Canadian CANNAINVESTOR Magazine August / September 2019 | Page 189

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Although medical cannabis has been legally accessible since 1999, the legalization of cannabis is rapidly changing Canadian views on mainstream use; the current environment creates a need for employers to act now to determine whether to provide coverage under their benefit plans for medical cannabis and the parameters for such coverage. Some clinical studies have shown medical cannabis to be valuable for multiple medical conditions; however, the use of cannabis also has known health risks.

Medical cannabis, or medical marijuana, is cannabis and cannabinoids that are prescribed by physicians for their patients. The use of cannabis as medicine has not been rigorously tested due to production and governmental restrictions, resulting in limited clinical research to define the safety and efficacy of using cannabis to treat diseases. Preliminary evidence suggests that cannabis can reduce nausea and vomiting during chemotherapy, improve appetite in people with HIV/AIDS, reduces chronic pain and muscle spasms and treats severe forms of epilepsy. Additionally, in the U.S. states where cannabis is legalized it is associated with decreased episodes of driving while intoxicated and domestic violence and decreased opioid abuse and deaths.

The public attitudes towards marijuana use, both recreational and medical, are changing quickly. Medical marijuana is accessible to anyone who obtains a “medical document” from a healthcare practitioner. This does not require a prescription from a doctor and there is no medical proof that medical marijuana is the best or only available treatment for the individual.

The ease with which medical marijuana is accessible has led to concerns about the legitimacy of the use of medical marijuana by many individuals and is forcing employers to consider how to address the use of medical marijuana by their employees. There are a variety of different considerations that come into play of which employers must be mindful.

One study stated that there is a duty for an employer to accommodate an employee with health issues as such accommodation is applied to disabled employees who use medical marijuana, therefore that duty should apply to all employees. Medical marijuana, when being used legitimately, is used in connection with a medical condition. Therefore, employees using medical marijuana legitimately are to be treated in the same manner as any employee using medication to deal with a medical condition. Therefore, they are to be accommodated to the point of undue hardship. Accommodating an employee who needs to use medical marijuana may require an employer to modify hours of work, allow for additional breaks or assign the employee to a less demanding or less safety-sensitive position.

However, the duty to accommodate does not entitle an employee to report to work in an impaired state. Therefore, it is important that employers review their occupational health and safety legislation policy and update their policy to address cannabis coverage. Employers have an obligation to maintain a workplace that is safe and healthy for employees and members of the public.

That being said, if an employee provides a documentation to an employer which allows usage of medical marijuana, the employer is required to treat this seriously. The ease with which employees are able to obtain medical marijuana means that employers will be confronted with issues of how to address marijuana use by their employees on an increasingly regular basis. Employers must be aware of their duties to accommodate an employee under human rights legislation. The duty to accommodate an employee has limitation; the fact that an employee has a medical document which allows him or her to use medical marijuana does not mean that the employee has a right to be impaired at work. Additionally, if necessary, employers can ask for additional information about the employees’ illness, the legitimacy of the use of medical marijuana and whether other, less impairing forms of treatment are available. Employers need to develop a strategy to address cannabis legalization with their human resources and legal team to define their position, then work on assessing and developing an approach on this issue. Once a decision is made employers should then implement policy and coverage provisions then communicate their positions to their employees.

It is important to note that cannabinoids products are currently approved by Health Canada and covered by most benefits plan. These includes product such as Cesamet and Sativex. Cesamet is used nausea and vomiting related to chemotherapy and cost $60 - $100 for month for the generic version. While Sativex is used for pain and spasticity from multiple sclerosis and cost $700 - $1,000 per month. Also, some medical cannabis plant products such as dried products (“joints”) which are used by smoking or vaporized and oils which are ingested orally are less expensive. The usual dose ranges from 1-3 grams per day and cost $3 - $15 per gram or approximately $75 - $300 per month. We are still waiting to see the results of the cost impact of using cannabinoids products versus the alternative medication used.

. A survey taken from several organizations show that most employees do not think that there will be any major impact to the workplace due to the legalization of Cannabis. Most employees feel that there should be no different to what occurs in the workplace from alcohol usage. On the contrary, employers are indecisive on whether they should provide coverage for medical cannabis. Most employers have the wait and see mentality.

Currently, coverage offer through private plan offerings differs from one carrier/vendor to another. The annual coverage maximum ranges from $1,000 - $6,500, and duration is mostly for a year but are subject to the carrier/vendors approval. Additional each carrier/vendor approved conditions vary drastically, approved condition coverage can be as minimal as only two conditions. Carriers/vendors also cannot decide on where the claim should be, i.e. is it should be claim under drugs, medical services or extended health.

This confusion amongst Canadian Insurers and administrators on the different positions on coverage for Cannabis has created confusions for employers regarding what the right or fair approach is. While employees are asking for expansion of coverage in the private health benefits program to include coverage for Cannabis and/or the specific conditions when coverage is already included on the plan.

There is a robust pipeline of cannabis products such as; sublingual strips, chewing gum, capsules and pills expecting to be coming to the market in the future. Therefore, it appears to only be a matter of time before Health Canada approves/provides a Drug Identification Numbers (“ D.I.N’s”) for cannabis products. Once as DIN number is assigned it will become difficult to exclude coverage under private health programs.

Adonis Samuel