I have spent my career caring for patients with chronic pain, dementia, and other conditions that drain not only quality of life but also the healthcare system’s resources. Too often, I’ve prescribed medications that are costly and dangerous and carry high risks of dependency and death.
There is another option many of my patients already use: medical cannabis. The plant is one of the most effective and safest treatments for a host of chronic conditions. Yet, every day, patients must choose between paying rent or paying out of pocket for cannabis because insurance companies refuse to cover it. Insurance coverage for medical cannabis is not a radical idea. It is the next logical step.
We face two epidemics quietly sinking our healthcare system: chronic pain and dementia. Together, these conditions consume a staggering share of Medicare and Medicaid budgets. They also drive patients toward the drugs fueling our overdose crisis. Cannabis can be an exit strategy. Studies show 30% to 50% reductions in opioid use when patients substitute with cannabis. Unlike opioids or benzodiazepines, cannabis has no recorded overdose deaths. Broader adoption could save as many as 50,000 lives annually.
For patients with dementia, cannabis improves sleep, appetite, mood, and agitation symptoms often allowing them to reduce or stop medications that have debilitating side effects. The oft-heard claim that cannabis “lacks data” is outdated. A comprehensive research review by the National Academies of Sciences, Engineering, and Medicine in 2017 classified cannabis as an evidence-based treatment for chronic pain, multiple sclerosis, and chemotherapy-related nausea.
Research has expanded since then, with international models from Israel to Canada demonstrating measurable benefits and cost savings. We also have growing patient-reported outcomes structured data gathered directly from people using cannabis. These outcomes capture what clinical trials often miss improvements in daily functioning, sleep, mood, and overall quality of life.
Federal agencies are stuck in a catch-22: The FDA cannot approve cannabis because products vary batch-to-batch, and without FDA approval, insurance providers won’t cover it. Patients are left to rely on advice from poorly trained dispensary staff or go without entirely. Hospice programs and integrative pain programs are already approved for insurance reimbursement and demonstrate significant savings.
Critics argue that cannabis is unsafe, but data shows otherwise. For adults, especially older adults, the benefits far outweigh the risks. By reducing hospital visits, imaging, and dangerous drug interactions, insurance coverage would save money. Insurance companies are already paying for the consequences of chronic pain and dementia covering cannabis is in their financial interest.
Nearly 75% of U.S. adults live in states with legal cannabis access. The data is growing, the public is ready, and patients are demanding it. Insurance companies should not ignore them. Covering medical cannabis is not just logical it’s ethical, necessary, and it will save lives.