Workers' Compensation Boards across Canada are finally starting to cover medical marijuana, but much more work needs to get done in order for injured employees to get access to cannabis.
Last year, New Brunswick became the first Canadian province to cover medical marijuana under Workers' Comp. Ontario, Nova Scotia and Prince Edward Island soon followed suit, but despite making those changes, only a small number of medical marijuana patients are actually getting covered.
Provincial Workers' Compensation Boards in Nova Scotia, PEI and Alberta only pay for around ten medical marijuana prescriptions each, and coverage in all regions is dealt with on a case-by-case basis.
The strict regulations involved in dealing with medical marijuana have left some patients out in the cold, according to Dr. Mary Lynch - a pain specialist and cannabis researcher based in Halifax.
"If first- and second-line treatments aren't working, then we will sometimes recommend a medical cannabinoid, depending on the patient's specific presentation," Lynch told CBC. "And for those who do benefit, we have run into difficulties with the workers' compensation board agreeing to cover the cost."
'I went from 26 pills a day to cannabis'
Getting those boards to pay for medical marijuana can be a years-long battle for medical marijuana patients like Melissa Ellsworth - a registered nurse who uses medical cannabis to treat chronic pain stemming from an incident in which her head was struck with a chair while on the job. Until recently, she's had to use fistfuls of addictive and potentially lethal painkillers to treat those symptoms because her Workers' Comp refused to cover medical marijuana for her until January of 2018.
"I went from 26 pills a day to cannabis," Ellsworth said. "I can function every day like a normal human being instead of being crippled up in pain."
But she's still reeling from the aggravation of having to fight with the board over her preferred medication.
"I'm trying to do everything I can...by avoiding addictive medications and everything else. And they're fighting me," Ellsworth recalled. "They're making it very hard to do."
Things are starting to change, however. Dr. Manoj Vohra - Chief Medical Officer for the Nova Scotia Workers' Compensation Board - says that as more evidence supports using medical marijuana to treat conditions like neuropathic pain, the board is starting to come around.
"If cannabis does help them in those areas where there is evidence, then we're more than open to trying to see how we can do that."
But medical marijuana remains a Plan B or in some cases a Plan C instead of the first-line of treatment for certain conditions.
"If first- and second-line treatments aren't working, then we will sometimes recommend a medical cannabinoid, depending on the patient's specific presentation," Lynch explained. And that could be because members of WC boards worry that covering a medication that hasn't been sufficiently researched could lead to a situation similar to the opioid epidemic.
"What's happens 10 to 15 years down the road is we've realized that there's harm that occurs. And so we want to make sure we don't repeat those mistakes from the past and that we use it and understand what are the risks, what are the contraindications to using it."
However, physicians like Dr. Lynch are hopeful that the introduction of new medical marijuana guidelines for the Nova Scotia compensation board will mean many more patients will get the medical marijuana they need.
"I'm hoping that the policy will be written in a way that as long as a physician has recommended it, the access will be reasonable, just like it is with any other prescription medication."