Side effects may vary: Medical marijuana's unintended impact on workers' comp
A lack of thorough research on marijuana is resulting in more questions than answers when it comes to its impact on work safety and accidents.
Editor’s note: This is the first installment of a two-part series reviewing the unintended effects marijuana legalization has had on the U.S. workers’ comp sector. The second half, which touches on the unintended benefits of cannabis and how psychedelics might change things, is available here.
In 1996, California became the first state to legalize marijuana for medical use and today 38 states, three territories and the District of Columbia have similar laws on the books. During all those legislative sessions — amidst the push and pull of politicians and special interest groups — no one took pause to consider how medical marijuana legalization would impact workers’ comp.
“Workers’ comp tends to be the redheaded stepchild with legislators. They forget about it until things are forced to a point and they don’t have a choice,” said Julie Schum, a partner with Quintairos, Prieto, Wood & Boyer, P.A., where she focuses on workers’ comp defense and cannabis issues. “No state thought of it right off the bat. Almost everyone has had to deal with it through case law or amendments to their acts.”
Schum noted legalization has had a number of unintended consequences as well as some surprising benefits on workers’ comp.
Who is paying for this?
Among the issues that needed ironing was the question of if it is appropriate to reimburse workers for their medical marijuana costs following an injury.
Today six states require reimbursement through workers’ comp systems and six expressly prohibit it. An additional 14 states have decided that insurance carriers can’t be required to reimburse an injured worker for medical marijuana, leaving open the possibility that reimbursement could be made on a voluntary basis.
However, Schum said the issue of reimbursement still has a lot of evolution ahead of it. She noted a handful of states circled back to address the matter through amendments, but a majority have turned to courts to settle it. States that have prohibited reimbursement have primarily done so based on “federal preemption,” or the idea that the state can’t make it legal because the federal government bans it.
“They kind of punted on the question,” Schum said of states leaning on federal preemption. “Any of the states that did it by case law will have to revisit it if the federal status of cannabis changes. Now, I am not expecting that to be in the next two years, but I don’t think it is the last word.”
Marijuana is causing more accidents, or it isn’t
One of the most significant potential side effects of medical marijuana is the increase in accidents among users. However, studies offer conflicting views.
According to a study published in the “Journal of the American Medical Association,” employees who test positive for marijuana had 55% more industrial accidents and 85% more injuries compared to those who tested negative.
Conversely, a study published in “Occupational Medicine” in 2020 found “no association between past-year cannabis use and work-related injury.”
In fact, a 2018 study noted legalizing marijuana actually improved workplace safety, positing that perhaps workers had started smoking pot instead of taking hard drugs or drinking.
Why the discrepancy? Schum explained that since marijuana remains illegal on the federal level, there is no federal funding to support research on the impact of marijuana use and workplace injuries. As such, research is limited and tends to lean on small sample sizes and self-reporting.
More clarity is potentially in the pipeline though. For example, the Medical Marijuana and Cannabidiol Research Expansion Act will expand research in a range of THC-related subjects, from its efficacy as a painkiller to its impact on workplace injuries.
While more research is needed on marijuana use and workplace injuries, one thing is for certain: More American workers are testing positive for cannabis.
A report from Quest Diagnostics found that employees testing positive for marijuana following a work-related accident hit a 25-year high in 2022, up 9% from the year prior.
Slightly more than 7% of the general U.S. workforce tested positive for marijuana following an accident, while the combined U.S. workforce positivity for all drugs stood at 4.6% this past year, according to Quest.
How stoned are you?
Although more workers are testing positive for marijuana following an accident, that doesn’t necessarily mean they were intoxicated at the time of the incident.
Since THC is fat soluble it can be detected in a person’s system up to 30 days after use, depending on the person’s metabolism. This makes proving intoxication at the time of an accident much more difficult. However, there are some breakthroughs taking place in testing. For example, THC breathalyzers are coming online.
An example of one was showcased at this year’s Risk World conference by Hound Labs, Inc. Unlike more traditional testing methods such as saliva or urine, Hound Labs’ breathalyzer testing can detect marijuana within a three-hour window after use. After three hours, THC becomes nearly undetectable on the breath. This can help determine when, and not just if, an employee used cannabis.
While breathalyzers can indicate if a person has consumed a THC-containing product during the past three hours, the ability to prove intoxication persists.
Unlike alcohol intoxication, which can be determined based on established scientific methods, the case isn’t so cut and dry from marijuana, Schum said, noting there is no established spectrum of THC intoxication.
“The reason the breathalyzer test works for alcohol is because we have a huge body of work that tells us that ‘X number of drinks for a 190-pound woman has this effect and X number on a 200-pound man has this effect,’ and we have that throughout the spectrum (of intoxication),” she said. “We don’t have that with regards to THC. We can’t say someone who has five milligrams of THC in their system is going experience a specific level of intoxication.”
She believes THC breathalyzers could serve more as a tool to prevent accidents on the job as opposed to being used in defense.
“If you have a bunch of labors working on a roof, everyone could blow before they go up and that would be a much more useful mechanism for it, obviously with the appropriate policies in place,” Schum said.
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