Marijuana: A Medical Perspective

Dr. Marco IiglesiasWe have a drug problem.

 

Americans consume more opioids than anyone else in the world. We are also among the highest consumers of marijuana. As a nation, we continue to rely on passive treatments for chronic conditions, instead of active management.

 

There is widespread acceptance of marijuana in the United States. A recent Quinnipiac University poll of US voters found that 63% of respondents believe that marijuana should be legalized and 93% support its use for adults with a medical prescription by a physician. The 2016 National Survey on Drug Use and Health estimates there are almost 38 million marijuana users in the United States. Thirty states and the District of Columbia currently have legalized marijuana in some form (most of these are so-called medical marijuana states). Eight states and the District of Columbia have legalized marijuana for recreational use.

 

Yet marijuana continues to be classified as Schedule I drugs under the Federal Controlled Substances Act and, therefore, illegal to manufacture, distribute, or dispense.

 

When it comes to the legality of medical efficacy of marijuana use, there are a number of factors at play. These include:

 

  • Pharmacology — how exactly do the relevant chemical compounds, THC and CBD, interact with the body? And, given the non-traditional routes of administration for marijuana (usually inhalation or ingestion), how can we anticipate or regulate what the response will be?
  • Adverse effects — we’ve all heard about the euphoria and impairment of memory, judgement, reaction, and other mainstream effects. But what about adverse physical effects? Or, the link to psychological disorders like depression, schizophrenia, or psychosis?
  • Efficacy — in some circles, marijuana is touted as a harmless cure with the ability to cure everything from cancer to chronic pain. The challenge with these claims is that there are few methodologically rigorous trials that can back the claims up. Is there something here for doctors to work with or should the claims be dismissed as nothing but rumors from idealistic hippies?
  • Workplace impact and safety — with additional increases in marijuana use, both recreational and otherwise, seeming inevitable, what is the link to workplace safety? And how can employers, insurers, and claims handlers respond?

 

As part of our dedication to staying at the forefront of medical advancements and opportunity, we have prepared a white paper and recorded webinar to dive deep into these questions. Using evidence-based research, we separate fact from fiction and seek to find out if there is legitimate use of marijuana in our industry’s future or if all the claims will go up in smoke.

 

 

 

Author: Dr. Marcos Iglesias is Broadspire’s senior vice president and chief medical officer with more than 25 years of experience in workers compensation, disability evaluation and treatment, and insurance leadership. Iglesias has a special interest in the prevention and mitigation of delayed recovery and disability. He is driven to help ill and injured workers live active, productive and fulfilling lives, which has led him to develop innovative, comprehensive disability management solutions that focus on returning workers to preinjury function. Iglesias is board certified in family medicine and utilization review and quality assurance. He is also a fellow of the American Academy of Family Physicians, American College of Occupational and Environmental Medicine and the American Institute of Healthcare Quality.

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