Magazine article Risk Management

Prescription for Pot: The Effect of Medical Marijuana on Workers Compensation

Magazine article Risk Management

Prescription for Pot: The Effect of Medical Marijuana on Workers Compensation

Article excerpt

Over the past several years, efforts to legalize the use of medical marijuana have gained momentum. To date, medical marijuana has been legalized in 23 states and the District of Columbia and 14 other states are considering similar legislation. In national polls, a majority of Americans--up to 78%--believe marijuana should be legal with a physician's recommendation for medical use. With this level of support, the push for national legalization will likely continue. This drive for change also brings with it a wide range of medical, legal and regulatory questions. One issue, in particular, is whether employers and their insurers will be called upon to pay claims for medical marijuana as part of their workers compensation coverage. The answer requires the consideration of many complicating factors.

MARIJUANA'S MEDICINAL VALUE

From a clinical perspective, medical marijuana has potential therapeutic value to relieve pain and muscle spasms, control nausea related to chemotherapy, stimulate appetite for AIDS patients, and control ocular pressure related to glaucoma. While most of these conditions would not result from a work-related injury, medical marijuana is also a potential line of treatment for chronic pain, a huge concern for workers compensation.

According to the Institute of Medicine, chronic pain affects approximately 100 million adults in the United States, and costs up to $635 billion each year in treatment and lost productivity. The use of opioids for pain related to a workplace injury has increased in recent years, resulting in both escalating treatment costs and significant safety issues. Patients using opioids often build up a tolerance, requiring increased dosages, and prolonged use can lead to addiction and even death. In fact, there were 16,235 overdose fatalities related to opioid painkillers in 2013, according to the Centers for Disease Control and Prevention.

While alternatives exist to treat pain, such as anti-inflammatory drugs, physical therapy and acupuncture, these therapies are not always effective and pain can persist. As a result, there is significant interest in using medical marijuana as an alternative to opiates to help alleviate and manage chronic pain, and as a remedy for pain that has not responded to other courses of treatment.

ILLEGAL SUBSTANCE OR PRESCRIPTION DRUG?

In order for marijuana to be widely accepted as a therapeutic option, more research needs to be conducted on its efficacy for pain management. Initial findings have been promising. The Journal of the American Medical Association reported in June 2015 that existing clinical trials have shown medical marijuana can effectively treat chronic and neuropathic pain. These trials were small in scale, however, and further study has been complicated by marijuana's current legal status.

The federal government classifies marijuana as a Schedule I drug under the Controlled Substance Act (CSA) of 1970. Under the CSA, marijuana is considered as dangerous and addictive as heroin. Cultivation and distribution of marijuana are considered felonies, and possession is a misdemeanor.

But enforcement of marijuana laws has changed. In response to the increasing number of states that have legalized medical marijuana, the U.S. Department of Justice issued a memo in 2013 to state attorneys essentially saying that the federal government would not elect to prosecute patients or their caregivers who are complying with state laws that legalize medical marijuana.

Even with the support of this memo, however, medical marijuana presents a catch-22: Reclassification of marijuana under the CSA would be required before large-scale, randomized studies could take place to confirm any therapeutic benefits that would justify its use.

The Food and Drug Administration has flatly refused to endorse the use of marijuana for medicinal purposes, stating that "no scientific studies support medical use of marijuana for treatment in the United States, and no animal or human data support the safety or efficacy of marijuana in general medical use. …

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