January 20, 2023

Cannabis Research Continues for Chronic Pain

Marijuana is currently medically legal in 36 states and recreationally legal in 21 states. With Minnesota and Kentucky already putting recreational marijuana legalization bills up for review, it is likely 2023 will continue the march towards greater legalization across the nation.

This of course continues to ask the question – perhaps louder than ever – what therapeutic value does marijuana offer that may be relevant to injured worker populations? Two new studies regarding marijuana’s impact on chronic pain add to the fire in favor of medical cannabis use.

The Journal of the American Medical Association (JAMA) recently published a new cross-sectional study that surveyed a representative sample of individuals aged 18 years or older with chronic pain who lived in the 36 states with active medical cannabis programs from March to April 2022.

The study assessed self-reported use of medical cannabis, pharmacologic treatments, and common nonpharmacologic treatments. Approximately 1,661 individuals completed the survey and 31% of adults with chronic pain reported using cannabis at some point to manage their pain,

Among adults who used marijuana, more than half found that cannabis led them to decrease their use of prescription opioids, prescription nonopioid drugs, and over-the-counter pain medications. Among adults with chronic pain in this study, 38.7% reported that their use of cannabis led to decreased use of physical therapy, while 26% reported it led to the decreased use of cognitive behavioral therapy.

Meanwhile, Regional Anesthesia and Pain Medicine published a new report that searched nine medical literature databases for randomized controlled trials comparing synthetic and natural cannabinoids to placebo in patients with neuropathic pain syndromes.

Eight trials were found and meta-analysis from all eight studies showed a significant reduction in daily pain scores in the cannabinoid group, while six studies were associated with a significant improvement in sleep quality.

As evidence in favor of the utilization of medical marijuana continues, it is important to consider how this could impact workers’ comp programs. Understanding how marijuana use impacts workplace safety is of key importance, especially if clinical evidence continues to drive legislative and regulatory change – or industry workarounds.

New Mexico recently saw the rise of a new industry model to circumvent federal banking restrictions that have prevented workers’ comp payers from directly paying for medical marijuana. Bennabis Health entered a partnership with AltaVida Dispensary to begin acting as a go-between for patients, allowing patients to acquire their medical cannabis at an AltaVida location, paying nothing out-of-pocket. Bennabis Health pays for the patient’s cannabis, and then later bills the workers’ comp payer.

As payers are not directly paying for marijuana directly due to federal banking restrictions, patients must pay out-of-pocket and then submit a receipt to their insurer to receive a check for the cost of their marijuana.

In theory, because this new business model allows patients to acquire medical marijuana without paying out-of-pocket, it could lead to greater utilization of medical marijuana since patients who may have been unable or unwilling to pay out-of-pocket will no longer face that point of contention.

If this business model were to gain steam and result in higher marijuana utilization, then the need to review clinical research grows even greater.

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