By Brian Allen, VP of Government Affairs
Three states recently joined the cohort that has pushed to legalize marijuana over the past decade: New York, New Mexico and Virginia. A third of the U.S. has now completely decriminalized marijuana and a majority of states have partially decriminalized the drug for medicinal use.
What’s next for the movement that keeps growing?
At the federal level, Congress has introduced bills in the past (MORE Act and SAFE Banking Act) that ultimately failed the senate. Three new bills have been introduced: moving marijuana from schedule I to schedule III (HR 365 – Marijuana 1-3 Act), prohibiting Veterans’ Affairs from denying benefits to veterans participating in state-legal marijuana programs (HR 430) and creating protections for financial institutions that provide financial services to marijuana-related businesses (HR 1996). Additional bills may be brought forward in upcoming months, but potential headwinds and President Biden’s unclear stance on legalizing marijuana at the federal level makes for several potential outcomes.
Reimbursement also continues to be a controversial issue, with some states or courts ruling that insurers must cover marijuana use by injured workers and other states ruling against reimbursement requirements. The most recent case arose in New Jersey (Vincent Hager v M&K Construction (PDF)), with the court ruling that insurers must reimburse for marijuana use. If decriminalization happens at the federal level, the topic of reimbursement may become moot, but for now it continues to be a state-by-state decision.
From a clinical standpoint, new studies continue to emerge on the potential benefits and drawbacks of marijuana use. While the drug remains a Schedule I substance at the federal level, there is still a lack of large-scale clinical studies. Some recent studies are listed below:
- Treatment of Pain: In the workers’ compensation industry, managing pain is vital. If marijuana provides pain-relieving properties with few side effects, it could be a viable option for treatment. However, studies are mixed on its actual efficacy in providing pain relief. Some studies have shown pain relief, with several of these self-reported by participants, while other studies have concluded that there is limited evidence for pain treatment. Overall, more studies need to be done to prove or disprove the claim that marijuana provides pain relief.
- Opioid Use: Studies are also mixed on whether marijuana use reduces opioid use. Some studies have found that self-reported opioid use decreases where marijuana is legal, while others have found that opioid use increases along with marijuana legalization. One study noted that co-use of marijuana and opioids is associated with “elevated anxiety and depression symptoms, as well as tobacco, alcohol, cocaine and sedative use problems, but not pain experience.”
- Health Effects: While many studies have looked at the benefits of marijuana in potentially treating pain and potentially reducing opioid use, recent studies have started to look at the health effects of the drug. Particularly, a recent release by the American Heart Association cited health concerns related to high-potency THC products, including heart attacks, strokes or heart failure, and the potential to interfere with prescribed medications.
Overall, it’s clear that legalization is outpacing research, but that de-scheduling needs to occur for larger scale clinical studies to be allowed. It is anticipated that additional research may also come out of Canada and/or Mexico in the coming years as both have legalized marijuana nationally. Health Canada has said that the Canadian Institutes of Health Research (CIHR) is “investing significantly in research on cannabis and cannabinoids.” As clinical research efforts, legalization and coverage issues continue, we will keep you updated on the latest developments.
About Brian Allen
Brian Allen is a nationally recognized policy expert for workers’ compensation and insurance issues across the country. Allen currently serves as Vice President of Government Affairs for Mitchell’s Pharmacy Solutions team. In this role, Allen provides clients with insight into new legislation and regulations in pharmacy solutions and workers’ compensation.
Allen frequently authors articles and blogs on relevant issues and is a regular source to reporters working with the various trade journals. Allen is also a frequent speaker and panelist at several conferences and events around the country, including the Southern Association of Workers’ Compensation Administrators (SAWCA), WCI360, the National Drug Abuse Summit, National Workers’ Compensation and Disability Conference (NWCDC), and many state and regional workers’ compensation conferences. He is also a member of the Medical Issues Committee for the International Association of Industrial Accident Boards and Commissions (IAIABC).
Allen has lobbied nationally for workers’ compensation issues for more than 16 years and has more than 25 years of political experience. Allen is a former elected member of the Utah House of Representatives. He has been instrumental in the development of drug formularies around the country including Texas, California, Tennessee, Montana and Kentucky. He was also a contributor to the model drug formulary legislation adopted by the National Council of Insurance Legislators (NCOIL) in December 2019. Allen is a leading voice on opioid prescribing, physician dispensing and the potential impacts of medical marijuana on the workers’ compensation system.
Allen has over 30 years of experience in the insurance industry as a licensed agent and agency manager for multi-line insurance agencies. Allen is currently licensed and maintaining a Certified Insurance Counselor (CIC) designation.
Headquartered in San Diego, Calif., Mitchell International, Inc. delivers smart technology solutions and services to the auto insurance, collision repair, disability and workers’ compensation markets. Through deep industry expertise, connections throughout the insurance ecosystem and advanced technology such as artificial intelligence, extended reality and cloud-based solutions, Mitchell enables its customers and clients to succeed in today’s ever-changing environment. Each month, Mitchell processes tens of millions of transactions for more than 300 insurance providers, 20,000 collision repair facilities and 70,000 pharmacies. Its comprehensive solution and service portfolio empowers clients to restore lives after a challenging event.
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