Winter 2018/2019

Myth Busters: Medical Marijuana Edition

Medical marijuana legalization continues to spread to more states for an increasing number of medical conditions. Because this controversial therapy has as many supporters as detractors, deciphering what’s fact and what’s fiction can be difficult.



There is insufficient evidence for the clinical benefits of marijuana

Despite federal schedule I status that claims marijuana has no medical use, several comprehensive reviews of medical literature found substantial evidence that marijuana can help treat: 1-2


Chronic, severe, or intractable pain

Severe or persistent muscle spasms


Post-traumatic stress disorder (PTSD)



Unlike opioids, marijuana does not present significant risk to injured workers

While marijuana does not share certain adverse effects with opioids such as high rates of addiction and overdose-related death, it does present some risks that are important to consider in the context of workplace injury:

Drowsiness, dizziness, confusion, and disorientation, which can lead to workplace accidents

Mental health concerns including anxiety, short-term memory loss, psychosis, and hallucinations

Broader public health concerns, such as driving while impaired



Workers’ comp benefits won’t have to cover marijuana because it’s federally illegal

The federal government currently defers to state governments in regard to marijuana regulation, which has led to a great diversity in policy across the country.

While new legislation and court appeals continue to evolve these policies, some states have required insurers to reimburse medical marijuana when clinically necessary, including:


Because there are no established clinical guidelines regarding the use of medical marijuana, the driving force behind marijuana utilization is still state-driven legislation. It is therefore important to understand the diverse stipulations surrounding:

Qualifying conditions – is marijuana legally permissible for a patient’s condition?
Reimbursement requirements – do insurers have to pay for marijuana?
Permitted formulations, dosage, and routes of administration – what forms of marijuana can a patient use, and how much can they get?
Drug-free workplace and workplace safety regulations – do workplace requirements make marijuana feasible?
The ability to swap opioid prescriptions for marijuana 3–4 – does a patient have the right to reject opioid prescriptions and use marijuana?


  1. The health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research. National Academies of Sciences, Engineering, and Medicine. 2017. doi: 10.17226/24625.
  2. Whiting PF, Wolff RD, Deshpande S, et al. Cannabinoids for medical-use: a systematic review and meta-analysis. JAMA. 2015;313(24): 2456-2473. doi:10.1001/jama.2015.6358
  3. New York state department of health announces opioid replacement now a qualifying condition for medical marijuana. New York State website. Published July 12, 2018. Accessed Oct 5, 2018
  4. Illinois Senate Bill 336 – the Alternatives to Opioids Act of 2018. Illinois General Assembly. Aug 28, 2018.


Since 2010, the semi-annual RxInformer clinical journal has been a trusted source of timely information and guidance for workers’ comp payers on how best to manage the care of injured worker claimants and plan for the challenges that lay ahead. The publication is an important part of Healthesystems’ proactive approach to advocating for quality care of injured workers while managing the costs associated with treatment.