Medical Marijuana in WC: One Call Expert Outlines What Case Managers Need to Know
Jacksonville, FL – As a result of the types of workers’ compensation accidents and injuries that occur, case managers often see a significant number of chronic pain cases vulnerable to opioid abuse and addiction. A recent study found that three out of every four injured workers are prescribed opioid medications for pain management.1
“With over 15,000 people dying each year from overdoses of prescription painkillers,2 case managers need to understand the potential for medical marijuana to serve as an alternative,” said Kevin Glennon, RN, BSN, vice president of clinical programs at One Call Care Management, who delivered an engaging presentation on the topic at the 2017 Case Management Society of America (CMSA) Conference.
Small-scale studies have shown that medical marijuana is effective in treating chronic and neuropathic pain, and publications like The Atlantic have reported that in states where medical marijuana is now legal, patients are electing to use medical marijuana over opioid medications.
“Medical marijuana is still illegal at the federal level, so injured workers face significant challenges in accessing the drug within the workers’ compensation system,” said Glennon. “New Mexico was the first state to face this controversy in court where it was ruled three times that injured workers were due reimbursement for medical marijuana deemed ‘reasonable and necessary’ for pain management.”
Whether other states see similar cases will be dependent upon ongoing legislative and regulatory developments, but we may soon see a critical tipping point in state-level adoption. Currently, 29 states and Washington D.C. have legalized medical marijuana, but this year, 16 additional states have introduced medical marijuana legislation. If these new states pass bills, as many as 45 states could have medical marijuana laws in place, creating a very different outlook on the use of medical marijuana.
“Because of its current classification as Schedule 1 substance, there are many bureaucratic hurdles to conducting the clinical research required to garner FDA approval,” added Glennon. “However, the University of Colorado in Denver has recently been approved to start the first large clinical study to compare medical marijuana to an opioid medication.”
This study and others like it are important in substantiating the efficacy of medical marijuana in treating pain. A 2014 study published in the JAMA found that states with medical marijuana laws experienced almost 25 percent reduction in deaths from opioid overdoses compared to states without those laws.
Such observational studies come at a time when public support is at an all-time high. In 1995, the year before California became the first state to legalize medical marijuana, a Gallup poll found that only 25 percent of survey respondents supported such legislation. In 2017, a recent poll conducted by Quinnipiac University found as much as 93 percent of respondents now support medical marijuana.
As the industry awaits stronger clinical evidence, workers’ compensation professionals are urged to heed treatment guidelines, while continuing to monitor for legislative changes. In April 2017, Congress proposed a comprehensive “Path to Marijuana Reform” package consisting of three bills that could bring significant changes to federal laws. However, passage looks bleak, as Congress may be too busy to adequately consider these bills in light of other pressing initiatives.
1 Interstate Variations in Use of Narcotics, 2nd Edition. Vennela Thumula, Dongchun Wang, and Te-Chun Liu. May 2014. MMWR Morb Mortal Weekly Rep 2016;64:1378-1382.
2 Centers for Disease Control and Prevention, https://www.cdc.gov/drugoverdose/data/overdose.html