MORE SMOKE

The drumbeat for medical marijuana in workers’ compensation systems continues.

Earlier this week I attended a lunchtime talk by a Bay Area physician which included his comments on the potential benefits of medical marijuana in treating certain patients.

Legal issues surround this, and a California WCAB panel has twice remanded a WCJ’s decision on reimbursement of marijuana in light of statutory interpretation questions. The case is Cockrell V. Farmers (see link at bottom of this post). I blogged about Cockrell earlier this year (see link below also).

The California MTUS does not recommend medical marijuana (nor does ACOEM or the ODG Guidelines).

But the local physician giving the talk circulated an article from CME Resource (an online medical education provider for physicians) which summarizes many research studies on marijuana efficacy for various conditions.

I’ve included a link to the article titled “Medical Marijuana and Other Cannabinoids” at the bottom of this post.

The article references studies that claim there are significant neuropathic pain control benefits from cannabinoids. Also, it notes studies claiming that there is a synergistic analgesic effect from co-administration with other prescriptions, including opioids.

The article discusses risks and concerns about medical marijuana, including the following: contaminants in the weed, pulmonary function effects, neurocognitive impairment, immunosuppression, anti-motivational syndrome, schizophrenic and psychotic reactions, gateway drug concerns,toxicity and overdose, cannabis addiction, and withdrawal syndrome.

Perhaps some readers of the blog can educate me and the comp community as to whether ACOM and ODG have really looked carefully at the sort of medical data on medical marijuana cited in the CME Resource journal article.

At the moment, however, a prescription from a California workers’ comp treating doctor for medical marijuana would almost certainly be rejected by utilization review and IMR.

In Cockrell the support for the medical marijuana had come from the AME and according to the WCJ’s opinion the defendant refused to provide the medical marijuana on non-medical grounds. Thus, in Cockrell it does not appear that the marijuana denial was based on a UR or IMR determination.

Today’s workcompcentral.com features an article on how New Mexico is handling the issue. There, a series of cases (Vialpondo v. Ben’s Automotive Service, Maez V. Riley Industrial, and Lewis v. American General Media) have cleared the way for reimbursement of medical marijuana expenses under New Mexico law where prescribed by a physician. The New Mexico workers’ comp administration is said to be working on rule making regarding how this will operate.

How all this fits into federal policy toward marijuana isn’t clear. And California will likely see a marijuana initiative on the 2016 ballot:

https://ballotpedia.org/California_Marijuana_Legalization_Initiative_(2016)

Here is the article on “Medical Marijuana and Other Cannabinoids”:

Medical Marijuana and Other Cannabinoids

Here is the link to my post “Reefer Madness”:

http://www.workerscompzone.com/2015/04/09/reefer-madness

And here is a link to the Cockrell v. Farmers case:

WorkersCompMedicalMarijuanaCockrellV.Farmers

Stay tuned.

Julius Young