By Mark Pew, Senior VP, Product Development & Marketing at Preferred Medical. He will present Is Marijuana Medicine? at BWC’s Medical & Health Symposium Saturday, April 27 at 7:30 a.m.
As society and workers’ compensation try to answer that question, there are some clarifying questions that need answers first. That’s especially true on such a polarizing subject where state policy and public opinion continue to have their say.
The initial question should be:how is “medical marijuana” defined? Which then takes you to a list of sub-questions:
- Is it the whole plant?
- Is it extracts of specific chemicals like THC or CBD?
- Is it organic (“natural”) or synthetic (“man-made”)?
- Is it smoked, vaped, eaten, or an oil that is ingested or rubbed on a body part?
- Is it just for a specific list of qualifying conditions or open to interpreted needs?
- Does a physician need to recommend it as “reasonable and necessary” treatment or is it up to the patient (injured worker) to determine for themselves?
- Is it grown at home, advised by a budtender at a dispensary or tightly controlled from seed to sale?
- Is the dosing, duration, frequency and formulation determined by the patient or a clinician?
Every state has its own answers, whether on program website FAQs or from how it works in everyday practice. States with more recent programs, like Ohio Medical Marijuana Control Program[i], generally have more attempts at controls. But if you have seen one state medical cannabis program, well, you have seen one medical cannabis program. In other words, every state is different.
Once past that initial question, the next is whether “medical” is a scientific or anecdotal adjective that precedes “marijuana.” Some physicians, pharmacists and policymakers (including the National Institutes of Drug Abuse[ii]) believe the science has not clearly proven the medical benefit. The DEA still believes it is yet unproven because, given the chance in August 2017 to re-classify marijuana from Schedule I (i.e., illegal),the agencyaffirmed that “right now, the science doesn’t support” it[iii].
Other physicians are demonstrating by their recommendations they believe it is medicinal. The FDA believes that at least CBD is medicinal by approving Epidiolex in June 2018[iv]. And then you have people with various medical conditions, including chronic pain, that offer anecdotal proof it helps them or someone they know where FDA-approved medications and treatments do not. Their evidence is compelling, especially to mainstream and social media. Similar to the various definitions of medical marijuana, opinions vary greatly whether it is a proven medical treatment. It is obvious that preconceived biases – for or against – heavily influence individual opinions.
Clear as mud? Good. Because that is our country’s current crossroads. Setting aside individual opinions, 46 of 50 states[v] have decided in favor of medical use, and that is unlikely to be reversed. So the answer to the original question –is marijuana medicine? – is a very firm … maybe.