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Medical pot wave raises comp concerns

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Workers compensation experts are calling for more research into medical marijuana after four more states approved its use for medicinal purposes, and one state is aiming to approve it as a treatment for opioid abuse.

“The (workers comp) industry is looking for good solutions,” said Greg McKenna, Itasca, Illinois-based vice president and counsel of governmental affairs at Gallagher Bassett Services Inc. “If there are viable solutions … and reasonable treatment methods for the overutilization of opioids, that’s good.”

Mr. McKenna and others in the comp industry argue that evidence of marijuana’s medicinal benefits is anecdotal rather than evidence-based.

But that hasn’t stopped a trend of states approving the use of medical marijuana.

More than half of all states now allow cannabis to be used for medicinal purposes after voters in Arkansas, Florida, Montana and North Dakota passed medical marijuana initiatives last month.

New Mexico, which approved medical marijuana in 2007, has gone a step further by trying to allow medical marijuana to be used in place of addictive opioids for pain management. A state advisory board for the New Mexico Health Department voted 5-1 last month to add “opiate use disorder” to a list of conditions that qualify for medical marijuana. The state health department is expected to vote on the recommendation.

The recommendation follows New Mexico’s decision in January to require employers and insurers to reimburse injured workers for medical marijuana under the state’s health care provider fee schedule.

Mark Pew, senior vice president at Prium, a Duluth Georgia-based medical cost management firm, said he believes there are not enough studies to prove marijuana’s effectiveness in pain management.

The idea of marijuana replacing opioids for pain treatment “is an argument that I have heard repeatedly in a variety of states from a variety of people over the past several years,” Mr. Pew said, noting that marijuana is still illegal under federal law.

Dr. Teresa Bartlett, Troy, Michigan-based senior vice president of medical quality at Sedgwick Claims Management Services Inc., said that soon could change.

She said there are “minimal studies” about marijuana’s medical efficacy because the U.S. Food and Drug administration still classifies it as a Schedule I substance, like cocaine and heroin.

If the FDA loosens its restrictions on marijuana, that could open the doors for much-needed research, Dr. Bartlett said.

“Marijuana isn’t a dangerous drug like the other Schedule I drugs … but that was part of the premise to get the (federal government) to remove it so there can be studies,” she said.

Mr. Pew said more research would help workers comp claim payers and managers make informed decisions about the use of medical marijuana.

Studies up to now have been very narrow, he said, leaving interpretation of the results “up to the bias of the person reading the science.”

“It can be looked at either way,” said Mr. Pew. “That’s what makes the subject of marijuana complex. The science isn’t one way or another.”

Dr. Bartlett said uncertainty about whether the benefits of medical marijuana can be proven is troubling for workers comp experts and claim payers.

“You are passing all these laws … and telling payers they have to pay for the drugs and there really isn’t the evidence,” she said. “We like to have medical evidence to substantiate treatment.”

Jeffrey Adelson, Santa Ana, California-based general counsel and managing partner for law firm Adelson, Testan, Brundo, Novell & Jimenez, thinks there is a future for medical marijuana in workers comp if states can provide enough oversight.

For instance, he notes that the New Mexico health department would oversee production and distribution of medical marijuana for injured workers.

“When you have that kind of regulation, I think an employer should be accepting of it,” Mr. Adelson said.

Mr. Pew noted that some major groups seem open to the idea of using medical marijuana for injured workers, pointing to an announcement last month from the National Football League Players Association that the players’ union will study medical marijuana as a pain-management tool for players.