by Karl Voigt
This week, Pennsylvania Governor Wolf launched opioid prescribing guidelines for workers’ compensation claimants, citing the opioid epidemic as its impeller. The Governor stated that Pennsylvania ranks third highest in the nation in the percentage of injured workers who become long-term opioid users. To counter that trend, these guidelines, which are not intended to replace clinical judgment, would advise doctors in the treatment of not just acute or post-surgical pain, but also chronic pain. To view the guidelines, click here.
Pennsylvania’s Medical Marijuana Act allows patients who are afflicted with one of 17 serious medical conditions to be certified to use medical marijuana. Included as a separate and distinct medical condition in the enumerated 17 serious medical conditions is “severe chronic or intractable pain.” Severe pain is also a symptom which is common in many of the other 16 medical conditions, including Cancer, AIDS, and MS. More often than not, opioid painkillers are the medication prescribed for patients who suffer from severe pain and/or chronic pain. Opioid painkillers are not only addictive and dangerous but generally more expensive than marijuana.
In May of 2016, the U.S. House of Representatives and the Senate approved an amendment that would prevent the Department of Veteran Affairs from using federal dollars to stop doctors from providing patients with recommendations to use medical marijuana. One of the reasons behind the amendment was the fact the death rate from opioids among VA health care patients is nearly double the national average.
In June of 2016, Pennsylvania Governor Tom Wolf participated in a drug epidemic roundtable in Washington D.C. where one of the topics was the dramatic surge in opioid related overdose deaths since 2000. Governor Wolf stated that there were roughly 2,500 drug related overdose deaths in Pennsylvania in 2014. Included as part of Governor Wolf’s proposed state budget was an allocation of $34 million to allow the Department of Health and Human Services to provide 25 new Opioid Use Disorder Centers to treat more than 11,000 new individuals for addiction.
Former Baltimore Ravens player, Eugene Monroe, is openly campaigning to get the National Football League to drop its ban on players using marijuana so it may be used to treat chronic pain. Monroe believes that the chronic pain associated with football has caused many players to become addicted to prescribed opioid painkillers. A 2010 study of 644 retired NFL players found that 52 percent had used opioid during their careers and that 71 percent had misused the opioid painkillers
Medical Marijuana offers a cheaper safer alternative to opioid painkillers. Research published in “Health Affairs” found that states that legalized medical marijuana saw declines in the number of Medicare prescriptions for drugs used to chronic pain, anxiety or depression and a dip in spending by Medicare Part D, which covers the cost on prescription medications. The researchers concluded that medical marijuana saved Medicare about $165 million in 2013. The researchers further estimated that if medical marijuana were available nationwide, Medicare Part D spending would have declined in the same year by about $470 million.
Marijuana is a viable alternative to opioid painkillers but remains listed as Scheduled I drug which is defined as “having no currently accepted medical use and a high potential for abuse” under the Controlled Substance Act “CSA”. Until the Federal government reclassifies marijuana, their will be problems and risks associated with prescribing medical marijuana in the 25 states where it is now legal. However, the benefits to patients as well as state economies is too great to ignore.