Cannabis Not a Safe Alternative to Opioids, Panel Says

Cannabis plant

A panel of experts at the annual Disability Management Employer Coalition Inc. conference discussed the value of cannabis as a “safer” alternative to opioids last week. The consensus among participants: Cannabis poses more risks than rewards for employers and employees alike. And while that opinion certainly isn’t shared by everyone in the field (even the National Institute on Drug Abuse admits there are therapeutic uses for THC)  it is important enough to give employer’s pause. 

Cannabis Not a Panacea

One member of the panel was Marcos Iglesias, the chief medical officer for Florida based Broadspire Services Inc. Speaking about the perceived lower addiction potential of cannabis, he urged employers to remain cognizant of the fact that cannabis use disorder is a recognized diagnosis that can lead to addiction in persons who regularly use the drug. According to Iglesias (and the NIDA) about 6 to 7 million Americans suffer from the disorder, which is going to be “an increasing problem” as medical marijuana use becomes more prevalent, Iglesias said. Citing a recent analysis from the Proceedings of the National Academy of Sciences, he also pointed out that medical cannabis has most likely not been a factor in reducing opioid-related deaths as was previously claimed. 

Joining Iglesias in urging caution on marijuana was Dr. Glenn Pransky, an associate professor at the University of Massachusetts Medical School in Worchester, Massachusetts, and a scientific adviser for Lincoln National Corp. Speaking about cannabis as an alternative to opioids for treating chronic pain, Pransky said, “It appears to be trading one form of mind- and mood-altering substance for another, but it’s not a cure for chronic pain.”

Iglesias even balked at the term “medical marijuana,” claiming it implies a difference between cannabis sold for medical use and that used recreationally. “… I think we err when we talk about medical marijuana versus recreational marijuana,” he said. “It’s the same substance. There’s no difference, and that’s one of the misconceptions that we have in our industry — that somehow medical marijuana is different, it’s safer, it has certain safeguards around it. It doesn’t.”

Iglesias’ objections aside, medical marijuana is currently legal in 33 states and the District of Columbia, and recreational use has also been approved in 11 of these.. States are split, however, as to whether cannabis is a compensable medical expense under workers compensation laws. In six states (Connecticut, Maine, Massachusettes, New Jersey, and New Mexico) it is. Another six states (Arizona, Colorado, Michigan, Montana, Oregon, and Vermont) specifically exclude marijuana as a reimbursable medical expense. 

Legal, But Dangerous on the Job

Regardless of its legality, cannabis and high-risk jobs simply don’t mix. But, at least at this juncture, there is little employers can do to screen for marijuana use on the job. Quantitative drug tests do exist, of course, but they only screen for metabolites of THC, which can be present in the blood or urine up to two weeks after marijuana use. There is currently no on-the-spot test that can reliably determine if an employee is impaired. “You should be scared by that,” said Stuart Colburn, a workers compensation specialist from Austin, Texas, because it means that an impaired worker may, without your knowledge, be operating heavy machinery or driving a truck. 

A few companies are currently working on a cannabis “Breathalyzer,” including the Bay Area, California, startup Hound Labs. But clinical trials are still a long way off, and the anticipated price tag of $5,000 may be a non-starter for small firms. What’s more, the question of whether post-incident drug testing constitutes adverse action against employees who report illnesses and injuries still looms large. If an employee claims they were threatened with drug testing to prevent them from filing a claim, “then you can still today be sued under OSHA regulations for discriminating against your workers,” Colburn said.

In the meantime, Iglesias urged employers to train supervisors to recognize signs of impairment and remove employees from any situation that isn’t safe. 

That sounds like excellent advice to us.  

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