The Mid-Atlantic Regional College of Occupational and Environmental Medicine (MARCOEM), a component society of ACOEM, has established a leadership position in opposition to legislation in New Jersey that would require workers’ compensation carriers, health insurance plans, and state health programs to cover the cost of dispensary-purchased ‘medical’ cannabis and cannabis-derived products.
MARCOEM joins other prominent physician organizations, including the American Medical Association
, the Medical Society of New Jersey
, the New Jersey Society of Interventional Pain Physicians
, and the New Jersey Orthopaedic Society
in expressing serious apprehensions about tacitly encouraging patients to use products not subject to evaluation and ongoing monitoring by the U.S. Food and Drug Administration (FDA) for safety, efficacy, potency and quality.
In a September 2022 letter
to members of the New Jersey legislature, MARCOEM highlighted several points as to why mandating insurance reimbursement of non-standardized, non-FDA-regulated cannabis products would be bad public policy and put the lives of patients and workers at serious risk:
- Mandating coverage and reimbursement ahead of peer-reviewed, scientific evidence supporting the use of cannabis-based products for medical purposes is, at best, risky; at worst, it’s dangerous. “… The medicinal benefits of medical marijuana and cannabinoids should be evaluated by the same standards that we apply to every other medication before being prescribed or recommended by physicians, and advertised to the public.”1
- The medical community believes mandated insurance reimbursement will encourage patients to forgo use of evidence-based treatments backed by safety and efficacy data in favor of unproven, non-FDA-regulated cannabis-derived products. For example, glaucoma and Post-Traumatic Stress Disorder (PTSD) are “approved qualifying medical conditions” under the New Jersey Medicinal Cannabis Program (NJMCP). Concerning glaucoma, the American Academy of Ophthalmology (AAO) states: “Until more research is done, the AAO does not recommend marijuana or other cannabis products for the treatment of glaucoma…Several current, effective treatments for glaucoma are more reliable and safer than marijuana.” As to PTSD, both the American Psychiatric Association (APA) and VA/DoD recommend against treating PTSD with cannabis…due to the lack of evidence of efficacy. “Preliminary evidence that natural and synthetic cannabinoids is offset by the significant side effects, including tolerance, dependence, withdrawal syndrome, psychosis, cognitive deficits, and respiratory symptoms if smoked."2
- MARCOEM is concerned by the promotional impact of online medical marijuana patient certification services that lure consumers with claims of “get your medical marijuana card in 15 minutes or less,”access to medical-only cannabis dispensaries, the gateway to lower fees, lower age restrictions, higher limits on purchase quantities, and, most disturbing to physicians and employers, products with more potent THC concentrations. “We believe reduced fees encourage more individuals to more frequently use higher potency cannabinoids, and that low or zero-co-pay policies resulting from mandated reimbursement will detrimentally expand their use.”
- MARCOEM emphasized that “mandating insurance coverage for cannabis products without requiring those products to demonstrate safety and efficacy through comprehensive clinical study will discourage future investment in the high-quality research necessary to enhance our scientific understanding of cannabis and its true therapeutic potential. After all, cannabis manufacturers will have no remaining incentive to invest in comprehensive clinical studies and subject their medicines to a higher standard of scrutiny, i.e., the FDA drug regulatory pathway. As a result, fewer approved cannabis-derived medicines with proven product profiles will be available to consumers; physicians will have less clinical information available to assist patients in making better informed treatment decisions; and patients will be at risk of serious debilitating adverse effects associated with cannabis use.”
We applaud our MARCOEM colleagues for speaking out on this important issue. ACOEM encourages other science- and medical-based organizations to add their voices to those who are committed to protecting the health and safety of America’s workers and society at large.
1Brady K. Medical marijuana: putting the cart before the horse. Am J Psychiatry. July 2020. Available at: https://doi.org/10.1176/appi.ajp.2020.20050648.
2Department of Veteran Affairs, Department of Defense, The Management of Posttraumatic Stress Disorder Work Group. VA/DoD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder. June 2017. Available at: