Marijuana: What’s the Science and the Law?

Growing societal acceptance of marijuana and its increased use raise many legal and medical considerations for workers’ compensation and disability. This session at the 2018 National Workers’ Compensation & Disability Conference provided updates and professional opinions on the legal and medical aspects of marijuana.

Speakers included:

• Stuart Colburn, Esq., Shareholder, Downs Stanford
• Marcos Iglesias, MD, Senior Vice President, Chief Medical Officer, Broadspire

The Law

Ten states, DC, PR and Guam have legalized recreational marijuana use and 33 states currently offer medicinal marijuana, however, it is still illegal federally. For workers’ compensation, seven states will currently preclude reimbursement and six will require reimbursement for medical marijuana. This is complicated for employers since federal law still considers it to be an illegal substance.

By 2020, marijuana is projected to produce $24.5 billion in revenue. It is becoming big business with several significant investors. We have rapidly hit a turning point and no one expects us to go back.

There is a problem, however, that is not apparently clear to everyone. Cannabis policy has raced ahead of cannabis science, so we do not scientifically know if our new laws are helping or hurting the general public.

The Science

America’s view of marijuana is rosy, but unscientific. Contrary to public opinion, marijuana does not prevent health problems, it is addictive and it is not safer than alcohol. Legal does not necessarily mean safe.

Although we classify them as such, medical and recreational marijuana are not different. The products are essentially the same. In fact, there is no real way to define “medical” marijuana. In addition, the conditions that medical marijuana is said to help are so varied that it cannot possibly solve all of these problems. That is a “snake oil” approach. We certainly do not have the science to prove these claims.

Doctors might be part of the problem. Doctors have become gatekeepers for the drug in certain states and, once a doctor makes the recommendation to a strain and dosage, the doctor loses control over the patient’s treatment. The dispensary then essential takes over. These doctors are unknowingly getting us into a potential problem.

Today’s marijuana is very different than it was years ago. Potency has increased from 4% to around 20% today. It also comes in a variety of forms. Employers need to be especially aware of routes of use and their effect on the workforce. Inhalation, for example, provides an almost immediate high. Edibles take time to kick in, so the high might not appear for hours. Someone who appears fine in the office, for example, could get behind the wheel hours later and be severely impaired. It is a challenge for employers because no good measurement exists. Drug tests do not necessarily help because they prove presence, but presence does not prove impairment.

There is limited evidence that marijuana helps chronic pain. In reality, studies only reported that is limited to neuropathic (nerve) pain and the pain relief is modest. It is less effective than the drugs that are already available. It is not helpful for acute pain either. For instance, if given post-operative, it actually makes the pain worse. Other studies show that cannabis increases opioid use disorder. It is not the cure all.