According to a recent release by the National Institutes of Health, marijuana use by U.S. adults has doubled over the past decade, with 9.5% of Americans reporting that they use marijuana. Of that number, about 3 in 10 users meet the criteria for addiction, with the prevalence of marijuana use disorder rising from 1.5% to 2.9%.

“Marijuana use disorder” is defined by the Diagnostic and Statistical Manual of Mental Disorders:

“This includes symptoms such as taking the drug in larger amounts or over a longer period than was intended by the user; the persistent desire to cut down or control use/unsuccessful efforts to do so; failure to fulfill major role obligations at work, school or home as a result of marijuana use; and tolerance and/or withdrawal.”

Roberto Ceniceros writes about the Cannabis Conundrums faced by employers in a recent edition of Risk & Insurance magazine, noting that marijuana remains the substance most often detected in workplace drug-testing programs.  But the patchwork of state laws poses challenges for the employers: 23 states now have medical marijuana laws, while four others states sanction recreational use.

“The new hodgepodge of state laws includes a few protecting marijuana use outside work hours, others limiting drug-testing practices, and still others raising unknowns, including how some state regulations will interact with disability laws.”

Ceniceros points to, comments on and recommends a Joint Guidance Statement of the American Association of Occupational Health Nurses and the American College of Occupational and Environmental Medicine: Marijuana in the Workplace: Guidance for Occupational Health Professionals and Employers.

This important report addresses such topics as  the Americans with Disabilities Act, state laws, medical issues, discussions on detecting and assessing impairment, legal considerations of accommodating marijuana use in the workplace and the development and management of a comprehensive chemical impairment policy, along with essential drug testing considerations.

The report notes that while employers may still ban or restrict marijuana use in most states, the marijuana landscape is changing, with laws evolving rapidly. Court decisions may require policy changes in the future.

The summary includes these important recommendations, among others:

“The Joint Task Force recommends that marijuana use be closely monitored for all employees in safety-sensitive positions, whether or not covered by federal drug-testing regulations. Best practice would support employers prohibiting marijuana use at work. Employers, in compliance with applicable state laws, may choose to simply prohibit their employees from working while using or impaired by marijuana. In some states, employers may choose to prohibit marijuana use by all members of their work force whether on or off duty. Nevertheless, in all cases, a clear policy to guide decisions  on when marijuana use is allowed and how to evaluate for impairment must be widely distributed and carefully explained to all workers.

Legal consultation during policy development and continual review is imperative to ensure compliance with federal, state, and case law. Drug-use and drug-testing policies should clearly delineate expectations regarding on-the-job impairment and marijuana use outside of work hours. Specific criteria for use by supervisors and HR personnel when referring employees suspected of impairment for an evaluation by a qualified occupational health professional are critical. Detailed actions based on the medical evaluation results must also be clearly delineated for HRs, supervisors, and workers.”

Additional resources

23 Legal Medical Marijuana States and DC
Laws, Fees, and Possession Limits

Three States Considering the Legalization of Medical Marijuana

Number of Legal Medical Marijuana Patients

Marijuana Resource Center: State Laws Related to Marijuana

Legality of cannabis by U.S. jurisdiction

Marijuana Policy Project State Laws



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