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Risk managers, insurers in the weeds over growing acceptance of medical marijuana

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PHILADELPHIA — Coming soon to a workers compensation claim near you: medical marijuana.

That was the message to a roomful of risk managers at a session Tuesday on medical marijuana at the Risk & Insurance Management Society Inc.’s annual conference in Philadelphia.

As of this month, 29 states and Washington now permit the use of medical marijuana — more than half the country.

Panelist Kevin Glennon, Jacksonville, Florida-based vice president of clinical programs for One Call Care Management, revealed that a majority of people in the United States are in favor of approving medical marijuana use for illnesses and ailments, and that the about the same number think the substance should be legal for recreational use.

Three federal bills that would permit widespread use of marijuana in various ways have been introduced, he said.

“For anyone who thinks this is going away, it’s not,” he said. “We will continue to see more.” 

The landscape of marijuana use in workers comp is changing, panelists said. In states such as New Mexico and Louisiana, judges have ordered insurers to reimburse injured workers for medical marijuana, and other similar cases are pending, Mr. Glennon said.

One of the key drivers for increased marijuana allowance has been the opioid epidemic, he said. His presentation included a scan of facts from news articles on opioid addiction and overdose deaths.

Many prescription opioids are synthetically derived from heroin, Mr. Glennon said. “You are giving them heroin,” he said of the most common drugs prescribed to injured workers.

According to a slide displayed for attendees, opioids can produce several dozen side effects, including dryness of mouth, distortion of time and increased heart rate. Mr. Glennon noted that marijuana has become more accepted because it has fewer, and possibly less dangerous, side effects than opioids.

“You don’t get the constipation or the respiratory issues when you use (medical marijuana),” he said.

The cumulative side effects of opioids are one reason marijuana is getting the preferred treatment even at the insurer level, he said, adding that more prescriptions are often needed to combat those effects.

“There are several states where the insurers have been ordered to reimburse for medical marijuana … they’ve stopped fighting it,” Mr. Glennon said.

“What (insurers) have seen is the significant decrease in the cost of prescription medication and in some cases, the individual is off all prescriptions and (only) using medical marijuana ... to manage their chronic pain.” “Many individuals are turning to medical marijuana” to abandon their prescriptions, he added.

“What we see in the work comp industry is primarily it is being recommended for the management of chronic long-term pain,” he added.

But medical marijuana still has a way to go before it gains full acceptance, he said.

Mr. Glennon said the federal government’s stance on marijuana has stalled research.

There are few clinical studies of marijuana because cannabis is classified by the U.S. Drug Enforcement Administration as an illegal Schedule I substance — a category that includes cocaine, heroin and other drugs deemed by the DEA to have no medical use.

Panelist Markie Davis, risk manager for the State of Colorado, told attendees of the state’s experiences with marijuana, which was approved by voters for medical use in 2000 and recreational use in 2007.

Among the pros: Tax revenues generated from marijuana sales have boosted state coffers. But a key challenge in the workplace has been measuring impairment when a person uses marijuana, she said.

Navigating the workplace implications will take time, added Mr. Glennon.

“(Marijuana is) truly going to change the way risk managers and employers are going to have to think about fit for duty and impairment in the workplace,” he said. “When we talk about the workplace, the majority of the people that we see (using medical marijuana regularly), they have long since settled their indemnity (claim). They aren’t coming back to work.”