In 2016, marijuana use in the U.S. was fully legal in four states and illegal in every form in 12 states. Now, in late 2023, there are 22 states with fully legalized marijuana use (meaning medicinal use is legal and it’s legally decriminalized) and only four states where marijuana remains fully illegal. As more states legalize medical cannabis, questions about its potential benefits and implications for workers injured on the job have come to the forefront. At the same time, there is a potential financial benefit for employers and Workers’ Compensation carriers since medical marijuana offers what may be a less expensive option than opioid-based treatments.
Medical marijuana refers to the use of cannabis and its constituent compounds - such as THC (tetrahydrocannabinol) and CBD (cannabidiol) - for therapeutic purposes. THC is psychoactive and CBD is non-psychoactive. Basically, THC is the element that “gets you high.”
CBD is legal under federal law if derived from the hemp plant, which has a very low level of THC. Strains of THC and CBD may differ, but the marijuana available today remains the same essential substance as marijuana grown and used prior to the passage of legalization laws in recent years. Although largely anecdotal, cannabis has been reported to have various medicinal properties, including pain relief, anti-inflammatory effects, muscle relaxation, and appetite stimulation. There is also a fair amount of research that has determined that CBD is an effective treatment for seizure disorders.1 These properties make it a potential candidate for addressing some of the medical needs of workers injured on the job.
Cannabis has been classified as a Schedule I drug under the federal Controlled Substances Act since 1970. Other Schedule I drugs include heroin, LSD, and ecstasy. Schedule II drugs, including oxycodone and hydrocodone, have a high potential for abuse but have acceptable medicinal use. Most recently, however, the U.S. Department of Health & Human Services recommended to the Drug Enforcement Agency that marijuana be reclassified as a Schedule III drug.2 Reclassifying marijuana would alleviate the inherent conflict between states where marijuana is legal and existing federal law that classifies it as a Schedule I controlled substance. A good example of this conflict is seen in NJ where Schedule I marijuana is considered an acceptable drug to wean someone from a Schedule II opioid addiction.
U.S. Legal Situation
Currently there are only four states where any form of marijuana is fully illegal (Idaho, Kansas, South Carolina, and Wyoming). Among the states that have legalized marijuana use, their laws range from the legalized use of CBD for limited purposes to fully legal marijuana for both medical and recreational purposes. The states that legalized medical marijuana have set up approval processes for its use and reimbursement under its Workers’ Compensation laws. For example, most states require a physician to obtain a license to prescribe medical marijuana and the prescription must be filled by a licensed marijuana dispensary to properly document a claim. There are also multiple forms of marijuana, such as edibles, pills or liquids, sold by dispensaries. Despite the potential benefits of medical marijuana, widespread prohibitions against smoking make it unlikely that a smoking form of medical marijuana would be approved for use in the workplace.
Marijuana Legality by State (updated October 30, 2023)