With recreational cannabis legalized October 17, 2018, discussion and questions have been raised surrounding the eligibility and coverage options under employee benefit programs.
Recreational Cannabis: is not covered under employee benefit programs under any circumstances.
Medical Cannabis: is currently eligible under Health Care Spending Accounts, but is not eligible under the extended health care benefit unless your policy is amended to include coverage.
Since 2001, medical cannabis has been available in Canada under the federal government’s Access to Cannabis for Medical Purposes Regulations (ACMPR). A patient must get authorization from a doctor or nurse practitioner, who must have the patient under current treatment. There are three choices for a patient for obtaining medical cannabis:
- Register with a Health Canada licensed producer of cannabis for medical purposes
- Grow your own personal cannabis
- Designate another person to produce cannabis for you
Medical Cannabis to Help Manage Health Conditions
There is no evidence supporting cannabis as a first line treatment for any condition. That said, current evidence supports the use of cannabis for some serious medical conditions where usual treatments have not been effective.
- Palliative Care: alleviating symptoms such as nausea and vomiting associated with chemotherapy or radiotherapy, anorexia/cachexia, and severe pain.
- Cancer: relief from moderate to severe pain and nausea/vomiting.
- Wasting syndrome and loss of appetite in HIV/AIDS patients
- Multiple Sclerosis (MS): treatment of spasticity and neuropathic pain.
- Rheumatoid Arthritis: treating pain when standard therapies have not been affective.
The Cost of Adding Medical Cannabis to Benefit Programs
The cost of medical cannabis coverage can be significant with estimates between $2,000 – $7,000 annually depending on condition and severity of symptoms. If you are considering adding coverage, ensure you have cost control measures in place, which can include:
- Only provide coverage for conditions where there is sufficient evidence (based on expert medical review).
- A prior approval process to ensure the claim aligns with medical needs.
- Coverage limits, like coinsurance and annual maximums.
- A claims process that requires an itemized receipt from an ACMPR licensed producer.
Consider Any Responsibility to Accommodate
Whether or not you choose to cover medical cannabis under your benefit plan, you may have a duty to accommodate employees at work, who have been prescribed medical cannabis under the ACMPR (Access to Cannabis for Medical Purposes Regulations). This potential duty to accommodate is for medical cannabis only, and does not extend to recreational marijuana. Each employee’s circumstances regarding use of medical cannabis for medical treatment is unique and we strongly consider obtaining legal advice to understand any responsibility to accommodate you may have.
Risks of Cannabis Use
Cannabis does have medical benefits; however, it also has limitations and risks.
Short-term side effects include:
- Impaired physical ability
- Impaired mental ability
- Impaired mental health
Long-term risks associated with habitual cannabis use:
- Lung damage caused by smoking
- Dependence and addiction (approximately 9% of users)
- Mental health issues: regular cannabis use over time is associated with an increased likelihood to experience anxiety, depression, psychosis, and schizophrenia. Stopping use can improve outcomes.
There is growing evidence that cannabis use by those under 25 years of age can cause long-term adverse effects on the developing brain, including increased risk of some mental health conditions.
Education and Awareness
Utilization of medical cannabis is increasing in Canada and is expected to continue in this direction. Here are some steps employers can take today to educate employees and manage cannabis in the workplace.
- Provide general education about the risks of cannabis use and safety issues due to impairment. Employee on the job safety, especially in safety sensitive workplaces like construction, should be at the forefront of this messaging.
- Review, and if necessary, revise your code of conduct and substance use policies to ensure they properly address cannabis use.
- Educate managers about your substance use and accommodation policies, to ensure that proper steps are following to help prevent an incident or claim.
For more information regarding medical cannabis in the workplace do not hesitate to contact us.
Jeremy Greening CEBS
Access to Cannabis for Medical Purposes Regulations, Justice Laws, Government of Canada (http://laws.justice.gc.ca/eng/regulations/SOR-2016-230/)
Based on Sun Life’s review of guidance provided by Health Canada, physicians’ licensing authorities and national medical professional organizations
Your Cannabis, questions answered. Get the honest facts. Government of Canada
Cannabis and Canada’s Children and Youth, Position Statement, Canadian Pediatric Society, 2017