Covering the costs of medical marijuana through workers’ compensation could be a “viable” option that improves health outcomes and leads to voluntary reductions in opioid use, according to a study led by Colorado state officials.
The Colorado Department of Labor and Employment’s Division of Workers’ Compensation (DOWC) conducted the first-of-its-kind experiment as part of its Alternative Pain Management Program, following a rigorously screened chronic pain patient for a year to assess the potential impact of medical cannabis reimbursements.
The study, published in the Journal of Occupational & Environmental Medicine, resulted in “meaningful life improvements,” no adverse events and voluntary reductions in opioid use.
The patient who received compensation for non-inhalable cannabis reported lower pain levels, as well as improved physical functioning, quality of life and psychosocial stability. The reduction in opioid use, which did not involve any tapering requirements, was initially “modest.”
“Due to improved symptom control under clinical supervision, the participant voluntarily reduced monthly opioid intake by 17%,” Colorado officials said. “Since the final compilation of the study’s data, the participant successfully transitioned off both opioids and THC completely, relying only on less psychoactive cannabinoids.”
“This program evaluation suggests that medical cannabis reimbursement may be a viable option for very select workers’ compensation patients,” the study says.
“Data revealed clear, measurable reductions in pain alongside significant improvements in physical function, overall mobility, and quality of life.”
While the “primary goal” of the study wasn’t related to opioid use, the researchers said the “improved symptom control under clinical supervision” was associated with a 17 percent voluntary reduction in opioid intake.
What’s more, since the 12-month study was completed, the patient “successfully transitioned off both opioids and THC completely, relying only on less psychoactive cannabinoids,” DOWC said.
Ethan Moses, medical director of DOWC, told local media outlet Westword that “the medical literature is really quite mixed on the efficacy of cannabis for lots of health conditions,” in large part because marijuana has long been classified as a Schedule I drug under the Controlled Substances Act (CSA).
That’s changed under the Trump administration for medical marijuana authorized for patients as part of state programs, which is now Schedule III—though cannabis remains in Schedule I for recreational use, pending the outcome of an administrative hearing.
Still, while the Colorado study established potential viability for medical marijuana coverage through workers’ compensation programs, there’s “no way in which we can require insurance companies to do this,” Moses said.
“That’s why having this program be voluntary was key for the patient, insurance company and primary caring physician,” he said. “When compared to opioids, I think some insurance companies would be interested in medical cannabis. They may want to consider medical cannabis in order to offset the costs of settlements.”
“The program demonstrated the feasibility of reimbursing medical cannabis under a coordinated care model.”
Last month, a congressional committee voted to prevent federal employees from having medical marijuana covered under their workers’ compensation programs—regardless of the administration’s move to reschedule cannabis.
Colorado’s agency-led study might have been a first of its kind in design, but past research has supported the idea that medical cannabis access could come with unique benefits in the workplace.
For example, legalizing medical marijuana appears to be associated with reduced rates of employees missing work—particularly in trades like manufacturing and agriculture where workers are more likely to experience symptoms such as pain that cannabis can help treat—according to a recent study.
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Research published last year on marijuana legalization’s effect on workers’ compensation also found that while the policy change was associated with a “gradual increase” in workers’ comp claims, the average cost per claim in fact fell after the policy change—as did patient use of prescription drugs, especially opioids and other painkillers.
In 2021, a separate study by the National Bureau of Economic Research found that adult-use cannabis legalization was associated with an increase in workforce productivity and decrease in workplace injuries.
Those researchers looked at the impact of recreational cannabis legalization on workers’ compensation claims among older adults, observing declines in such filings “both in terms of the propensity to receive benefits and benefit amount” in states that have enacted the policy change.
They further identified “complementary declines in non-traumatic workplace injury rates and the incidence of work-limiting disabilities” in legal states.
“We offer evidence that the primary driver of these reductions [in workers’ compensation] is an improvement in work capacity, likely due to access to an additional form of pain management therapy,” says the earlier study, which received funding from the National Institute on Drug Abuse (NIDA).
A 2020 study, meanwhile, found that legalizing medical marijuana led to fewer and cheaper workers’ compensation claims. Researchers from the University of Cincinnati Ash Blue College and Temple University concluded that permitting medical cannabis “can allow workers to better manage symptoms associated with workplace injuries and illnesses and, in turn, reduce need for [workers’ compensation].”
Also that year, the U.S. Supreme Court declined to take up a pair of cases concerning workers’ compensation for medical marijuana.
Other research from 2023 into employee marijuana use found that workers who used the drug off the clock were no more likely to experience workplace injuries compared to those who didn’t consume cannabis at all. However, people who indulged during work hours are nearly twice as likely to be involved in a workplace incident than both non-users and off-duty users.
Separately, a 2024 analysis of five years’ worth of federal health survey data by researchers at the Centers for Disease Control and Prevention (CDC) found that employees in the food service and hospitality industries were some of the most common consumers of marijuana among U.S. workers.
People in arts, design, entertainment, sports and media occupations also reported comparatively high rates of past-month cannabis use, as did workers in construction and extraction. Among those least likely to report marijuana use, meanwhile, were law enforcement, health care providers and workers in libraries and education.
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