EMPLOYEE HEALTH POLICY: MARIJUANA
Cannabis, better known as marijuana, is the most widely used illicit drug in Western societies. More than 96 million Americans (40 percent) age 12 or older report having used cannabis during their lifetime, and an estimated 15 million Americans are current users (defined as using the drug at least once in the past 30 days.) Documented reports of humans consuming cannabis for medicinal and recreational purposes date back over 2,000 years.
Active chemical compounds in cannabis – known as cannabinoids – are responsible for its psychoactive and physiological effects. Scientists have identified more than 60 naturally occurring cannabinoids, some of which bind to receptors in the body’s central nervous system as well as to additional receptors located in the endocrine, digestive, and musculoskeletal systems. The most well understood and well studied of these cannabinoids is delta-9-tetraydrocannabinol (THC), which is primarily responsible for cannabis’ psychoactivity.
Acute physical and behavioral effects associated with cannabis correspond with the levels of THC in the blood. Peak THC/blood levels are typically attained 15 to 30 minutes following smoking and taper off within two to three hours. Blood levels typically return to baseline four hours after smoking.
Commonly reported short-term psychoactive effects of cannabis include feelings of euphoria, relaxation, and sociability. Short-term physical effects and cognitive effects include a mild increase in heart rate and blood pressure, as well as some impairment in concentration, short-term memory, and certain psychomotor skills – primarily decision-time and trajectory. Additional physiological effects include dry mouth, reddening of the eyes, and increased appetite. Less commonly reported uncomfortable effects of cannabis use include occasional transient anxiety sometimes accompanied by paranoid ideations (particularly in naive users).
Long-term effects associated with chronic cannabis use are less conclusive, but are at this time typically limited to bronchial irritations such as increased incidences of bronchitis and/or cough. No clear cause-and-effect relationship exists for the use of cannabis and other illicit drugs (the so-called ‘gateway theory’) and/or the use of cannabis and negative educational or workplace performance. Cannabis lacks the addiction potential of alcohol or tobacco.
In general, population studies have failed to document demonstrable deficits in neurocognitive performance – including simple reaction time, verbal/language skills, executive function, motor skills, learning, and recognition – in long-term cannabis smokers compared to non-users, nor have they identified many of the significant negative health consequences typically associated with tobacco smoking – such as increased incidences of lung, upper aerodigestive tract, and oral cancers – in cannabis-only populations. A pair of recent case-controlled studies reported that past use of cannabis – unlike alcohol use – is not associated with an increased risk of injury, including both violent injuries and non-violent injuries such as burns. Self-reported use of cannabis is also associated with a substantially decreased risk of injury requiring hospitalization compared to self-reported use of alcohol and/or other illicit drugs.
To date, 13 states – Alaska, California, Colorado, Maine, Massachusetts, Minnesota, Mississippi, Nebraska, Nevada, New York, North Carolina, Ohio, and Oregon – have ‘decriminalized’ the use of cannabis so that possessing the drug yields only non-criminal penalties, such as payment of a small fine. One state, Alaska, has legalized the possession of up to one ounce of cannabis within the privacy an adult’s home. Additionally, 11 states – Alaska, California, Colorado, Hawaii, Maine, Montana, Nevada, Oregon, Rhode island, Vermont, and Washington – have legalized the possession and use of cannabis when a physician recommends such use. Case law in two of these states (California and Oregon) has determined that a private employer may still terminate an employee for failing a company drug test, even if that employee is authorized under state law to use cannabis medicinally. Most states, however, have not reached a legal consensus on this issue.
Among the reported 75 million Americans over age 26 who report having used cannabis, more than 70 percent are employed full-time. Many of these individuals are subject to random workplace drug testing. Urinalysis remains the most popular means of drug detection available in the United States, particularly in workplace drug testing programs. Courts generally look upon urine specimen collection as a relatively non-invasive practice, and there are national standards for urine testing in place as well as national certification programs for laboratories performing forensic urine drug testing.
However, standard urinalysis tests for cannabis, in their current form, are not suitable for detecting acute cannabis impairment or recent cannabis use because the procedure only detects the presence of inert drug metabolites (compounds produced from chemical changes of a psychoactive substance in the body, but they are not necessarily psychoactive themselves), not the psychoactive parent compound THC. Presently, no dose-concentration relationship exists correlating cannabinoid metabolite levels to cannabis impairment, nor does a positive test result provide an employer with any indication as to whether the substance may have been ingested while their employee was on the job. This is because cannabis’ primary metabolite (THC-COOH, which is readily detectable in urine) is not psychoactive, but may be detectable on a standard drug screen for days or even weeks after past use — long after any intoxicating effects of the drug have worn off. As a result, employers wishing to determine whether an employee is acutely under the influence of cannabis at work may wish to utilize post-accident testing of an employees’ blood or saliva rather than implementing random urine testing. Unlike urinalysis, both saliva and blood testing can estimate recent cannabis use by detecting the presence of THC, not inert cannabinoid metabolites. Overall, however, there exists little evidence that cannabis use is associated with lower productivity and/or elevated health costs among full-time employees. Like alcohol, moderate use of cannabis by employees during non-work hours should be of little concern for most employers.
INTOXICANTS IN THE WORKPLACE
The company has vital interests in ensuring a safe, healthy and efficient working environment for our employees, their co-workers and the customers we serve. Using or possessing alcohol or other intoxicating drugs in the workplace presents a danger to everyone. For these reasons, we have established as a condition of employment and continued employment with the company the following intoxicants in the workplace policy.
Controlled substances (because of psychoactive effects) are defined by the federal and state governments to describe five levels of drugs, with schedule I drugs being the most restrictive and illegal to possess or use (i.e., heroin, LSD and cannabis*) and schedule V drugs (i.e., cough syrup, aspirin and sleep aids) available without prescription at most retail stores.
Employees are prohibited from reporting to work or working while under the influence of alcohol and/or other drugs that adversely affect the employee's ability to safely perform his or her job duties.
[Name of company] does not engage in random and/or pre-accident drug testing of employees. Employee substance abuse problems will be identified by issues with behavior and measures of performance only.
The company understands that there is a difference between substance use and substance abuse, and that use isn't necessarily abuse. Employees are free to make their own lifestyle choices when not in the workplace or otherwise on company time. However, such choices must not be allowed to interfere with job performance.
Employees are prohibited from reporting for duty or remaining on duty with any alcohol or any other intoxicants in their systems. Employees are further prohibited from consuming alcohol or other intoxicants during working hours, including meal and break periods.
Failure to comply with the foregoing substance abuse policy may result in disciplinary action, up to and including discharge. For more information, please speak to the COO.