Legal “pot” use is no longer a pipe dream. Although marijuana remains the most commonly consumed illegal drug1 in the world, many nations and at least 28 U.S. states and the District of Columbia have decriminalized its medicinal use,2 and efforts to liberalize recreational consumption continue to gain momentum.
Obstacles to universal legalization persist. Non-medicinal use of marijuana is completely legal only in Uruguay and North Korea and is tightly restricted on a U.S. federal level. The U.S. Food and Drug Administration lists marijuana, or cannabis, as a “Schedule 1” drug with "no currently accepted medical use"3.
Still, societal attitudes are changing, and the legal status of cannabis is evolving rapidly. In November 2016, the U.S. states of California, Massachusetts, Maine, and Nevada voted to pass expansive measures legalizing recreational use of marijuana and other cannabis products for adults 21 and older4. These states bring to nine the number of U.S. jurisdictions allowing recreational marijuana use. In addition, legislatures and governors in Ohio and Pennsylvania authorized medical marijuana laws — as did voters in Arkansas, Florida and North Dakota5. U.S. liberalization of marijuana regulation through state-level referendums has the potential to influence global policy toward the drug, with Canada, Mexico, and various Latin American nations, as well as the United Nations, advocating a new approach6.
As popular access to marijuana increases internationally, the effects of this drug on mortality and morbidity, as well as its potentially positive impact when used for medicinal purposes, will be a topic of great interest to the insurance industry.
Evidence is still inconclusive regarding the health risks and potential benefits of smoking marijuana. On one hand, no deaths have been reported due to acute marijuana poisoning, and no studies have clearly documented increased mortality from the use of the drug. Advocates claim that “cannabinoids” in the marijuana plant can relieve pain or alleviate symptoms of a wide range of debilitating conditions7.
On the other hand, the U.S. Health and Human Services Administration finds no “consensus among qualified experts that marijuana is safe and effective for use in treating a specific, recognized disorder”8. The April 2014 issue of the Journal of the American Health Association points to a French study noting that marijuana use by younger people with risk factors for cardiovascular disease can lead to cardiovascular events and potentially to death9. Additionally, a recent study found the risk of having a heart attack within an hour of smoking marijuana is five times greater than non-smokers’ risk10. Some studies suggest that adolescents’ developing brains may be vulnerable to damage through heavy marijuana use11, and the U.S. Drug Enforcement Administration (DEA) notes marijuana has a "high potential" for abuse and can result in psychological dependence12. Further studies will be necessary to reach a definitive conclusion on the long-term health and mortality impacts of marijuana consumption.
The insurance industry must consider the underwriting implications of more widespread marijuana use. The primary focus in underwriting medical marijuana users will be on the health condition prompting the use. Although the U.S. Food and Drug Administration’s (FDA) list of approved conditions is quite limited, there are many approved conditions in states that now permit medical marijuana use. For all users, key underwriting considerations will include the frequency, purpose, and admission of use, as well as the type of marijuana used, the applicant’s age, history of accidents, risky behavior, and other substance abuse.
1. United Nations Office on Drugs and Crime. World Drug Report 2016. s.l.: United Nations, 2016. [Online] https://www.unodc.org/doc/wdr2016/WORLD_DRUG_REPORT_2016_web.pdf
2. 28 Legal Medical Marijuana States and DC. ProCon.org. [Online] http://medicalmarijuana.procon.org/view.resource.php?resourceID=000881
3. Drug Classifications, Schedule I, II, III, IV, V. MedShadow. [Online] http://medshadow.org/resource/drug-classifications-schedule-ii-iii-iv-v/
4. 4 states just voted to make marijuana completely legal — here's what we know. Business Insider. [Online] November 9, 2016 http://www.businessinsider.com/marijuana-states-legalized-weed-2016-11
5. “One in every five Americans is about to get legally high after this election.” Quartz. [Online] November 9, 2016 https://qz.com/832370/marijuana-legalization-succeeded-in-the-2016-elections-despite-the-results-of-the-presidential-race/
6. Marijuana Legalization: As the UN Prepares to Tackle The World Drug Problem Again,Will Cannabis Laws Change Global Policy? IBT. [Online] March 11, 2016 http://www.ibtimes.com/marijuana-legalization-un-prepares-tackle-world-drug-problem-again-will-cannabis-laws-2334526
7. Chronic Pain. NORML. [Online] http://norml.org/library/item/chronic-pain
8. Marijuana to remain illegal under federal law, DEA says. USA Today. [Online] August 11, 2016. http://www.usatoday.com/story/news/2016/08/11/dea-marijuana-remains-illegal-under-federal-law/88550804/
9. Jouanjus, Emilie, Lapeyre-Mestre, Maryse and Micallef, Joelle. [Online] http://jaha.ahajournals.org/ content/3/2/e000638.full.
10. US Study Beth Isreal Deaconess/Harvard. [Online] June 12, 2014. abcnews.go.com/health/ story?id=117399.
11. Marijuana and the developing brain. American Psychological Organization. [Online] November 2015. http://www.apa.org/monitor/2015/11/marijuana-brain.aspx
12. DEA Website [Online] https://www.dea.gov/druginfo/ds.shtml