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Medical marijuana

Who would have thought the time would come when manufacturers would have to find ways to accommodate weed (aka marijuana) in the workplace? You better believe it.

Now that marijuana is considered legit for “medicinal” purposes and is prescribed by doctors to treat a variety of maladies from anxiety disorders to acute, chronic pain, it’s something employers will have to deal with.

Set aside the image of a slacker listening to Dark Side of the Moon while digging into a bag of Cheetos to satisfy post-toking munchies.

“We have this imagery in our heads of a stoner, but medical marijuana can be beneficial to some patients,” said Dr. Barry Kurtzer, medical director and chief medical review officer of DriverCheck Inc., a provider of workplace medical testing and assessments based in Ayr, Ont.

Kurtzer, heading up a session on medical marijuana at the recent Partners in Prevention safety conference held in Toronto, stressed medical marijuana is now like any other prescription med.

Since the “Marijuana for Medical Purposes Regulations (2013/2014)” were implemented a year ago, patients no longer have to go to Health Canada for their medicine. But they aren’t allowed to grow their own either. It can only come through licensed producers (LPs), of which there are currently 17 who grow and sell. Eight others just grow. Prescriptions come from doctors or nurse practitioners.

Health Canada estimates there will be 450,000 authorized patients by 2024 (currently there are 40,000) and there are as many as 1,000 LPs under review.

Patients can only possess 30 times the daily dose of the dried plant material up to a maximum of 150 grams (the equivalent of 10 joints).

The therapeutic ingredients – tetrahydrocannabinol or THC, and cannabidiol or CBD (this one lacks the high) – are activated by heat, either by lighting up or using a vapourizer (which heats but doesn’t ignite).

An employment and labour bulletin from McMillan LLP, a Toronto law firm, observes that employers have a duty to accommodate employees’ disabilities to the point of undue hardship. A court would look at the cost, whether there is outside funding to subsidize the cost, and the health and safety issues that may be involved. If second hand smoke is the issue, an employer would have demonstrate the user couldn’t be isolated or a vapourizer would be a problem. So far, no employer has been able to make the undue hardship case.

“In Canada, automatic job termination without case-by-case review could result in human rights complaints or other legal consequences,” Kurtzer warned.

He recommended employers put a marijuana policy in place and offer employee education as well as supervisor training; ensure the user is okay for safety sensitive work; conduct periodic drug tests; monitor outcomes of physician follow-ups; and find other work for those not fit for safety sensitive activities.

Establishing policy

When developing policy, get legal advice, and consider these issues: develop a statement of purpose; self declaration of use; change of strength and side effects reporting requirements; monitoring for safety sensitive workers; adherence to human rights and privacy laws; accommodation for those not fit for safety sensitive work; means of identifying authenticity of marijuana use; and the state of the problem being treated.

Evaluations should be conducted by experienced occupational medicine physicians who are provided with detailed job descriptions and a physical demands analysis, plus identification of all safety related functions. Do a detailed review of the health condition being treated and evaluate its impact on health and safety. Review all medications being used, evaluate the risk of addictive behaviour, review potential alternate treatments, conduct a full medical exam and validate the need for medical marijuana.

Review work and non-work safety issues, detail them and provide recommendations, and determine fitness for safety sensitive work. Generate a detailed report covering key issues and fitness for work recommendations. Advice for both employer and patient should be made regarding follow-up care and assessments. And make sure the appropriate authorizations are signed for the release of information to stakeholders.

A final note: medical marijuana as a reimbursable prescription will impact company drug benefits. Employers decide what to put on their plans, but be prepared for blowback if medicinal marijuana is excluded.