say doctors actually don't technically prescribe it — they can only "recommend" the patient for a medical marijuana license, Krebel Chang said. The Oregon patient lost.
'Every person who has sued — who lost their job because of medical marijuana pursuant to state law — has lost.'
In another case, the employee argued that being allowed to use medical marijuana should be considered a "reasonable accommodation" for someone with a disability, but the court ruled that using an illegal drug was not "reasonable," Krebel Chang said.
If there were clear evidence that medical marijuana was the only effective treatment for Coats' muscle spasms, he would at least have ethics on his side, said Brendan Saloner, an assistant professor of health policy and management at the Johns Hopkins Berman Institute of Bioethics.
"Marijuana has clinical benefits but those benefits are not totally understood right now. That's where cases like this get murky," said Saloner, adding that he could not weigh in from a legal perspective.
The American Medical Association's policy has said it wants the Drug Enforcement Administration (DEA) to review marijuana's current designation as a Schedule I drug — a category reserved for the "most dangerous" narcotics, including heroin and ecstasy — according to the nationwide doctors' organization's policy. It also called for more well-designed studies of marijuana in patients with serious medical conditions.
"Patients Really Are Sick"
Coats' doctor declined to be interviewed for this story, Coats said, explaining that his doctor didn't want his name "out there" associated with the case.
It's a fear Dr. Gedde of Colorado has seen before. Gedde has been treating only medical marijuana patients — more than 2,000 of them each year — since 2009, and she views what she does as a specialty, not unlike someone who specializes in pediatrics or optometry.
Even though pot is legal in Colorado, Gedde said there's still a stigma against doctors who formally recommend it to their patients. Doctors are afraid to sign off on it, especially if they're at institutions that receive federal funding, she said.
As a result, doctors send patients to her, she said.
Gedde's patients use medical marijuana to treat pain, gastrointestinal issues, and seizures, to name a few, she said. Although most of her patients are adults, some are children whose families have moved across the country to work with her and try cannabis derivatives such as the Charlotte's Web, a low-THC cannabis derivative that supposedly alleviates seizures without the psychoactive side effects.
She said too many doctors in Colorado have overprescribed medical marijuana, and that's resulted in negative consequences for everyone. She said the state health department has implemented policies to investigate doctors who prescribe it even if there are no complaints against them.
"Basically, it's ridiculously easy to get a marijuana card. The doctor says you have a headache and gives you a card," she said. "That to me just really does make my blood boil. There's so much physicians can do with and for the patient when they're engaged and paying attention.
"The patients really are sick," Gedde continued. "And they need someone with a doctor's status. And we need doctors who can do this and work with it."
Follow Sydney Lupkin on Twitter: @slupkin
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