Ontario study finds injured workers use for persistent pain, sleep problems and stress
As legal cannabis becomes more entrenched in Canada, injured workers appear to be integrating it into their recovery in complex and largely self‑directed ways. A new qualitative study led by Institute for Work & Health (IWH) scientist Dr. Nancy Carnide draws on interviews with 45 Ontario workers who used cannabis to manage symptoms of a work‑related injury. The participants were originally identified in a prior survey of workers with accepted lost‑time compensation claims and were re‑interviewed four to five years after their injury.
Cannabis as a “pragmatic option” after work injury
In that earlier survey, about 14 per cent of workers reported using cannabis to treat their work‑related condition. Compared to those not using cannabis or using it only for non‑injury reasons, these workers were more likely to report higher pain, more sleep difficulties, poorer mental health and not being at work – and most were using cannabis without guidance from a health‑care provider.
The follow‑up interviews were designed to go deeper into workers’ experiences. “Cannabis often became a pragmatic option for treatment when other approaches fell short,” Carnide says, noting that it was rarely a first‑line strategy. Participants typically tried over‑the‑counter and prescription medications, along with physiotherapy, massage and chiropractic care, before turning to cannabis, but many described limited effectiveness, difficult side‑effects, concerns about opioids and cost barriers to ongoing physical therapies.
Workers also described prolonged and complicated recoveries. Many still experienced symptoms years after the initial injury, sometimes against a backdrop of multiple past injuries. Some reported delays in accessing surgery, pressures to return to work despite pain, difficult interactions with the compensation system and accommodations that were short‑lived or poorly matched to their needs.
Symptom relief, but not a cure
Most participants reported at least some perceived benefit from cannabis use. The effects they highlighted were symptom‑focused: pain relief, better sleep, reduced muscle tension or spasms, and, for some, lower anxiety or stress. Benefits for work were typically indirect, with workers describing cannabis as helping them get enough rest to function the next day or to better tolerate residual pain during a shift.
Carnide says interviewees rarely framed cannabis as fixing the underlying injury. Instead, it was “more of a coping tool – one part of a broader toolbox rather than a cure,” used alongside other medications, physical therapies and self‑management strategies. A subset of workers reported cannabis reduced their reliance on other medications or made it easier to participate in rehabilitation activities because symptoms were more manageable.
Not all experiences were positive. Some workers described functional downsides, including feeling less motivated, difficulty concentrating and a sense of “brain fog.” A small number worried their use was becoming habitual and less focused on injury‑related needs. Many went through a trial‑and‑error process with different products, strains, doses and methods of consumption; for some, that process led to unpleasant experiences or failed to produce a workable regimen.
Carnide says the study was not designed to establish effectiveness and “cannot say that cannabis is an effective option for injured workers…what it does show is that workers are using cannabis and self‑reporting benefits across a range of injuries and symptom profiles,” including some conditions beyond those with strong evidence for cannabis in the general literature.
Private use, limited disclosure and policy gaps at work
A major focus of the study was how workers navigated cannabis use in relation to employment. Many participants described setting personal boundaries to balance symptom management with perceived safety and policy expectations. Common strategies included restricting use to evenings or bedtime to maintain a clear separation from work hours or choosing products they believed to be less impairing, such as CBD‑dominant or topical products, when use was closer to work.
Formal accommodation for medical cannabis use was largely absent in this sample. Carnide says cannabis use was “often managed privately, without formal workplace processes to support it,” and that hesitancy to disclose was widespread. Workers cited stigma, fears of being viewed as constantly impaired and concerns that any incident at work would be blamed on cannabis, regardless of whether they were impaired at the time.
The findings point to several implications for employers and occupational health professionals. Carnide argues there is a need for clear, well‑communicated workplace substance‑use policies that explicitly address medically used products that may impair, along with safe disclosure channels that reduce the incentive to conceal use and support proactive risk management.
