Microdosing: A Significant Life Underwriting Challenge
In recent years, microdosing has become an increasingly discussed topic, posing significant challenges to the underwriting of life insurance applications. While not yet widespread, microdosing is gaining mainstream awareness and warrants the careful attention of agents during the interview and application process.
Microdosing involves the ingestion of very small quantities of a psychedelic substance to achieve specific benefits, including improved mood, mental health, creativity, energy, cognition, and awareness. Substances such as LSD, Psilocybin, mescaline, ketamine, and others are consumed in quantities that are below hallucinogenic levels—often one-tenth of a recreational dose. Due to the lack of standardized dosages for microdosing, the amounts can vary, potentially leading to adverse psychedelic effects.
Research and knowledge on microdosing remain limited, and its safety and efficacy are matters of concern for the life insurance industry. Insurers view various forms of drug use as heightened risks, often resulting in higher ratings or declinations of coverage. However, attitudes towards certain drugs have evolved as they become more commonplace and legal in various states, with marijuana being a notable example.
Although it may be difficult to question applicants about drug usage, it is crucial to understand what drugs applicants are consuming and why. Most carriers conduct drug testing during the underwriting process, looking for the presence of both prescribed and unprescribed substances. Additionally, medical records often reveal the use of prescribed medications and illicit drugs. Any type of unprescribed or illicit drug usage, depending on the findings and details provided, is generally viewed unfavorably, making it essential to gather this information upfront before initiating the application process.
Remaining informed about state regulatory changes is always important, particularly concerning microdosing and the legal status of the involved substances. Notably, these substances are often illegal, as highlighted by Annika Luckmann in her article, Microdosing - The Underwriting Perspective.
Luckmann notes that carriers may evaluate an applicant who practices microdosing by considering several factors, both positive and negative. Positive factors include:
- Medical supervision, which can reduce the risk of adverse impacts
- Stable mental health with no prior history of substance abuse
- Honesty and openness about microdosing practices
- Improved health outcomes, such as enhanced mood, mental clarity, and reduced anxiety
- Consistent and responsible practices, including adherence to schedules and advised dosages
- A stable professional and educational background, where microdosing has not negatively impacted the individual
Negative factors include:
- A history of significant mental health issues and substance use disorders
- Adverse experiences from using psychedelic drugs in microdosing
- Lack of healthcare professional involvement or medical documentation
- Inconsistent disclosure and lack of candor regarding microdosing
- Concurrent use of multiple drugs, whether legal or illegal, that together produce negative effects
- Significant behavioral instability and changes indicating adverse side effects or management concerns
When encountering applicants for life insurance who microdose, you should first collect detailed information about their reasons for microdosing, the types of drugs used, whether the drugs are self-prescribed or prescribed by authorized professionals, the frequency and timing of usage, and any available medical records related to the practice. Subsequently, discuss the merits of the case with your underwriter before submitting an application, to set expectations and avoid adverse outcomes and reporting. As you would expect, carriers today usually consider these applicants on a case-by-case basis, and current experience shows that many microdosing applicants are declined. But, as we've seen with marijuana, when underwriting and medical information become more comprehensive, there can be increased underwriting acceptance of this practice.
Although as a financial services professional you probably won't encounter microdosing applicants very often, its practice presents considerable challenges for you, the applicant, and the life underwriter. Awareness of this practice is important, and gathering all the information needed for a full underwriting evaluation can result in positive outcomes. As carrier understanding and government regulations evolve, there may be greater acceptance of microdosing in the future.
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