Battle Against WCB Nova Scotia For Medical Cannabis Coverage – Melissa Ellsworth’s Story – Cannabis News, Lifestyle

Melissa Ellsworth is a psychiatric nurse who has worked in federal correctional facilities. After an accident at work, she was in severe chronic pain and her life changed forever. When pharmaceutical medications weren’t working, her doctor recommended she switch to cannabis. This suggestion brought her unprecedented pain relief, but it also began the struggle of her life. Nova Scotia’s Workers Compensation Board (WCB) has no problem with opiate drugs; Medicinal cannabis is a different matter entirely. WCB cannabis coverage has been an ongoing struggle in Nova Scotia; This is the story of Melissa Ellsworth.

Photo courtesy of Melissa Ellsworth

violation of opiates

In 2006, Melissa Ellsworth was a licensed resident nurse at a psychiatric facility in Dartmouth, Nova Scotia. She was hit in the head by a chair and sustained injuries that will stay with her for the rest of her life. Left with neuropathic pain in her neck, jaw, shoulders and head, Melissa took various prescriptions to try to cope and get back to work. At one point she was taking a mix of opiates, tranquilizers, and benzodiazepines; up to twenty pills a day and it’s all covered by Nova Scotia’s Workers Compensation Board. Everything changed when she started using THC.

Synthetic to natural THC

“I ran the drug gambit as far as prescription and traditional drugs went. Nothing worked. Eventually they put me on Cesamet, which is basically a synthetic THC. When I maxed out at 6 mg, my pain doctor at the time suggested I switch to cannabis.” – Melissa Ellsworth

Image courtesy of PubChem

If you take a lot of synthetic THC, switching to the natural form seems like an obvious choice. When you work for the federal government, it’s not that easy. As a prison health worker, she had major reservations about cannabis use. With encouraging results from synthetic THC and her doctor’s recommendation, she decided to give it a try.

cannabis use

Today, Melissa is able to treat her neuropathy with cannabis alone. She will vape when she needs some fast-acting pain relief. She also makes her own edibles and topical products. As a healthcare worker, Melissa only orders from a licensed manufacturer and knows what works best for her. When it comes to relieving pain, Sour Diesel and Cannabliss are her most effective strains. If these buds are in stock, she will place an order, but stock is never guaranteed.

An average month of cannabis medication costs around $1900. She has a recipe for everything. She has completely replaced a routine of highly addictive medication with natural plant medicines. The only problem is paying for it.

WCB Nova Scotia Medical Cannabis Guidelines

If you navigate to WCB Nova Scotia’s website you will find all of the forms and policies related to medicinal cannabis. One such document is Model 2 of a Patient Treatment Agreement, which specifically mentions heroin and cocaine. If you want to use medical cannabis instead of prescription opiates, you have to sign a form and promise not to use heroin. However, you cannot try medicinal cannabis without first using heavy medicines, including opiates.

Image created by the author

Nova Scotia’s WBC has published a document entitled “Medical Cannabis Guidelines” which outlines the eligibility criteria. According to this document, a patient must have completed pharmaceutical studies before coverage can be considered. Specifically, this means a failure to “respond to appropriate studies with at least THREE DIFFERENT categories of first-line (e.g., TCA, SNRI, gabapentinoid) and/or second-line (e.g., tramadol or opioid) drugs. If a category of agent has not been brought to justice, a compelling reason must be given.” In addition, the patient must try synthetic cannabinoids for at least 12 weeks. WCB will not consider reimbursement until each drug has been determined to be unsuccessful.

Nova Scotia WCB cannabis coverage limits

When it comes to coverage limits, the guidelines are strict and without explanation.

The medical cannabis permitted for the worker and the route of administration must meet all of the following requirements:

  • The route of administration must not smoke.
  • The daily amount of dried medical cannabis must not exceed three grams per day.
  • Medicinal cannabis should be high in CBD with minimal THC.
  • The THC content of medical cannabis must not exceed nine percent.
  • The milligrams (mg) of THC per day should not exceed 30 mg, but should not exceed 75 mg. The daily amount of dried cannabis must not exceed 3g/day. If alternative forms are prescribed (e.g. oil), they must be converted to a similar ratio and amount.
  • Cannabis must not come from home cultivation.

Battle for Cover – Nova Scotia WCB Tribunal

For Melissa Ellsworth, the road to recovery has been long and hard. Healing was challenging and stressful, but getting cover was a struggle. Initially, she asked her WCB clerk to cover her medical expenses, but the request was denied. So she asked again. When it was denied a second time, she took it to a hearing officer; they also dismissed the claim. Melissa didn’t give up. In 2018 her lawsuit was brought to court and eventually she won her right. After a five-year bureaucratic struggle, Nova Scotia’s WCB would pay the cost of four grams of cannabis per day.

“My Cesamet was 100% covered without question. I picked it up at the pharmacy the same day. Any increases from 1mg/day to 6mg/day of either Nabilone or Marinol (tested first) were not challenged, nor did I need a judgement. I didn’t need a court for the opiates, gabapentin or sleeping pills…nor were the increases questioned/contested.” – Melissa Ellsworth

Still fighting for insurance – Nova Scotia WCB Tribunal #3

Over time, Melissa Ellsworth developed a tolerance to cannabis that required a change in her prescription. Her doctor increased her daily allocation in 2019, 2020 and 2022, but all increases in coverage were rejected by WCB. This is where things get really confusing: When she was denied the first increase, the recommendation was opiate drugs. The WCB would approve all costs associated with a narcotics prescription, but they would not pay an extra gram or two. Once again, Melissa prepared for battle.

As it stands today, Melissa Ellsworth has won eight WCB tribunals.

Photo courtesy of Melissa Ellsworth

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