Cannabis (marijuana) use that has been authorized for medical purposes has soared in Canada over the last number of years. Recently, we have seen a large spike in medical authorizations, which is likely in part due to society and many medical professionals’ general acceptance of cannabis use as a treatment option for a variety of medical conditions. Despite legalization, expect there to be the continued growth of cannabis for medical purposes.
Although authorized by a physician or nurse practitioner, cannabis, where and when it contains sufficient quantities of euphoric cannabinoid chemicals such as tetrahydrocannabinol THC, remains a psychoactive substance that has the potential for safety concerns at work, especially when working in safety-sensitive or safety-critical jobs.
Not all cannabis products are the same in form and composition. Cannabis can contain 80 to 100 or more cannabinoid chemicals, some euphoric such as THC, and some not euphoric such as CBD. As more research studies have conducted that outline the impact of various cannabis products on decision-making skills, motor skills, coordination, and reflexes, it is apparent that if a worker has authorization for cannabis for medical purposes, an evaluation is required to determine whether the worker would be fit for duty in a safety-sensitive occupation.
A candidate/worker does have an obligation to work with their employer to manage risks in the workplace, and even more so if a medical issue is involved. Notwithstanding applicable medical confidentiality and privacy rules, employers have the general right to know from a worker whether or not the worker has a health condition that could impact workplace safety and/or is under treatment that could impact workplace safety (employers should seek legal counsel in their provinces for guidance on this matter). However, the challenge for the employer is to utilize an arm’s-length approach to manage the medical agenda, but still try to obtain objective and valid information regarding a medical issue, including treatment. This objective and valid information could then be used to support an employer’s position regarding how to best manage this risk and ensure safety in the workplace for the worker as well as co-workers.
We developed a Medical Cannabis Review Process to assist the candidate/worker, the employer, as well as treating physicians to manage the medical issue.Outlined below is a summary of the step by step process while reviewing medical cannabis files. Please note that all reviews may not require all of the steps listed, as a solution or outcome may be determined before proceeding to the next step.
Step 1: Request for Service (Referral)
Step 2: Validating User Authorization
Step 3: Communication of Findings to the Referring Party
Step 4: Letter to the Authorizing Physician/Nurse Practitioner
Step 5: Independent Physician File Review