A Healthesystems publication

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
  • Seizures/epilepsy
  • 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:

states chalk-line-bottom

Know the Regulations

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:

  • list item icon Qualifying conditions – is marijuana legally permissible for a patient’s condition?
  • list item icon Reimbursement requirements – do insurers have to pay for marijuana?
  • list item icon Permitted formulations, dosage, and routes of administration – what forms of marijuana can a patient use, and how much can they get?
  • list item icon Drug-free workplace and workplace safety regulations – do workplace requirements make marijuana feasible?
  • list item icon 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. https://www.health.ny.gov/press/releases/2018/2018-07-12_opioid_replacement.htm 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.
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