microdosing-vs-your-insurance Microdosing vs your insurance

The psychedelic microdosing movement is new, experimental, and may do a lot of good. It’s gained traction and millions in investment as a viable treatment for mental illness, with recent studies having shown promising results. But what exactly is microdosing, and considering its health effects, does it have implications for your insurance?

Microdosing in a nutshell

Microdosing means taking microdoses of a drug to benefit from its physiological action while reducing the risk of side effects. Popular drugs of choice are hallucinogenic chemical psilocybin (found in magic mushrooms), MDMA and marijuana. These and other long-stigmatised drugs are making a major comeback and are speculated to be effective for depression, eating disorders, addiction and PTSD, so much so that psychedelic medicine start-ups have made about $329 million from January to April 2021.

So, how does microdosing work? Quartz explains: psychedelics appear to bond with our brain receptors that attract serotonin – the ‘happy’ hormone. They also seem to restrict blood flow to the brain’s default mode network (DMN), which helps us make sense of the tide of information our senses send us. This gets ‘locked’ into ‘rigid, repetitive patterns of thought’. When we suppress it, we can break these ‘ruts’ and form new neural connections. So, a depressed person may be able to ‘break out’ of repetitive negative thoughts.

And when the drug wears off? Further research is still needed to determine the perceived versus actual efficacy of microdosing.

There is, however, a growing body of evidence for the therapeutic effects of MDMA and psilocybin. Combined with talk therapy, MDMA has shown impressive results in the treatment of post-traumatic stress disorder (PTSD), while psilocybin users have reported enhanced mood, creativity, focus and sociability, with minimal side effects. In one small study comparing it to a top-performing antidepressant, it fared just as well, with faster onset and fewer side effects. The obstacle, for now, is that both drugs remain illegal in South Africa. On the other hand, cannabis has been legal for private use in South Africa since 2018, and there is evidence that small, regular doses of THC (the psychoactive compound in marijuana) may be beneficial for moderating moods, boosting creativity and more – without users becoming ‘stoned, paranoid or lethargic’.

Microdosing and your insurance

Dr Blanche Andrews, Medical Adviser at Sanlam, says while microdosing on psychedelics is ‘new’, the underwriting process would be the same as for any other drug.

When it comes to any drug use, she says insurers like Sanlam follow a set procedure for underwriting:

• First, they consider the mortality aspects. Could using the drug impact life expectancy?
• Then there’s the morbidity aspect. Could using the drug ramp up the risk of illness or disability? Could it mean a person risks leaving their occupation earlier?
• Is use of the drug medical or recreational? If it’s medical, what’s the underlying condition it is being used to treat? For example, if you were microdosing for a mental health condition, the insurer would probably ‘rate’ for that condition, rather than (or perhaps as well as) the drug use.
• They then ‘risk stratify’ according to how often and how much of the drug is used. For example, an experimental user may have ‘dabbled’ once or twice, whereas a heavy user would be using regularly throughout a given day.
• In the case of marijuana, they’d also need more detail about the product. Is it the THC compound (which causes the ‘euphoric high’) or cannabidiol (CBD) that’s being used? Is it being ingested, smoked or used topically as a cream? Smoking a high potency of THC (over 10%) has been linked to psychosis, so would be an important consideration.
• What’s the likelihood of dependency? For example, THC is more addictive than CBD.
• Is there a risk that it’s a gateway substance? The gateway hypothesis is that substance use progresses sequentially; for example, starting with alcohol and tobacco use, followed by cannabis, and later illicit drug use.

Dr Andrews adds that each insurance application is assessed on a case-by-case basis, taking into account the criteria mentioned and the overall risk profile of the client. An application may accordingly be accepted, accepted with ‘a loading’ or an exclusion(s), or rejected.

“The bottom line is that it’s critical to disclose any substance or medication you’re taking to your insurer, to decrease the likelihood of any delays or rejection, should you claim. Honesty is always the best (for your) policy. Even something as seemingly common and innocuous as Ritalin should be disclosed, especially if taken regularly.”

Dr Andrews concludes, “Microdosing, while demonstrating exciting potential, should be entered into with caution and consideration. Its impact on an insurance application must be one of the things to think about.”