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Safety By Adele L. Abrams, Esq., CMSP


Medical Cannabis, Opioids & Workers’ Compensation: Clearing the Air on a Complex Issue


E


veryone knows that the United States is experiencing an epidemic of opioid addiction and overdoses. Recent data reflect nearly 17,000 prescription opioid overdoses – 35 percent of the total 47,600 opioid ODs overall. What everyone doesn’t know is that many of these opioid addictions and eventual prescription drug overdoses arise from initial use to treat workers’ compensation injuries.


The Sad Facts


The statistics are sobering: A worker who uses opioids for a single day has a 6 percent chance of still using the drug a year later; a worker who uses opioids for 7 days has a 13.5 percent chance of still being on them a year later, and someone who uses the pre- scription for over a month has a 30 percent chance of taking them for a year or more. This long-term use can lead, in turn, to increased perception of pain, increased risk of depression, and increased risk of suicide. Workers who are abruptly cut off from prescribed opiates are also more like to turn to “street drugs” to avoid withdrawal and to alleviate the continued perceived pain. This ultimately can lead them to opi- oids contaminated with fentanyl – respon- sible for so many deaths in the U.S. A study by the Workers Compensation Research Institute (WCRI) found decreases in the frequency and amount of opioids dispensed to injured workers in recent years, a welcomed trend, but some states experienced higher utilizations of opioids and other high-risk utilization patterns. The states experiencing an increase in dispensing of opioids through workers’ compensation were Indiana and Wisconsin (with Virginia, Louisiana and Iowa expe- riencing minor reductions). The biggest reductions were observed in Michigan, Maryland and New York – all states with


26 // May-June 2021


legal medical cannabis (since this study was done, Michigan and New York also legal- ized recreational cannabis).


WCRI also found that opioid use was prevalent among nonsurgical claims with more than 7 days of lost-time – up to 75 percent of these injured workers received at least one opioid prescription – and even higher in Arkansas (85%), Louisiana and South Carolina (80% each). A sizable per- centage of workers’ compensation claims resulted in “chronic” dispensing of opioids (at least a 60-day supply).


Medical Cannabis and Safety Concerns How does this relate to medical can-


nabis? An increasing number of states – a dozen by last count – have acknowledged that legal medical marijuana can be an effective alternative to opioids for relief of chronic pain, without having any over- dose potential. Medical cannabis is also increasingly being used as an alternative


treatment for other conditions such as insomnia, PTSD and depression, which may be treated otherwise with addictive benzodiazepines or other medications that can cause on-the-job impairment and an increase risk of accidents or suicide. But, if not properly managed, both can cause safety issues in the workplace if an employee must use the medication during the work day – particularly if in a safety- sensitive position.


While cannabis remains a Schedule


I drug federally – classified along with heroin and cocaine as drugs with no medi- cally recognized use – 36 states plus Wash- ington, D.C. and all of the U.S. territories have now legalized medical marijuana in some form. The prospects are likely that it will be legalized at the federal level during the Biden administration, in which case all of the existing case law brought under the federal Americans with Disabilities Act (ADA) will no longer be valid, because the


Automotive Recycling


iStockphoto.com/stefanamer


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