Rapidly evolving cannabis landscape raises questions for employers

In a recent virtual forum, panelists discussed key issues for employers to consider with cannabis, from employee safety to claims.

Several more states have recently approved the legal use of marijuana, creating more compliance issues for employers. (Photo: Shutterstock)

As the number of states permitting some form of cannabis use continues to expand, so do the issues that employers must address.

“We have some therapeutic use and access in 48 states and recreational use of marijuana in 16 states,” said Wade Aubry, clinical professor of medicine and health policy at the University of California, San Francisco. “There are 100 qualifying conditions approved by states, although some states allow doctors to recommend marijuana for any condition.”

Aubry spoke as part of a breakout session on “How Should Workplaces be Adapting to a Changing Cannabis Landscape?” during the National Alliance of Healthcare Purchaser Coalitions’ virtual 2020 Annual Forum.

“Over the past few years, there have been rapidly evolving federal cannabis policies that employers are really starting to have to take a look at,” said moderator Margaret Rehayem, vice president of the National Alliance. “The changes in these policies can have a significant impact on where employers’ day-to-day operations are, as well as the policies they already may have in place on substance and drug use, hiring and firing practices, and even workplace safety.”

Panel members identified several important issues for employers to consider.

Safety

“Safety is the top priority,” said Tanya Levine, senior health compliance coordinator for Louisville Gas & Electric. “The other thing is the safety of the employee who uses those products while not knowing what they are purchasing. How do we educate our employees to know the difference and make good choices if they are going to use that product? For our employees, it can mean the end of their career if they test positive for THC.”

Efficacy

“State-authorized use of cannabis is an anomaly compared to how we usually regulate medicines in the United States,” Aubry said. “We have a robust system for rigorously studying and approving prescription drugs, governed by federal law and implemented and enforced by the Food and Drug Administration.

“There are FDA-approved cannabis-based medicines that have met the standard practice of FDA regulation. In general, the medicinal use of cannabis is approved by voters or state legislatures rather than the FDA. Thus, you could say that medical marijuana is subject to a different set of standards for safety and efficacy, and a different set of standards for quality and consistency, than FDA-approved medications. I would argue that this is a lower standard, both for quality and evidence of effectiveness.”

FDA approval

The National Alliance recently held four roundtables to hear from employers on cannabis-related topics. “There was a lot of discussion about the distinctions between FDA-approved and non-FDA approved products,” said Gus Georgiadis, area president for Gallagher Benefit Services.

“We then focused on concerns employers have regarding their employees’ use of medical cannabis and what that means in the workplace,” Georgiadis added. “Chief among those concerns, with almost universal feedback, is that their coverage decisions would be based on the product having FDA approval. They believe the rigorous process the FDA follows for not only the quality but the efficacy of these products is important.”

Consistency

“Looking at the landscape of studies that have been done on cannabis products, the overall quality of the evidence of effectiveness and safety is relatively low,” Aubry said. “It all starts with the fact that the product is not consistent in terms of quality and contaminants. We need better studies, and we also need a more consistent product. These are big issues that need to be resolved.”

Misleading claims

“The issue of deceptive medical claims also was an area of great concern,” Georgiadis said. “Non-approved products frequently are marketed as being capable of treating serious disease without any evidence-based medicine to support it.”

At this early stage, there still may be more questions than answers. However, with the average patient using an average of $5,000 to $6,000 worth of medical marijuana issue each year, it’s important to seek answers, Georgiadis said.

“Risk management starts with a policy,” he said. “Employers need to put in place a policy that articulates very clearly their position so it’s clear to the workforce what the position is and what the ramifications are.”

An action brief about cannabis in the workplace can be downloaded for free at www.nationalalliancehealth.org.

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