The debate over the use of medical marijuana as an alternative to opioid painkillers continues despite these recent political developments. (Photo: Shutterstock)
A growing number of clinical experts believe medical marijuana could play a critical role in reducing the nation’s reliance on opioid painkillers. Publications like The Atlantic have reported that in states in which legalization has occurred, patients are now turning down popular opioid painkillers, like oxycodone, in favor of medical marijuana — and according to patients, marijuana is helping to alleviate their pain.
Related: Employees’ medical marijuana use not protected under state law says Colorado Supreme Court
Opiod use dropping thanks to marijuana?
Several studies have found correlations between states with legalized medical marijuana and a drop in painkiller prescriptions, opioid use and deaths from opioid overdoses. For example, a 2014 study published in the Journal of the American Medical Association found that states with medical marijuana laws experienced a nearly 25% drop in deaths from opioid overdoes compared to states that did not have those laws.
According to the Centers for Disease Control and Prevention, these trends come at a time when the opioid epidemic is rampant with more than 15,000 people dying annually due to overdoses from prescription painkillers.
In workers’ compensation, medical marijuana is also in demand to treat chronic pain, particularly when other therapies have failed. In New Mexico, courts ruled three times that injured workers were due reimbursement for medical marijuana deemed “reasonable and necessary” for the management of their pain. Whether other states see similar cases depends on ongoing developments in terms of legalization, regulations, public support and case law.
Here are five recent developments that could have far-reaching implications for use of medical marijuana within the industry:
Related: Why workers’ compensation treatment guidelines matter
1. DEA decides not to reclassify marijuana
In August 2016, the Drug Enforcement Agency (DEA) denied two petitions to reclassify marijuana from the most restrictive category of controlled substances (Schedule I) to a category deemed less dangerous. The DEA came to this decision because it claimed marijuana still did “not meet the criteria for currently accepted medical use,” and in its view, marijuana still lacked safety standards and had a high potential for abuse.
Ironically, this ruling was made despite 29 states having passed medical marijuana laws. Denying the medical value of marijuana seems incongruous since the FDA has already approved medical use of pharmaceutical products derived from marijuana, such as Marinol, a synthetic form of THC (the component of marijuana that makes a person feel high). In fact, experts feel the FDA process favors the development of pharmaceutical products containing specific, isolated and synthetic marijuana components.
Related: Seeing marijuana through the haze of myths
Attorney General Jeff Sessions testifying on Capitol Hill in Washington, June 13, 2017. (AP Photo/Jacquelyn Martin)
2. Threat of a crackdown has not hampered legalization
During his campaign, President Trump expressed support for legalizing medical marijuana, but Attorney General Jeff Sessions wants to crackdown on recreational use. Sessions is not in favor of expanding legalization, saying it “remains a violation of federal law to distribute marijuana throughout any place in the United States, whether a state legalizes it or not.”
Initially, it was thought that this threat of enforcement would slow down legalization efforts, but it hasn’t been the case. This year, 16 more states have introduced medical marijuana legislation, and this trend previously limited to liberal territory is now expanding into conservative states. Furthermore, 17 more states introduced bills to make recreational marijuana legal for adult use, while five others are considering voter referendums for recreational use. Needless to say, state legalization has continued its momentum, despite the views of the current administration.
Related: Study finds support for marijuana legalization, but its future is still cloudy
3. In May 2017, Congress approved a federal budget that protects medical marijuana
The $1 trillion spending bill, which will fund the U.S. government until the end of September, includes language that protects state medical marijuana programs from federal enforcement.
Under this approved bill, the U.S. Department of Justice is unable to use funds to interfere with states that have passed medical marijuana laws. However, recreational businesses and users are not protected under this provision.
Related: Cannabis compliance software eases business insurance snags
4. Congress proposes comprehensive ‘Path to Marijuana Reform’
In April 2017, lawmakers introduced new legislation that may be the most comprehensive marijuana reforms proposed to date. There are three bills altogether:
The Small Business Tax Equity Act would create an exception and allow marijuana-based businesses to take normal business deductions.
The Marijuana Policy Gap Act would bridge discrepancies between state and federal marijuana laws through a variety of reforms, such as easing restrictions on banking and medical research.
The Marijuana Revenue and Regulation Act would remove marijuana from the list of scheduled drugs on the Controlled Substances Act; the drug would then be treated like alcohol or tobacco under federal law.
However, the likelihood that these bills will receive Congressional approval is bleak given that both houses of Congress are controlled by Republicans, most of whom are against sweeping reforms. Furthermore, Congress has so many other priorities that it may simply be unable to adequately consider these bills.
Related: Insurance implications of legal marijuana: Questions continue to roll in
5. New clinical trials are beginning
After two years of bureaucratic hurdles, the first large study to directly compare medical marijuana to an opioid drug is scheduled to begin at the University of Colorado, Denver.
The marijuana used in this study will be kept inside secured lockers with surveillance cameras. Each locker has tamper-proof hinges and requires two keys—each held by a different person. If someone puts the wrong key in one of the locks, it will become inoperable and have to be drilled out. All of these measures are necessary to comply with rules imposed by the DEA to protect controlled substances meant for research.
Colorado lawmakers had the foresight to channel tax money from marijuana sales to fund such research. The grant for this study is part of $9 million awarded by the state for trial purposes. This is important as stronger clinical evidence is what is needed at this point to obtain FDA approval.
Related: 4 burning questions about medical marijuana
These five developments are among the most recent that could affect the use of medical marijuana in workers’ compensation. Interestingly, the status quo on legalization and adoption in the medical community continues to evolve, driven in large part by changing public perception.
In 1995, the year before California became the first state to legalize medical marijuana, a Gallup poll found only 25% of survey respondents supported legalization. In 2017, a recent poll from Quinnipiac University found that 93% of respondents now support medical marijuana. And, if all the states that have currently introduced legislation pass bills, as many as 45 states could soon have medical marijuana laws in place, creating a very different outlook for use within the industry.
Workers’ Compensation: 10 issues to watch for 2017
Workers’ Compensation: 10 more issues to watch for 2017
Kevin Glennon, RN is vice president of clinical programs at Jacksonville, Fla.-based workers’ compensation solutions provider One Call Care Management. Email him at firstname.lastname@example.org.