The legalization of marijuana in multiple states across the country for medical use is generating conversation among all levels of stakeholders in the workers’ compensation and auto no-fault industries. There are a number of concerns, including safety and the effectiveness of medical marijuana for medical purposes.
While marijuana is legal for medical purposes in 24 states and the District of Columbia, it is still illegal at the federal level. The federal government classifies marijuana as a Schedule I substance. Schedule I substances are considered to be the most dangerous substances with potentially severe psychological or physical dependence, without accepted medical use, and a high potential for abuse. Other Schedule I substances include heroin and LSD.
Because of this, there is no national drug code (NDC) for marijuana, which means pharmacy benefit managers can neither process nor electronically adjudicate prescription transactions using current pharmacy industry standards.
Clinically, there has been a lack of FDA-quality clinical trials confirming the drug’s value in treating medical conditions. Quality control and grading standards have not been implemented to systematically verify the safety and potency of marijuana. This results in a significant barrier to safe prescribing and dispensing processes.
Another concern is for when an injured person receiving medical marijuana returns to work. Most employers have anti-drug or sobriety standards. This is of particular concern with manual labor and safety-sensitive jobs where the residual effects of marijuana could cause harm.
At Optum, we remain sensitive to the continued exploration of and advances in pharmacologic and non-pharmacologic therapies necessary to relieve pain and suffering. We are equally committed to the extensive evaluation and oversight provision on the treatments provided to our claimants.
In developing our injury-based medication plans and formularies, we rely upon evidence-based medicine and state and national medical guidelines for the workers’ compensation and auto no-fault industries. Based on the best available scientific evidence and recommendations at this time, in addition to the lack of essential quality control measures, an unchanged Schedule I classification, and the absence of an NDC needed for adjudication and processing, we exclude medical marijuana from our formularies and medication plans.
Medical marijuana and its use in the treatment of chronic pain presents many challenges and requires careful consideration. Research to explore the safety concerns and potential therapeutic benefits continues, and we continue to follow these developments. Additionally, our government affairs team remains abreast of the changes in the legislative and regulatory landscape.