What’s the impact of medical marijuana on patients, drug plans?

With increasing use of cannabis for therapeutic purposes and legalization pending for recreational use, many employers are wondering about the implications for their drug plans and the health of their employees. Zachary Walsh, clinical psychologist and assistant professor of psychology at the University of British Columbia, drew on numerous studies to discuss the potential impacts of cannabis at the recent Face to Face in Drug Plan Management conference in Vancouver.

“I urge you to consider cannabis in the context of other medications when looking at the potential benefits of introducing medical cannabis in drug plans,” said Walsh, noting that 100 million people in North America now use medical marijuana to treat a range of symptoms, including sleep, pain, anxiety, depression, loss of appetite and nausea.

Among patients taking medical marijuana, University of British Columbia studies show about 80 per cent are substituting it for prescription drugs such as acetaminophen, opioids, non-steroidal anti-inflammatory drugs (NSAIDS) and benzodiazepine. When asked why they substitute cannabis, people said it has a more acceptable side-effect profile and provides for better management of symptoms.

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“We asked people using NSAIDS, opioids and cannabis how they compare,” said Walsh. “They said cannabis was equally effective as NSAIDS when it came to reducing pain and it made the pain more bearable, less irritating and allowed them to live a normal life despite the pain.”

As well, cannabis appears to address some mental-health concerns. “Almost all report reductions in anxiety and depression and strong evidence suggests cannabis can be effective in treating post-traumatic stress disorder.”

Nevertheless, Walsh noted concerns about deficits in short-term memory and the impact on executive function among chronic users. “But these deficits resolve or reverse in a month or so of abstinence,” he said, adding that there’s no evidence that cannabis use leads to increased violence or suicide and studies show that people who use cannabis tend to drink less alcohol.

Despite Walsh’s generally positive findings, he noted the war on drugs has created a barrier to researchers and limited clinical trials. But Canada is now in a position to produce better research since licensed cannabis producers came on board in 2014. And the current situation in the United States where states with and without medical cannabis exist next to each other creates a unique opportunity to examine the drug’s consequences in the real world.

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“We can expect an increased uptake of cannabis,” said Walsh. “The side-effects are tolerable and cannabis is reasonably effective for a high number of relevant conditions. According to the data, we can expect savings with substitution of cannabis for other drugs.”