If you are in the healthcare profession or plan to enter the healthcare profession and use medical marijuana for a health problem, then it is highly likely that at some point in time, you have wondered whether the use of medical marijuana will cost you your job. It is a legitimate concern since the healthcare sector is one of the most regulated sectors in the United States, and the use of cannabis has been declared illegal by the US government.
The simple truth is that it all depends upon several factors.
Yes, Healthcare Workers Can Legally Hold a Medical Marijuana Card
So let’s begin with some positive information first. When we are talking about states with programs for medical marijuana use, there is nothing that would prohibit doctors, nurses, pharmacists, or any other medical staff from getting a medical marijuana card, just like other citizens. The key is to have a certified disease and recommendation from a doctor.
However, having a medical marijuana card and using cannabis at work without any consequences is a completely different issue.
Why Healthcare Jobs Are Treated Differently
Medical cannabis laws at the state level that protect the patient against discrimination in the workplace provide an exclusion when the individual is performing a so-called “safety-sensitive” task where impairment may endanger the health or well-being of another individual. All healthcare positions are included within this category, along with all occupations that include operating machinery or driving a motor vehicle commercially.
This means that even though state law will protect one employee against dismissal due to a positive drug test, it may not apply to the nurse, surgical technician, or EMT who works in the hospital setting. Employers in such safety-sensitive positions have the authority to impose mandatory drug screening or testing on their employees without any restrictions.
Federal Law Still Casts a Long Shadow
Despite the legalization of the use of cannabis for medical purposes for many years in many states, it still remains a Schedule I controlled substance in terms of federal laws (even though rescheduling processes are underway). It makes a huge difference in the healthcare sector due to the following facts:
- Healthcare institutions receiving any kind of financial support from the federal government (Medicare, Medicaid, grants) should have drug-free workplace policies according to federal regulations.
- Institutions having contracts with the federal government should adhere to the federal Drug-Free Workplace Act, which disregards any protection provided by the states for medical marijuana use.
- Healthcare workers who are federally employed (VA hospitals, military medical facilities) are subject to federal laws above anything else, regardless of their state.
That is why two nurses working in the same city, but under different employers, may experience completely different consequences after testing positive on the drug test.
What This Looks Like by Role
Nurse: There is no state law prohibiting a nurse or nurse practitioner from being able to obtain a medical marijuana card. It is important to note, however, that it is unacceptable and will never be allowed to use cannabis while on the job or to come into work impaired. The National Council of State Boards of Nursing has made it clear that impairment that affects job performance will result in disciplinary action for one’s nursing license, in addition to whatever else one’s employer decides to do to that employee.
Doctor: In general, there should not be any problem for physicians who want to hold a card; however, medical boards are very strict about doctors being impaired on the job, and the credentialing/privileging process at hospitals can have its own policies concerning drugs that are separate from state protections.
Pharmacy techs: Pharmacy techs are legally allowed to hold a card; however, it could become an issue if working at a pharmacy that bills Medicare/Medicaid, because that would mean it would have to follow federal drug-free workplace standards.
EMT/First responder: It is almost universally considered to be a zero-tolerance position due to split-second decisions.
What You Can Do to Protect Yourself
Know your state’s specific protections
Some states exclude employment in the field of health care, as well as other safety-sensitive jobs from the non-discrimination laws protecting the cardholder. Some other states provide wider protections to cardholders in their employment practices.
Read your employer’s actual drug policy
Don’t guess – ask HR directly (or review the employee handbook) for their specific stance on medical marijuana, not just recreational use.
Understand the difference between having a card and being impaired at work
Nearly every legal protection that does exist only covers off-duty, off-site use, never being under the influence on the clock.
Think carefully about disclosure
Whether to tell your employer about your card is a personal decision. In states with strong protections, disclosure can work in your favor if a drug test ever comes up. In states without those protections, some employees choose to keep it private unless directly asked.
Keep your card current
If you are ever drug tested, most policies that do offer protection only apply if your card is active and valid at the time of the test.
The Bottom Line
Having a medical marijuana card does not make you ineligible for jobs in the healthcare industry, and in the majority of states, it is perfectly legal for doctors and other healthcare professionals to be patients themselves. However, healthcare is among those industries where having a card is least protected by law due to the sensitive nature of the job itself, as well as some federal laws that are still in effect. The most appropriate thing to do is to study the law of your state.
Frequently Asked Questions
Can I be fired from a healthcare job for having a medical marijuana card?
It depends on your state and employer. In many states, healthcare positions are classified as safety-sensitive, which means the anti-discrimination protections that cover other industries often don’t apply. Some employers may take action based on a positive drug test alone, even without evidence of on-the-job impairment, so it’s important to know your specific state’s law before assuming you’re covered.
Will a medical marijuana card protect me from a positive drug test at work?
Disclosing or not disclosing this information to the employer remains an individual choice. However, in the state where strong laws exist that provide protection, disclosure may prove beneficial in case any testing becomes necessary in the future. Otherwise, in other states, people may prefer not to disclose this information at all.
Does it matter if my hospital receives federal funding?
Indeed, potentially. Federal funding, federal contracts, or being a federal healthcare facility can make you subject to federal drug-free workplace requirements, which disregard medical marijuana laws in all states. It is one of the major factors why results vary greatly for healthcare employers from the same state.
Can nursing boards discipline me for having a medical marijuana card?
Just being in possession of a valid card is usually not enough to face punishment. However, if it can be proven that you are using cannabis in such a way that it affects your capacity to perform your job safely, it can be the reason for disciplinary actions taken by nursing boards due to the priority of the patient’s safety above all.
Should I tell my employer I have a medical marijuana card?
It depends and is purely your decision. It can turn out well for you if you are in a state where there are strict employee protections and you need to be tested. If you are not in such a state, some healthcare professionals prefer not to disclose the information if it was not asked from you before.
Are there healthcare jobs where a medical marijuana card is essentially never a problem?
In most cases, healthcare jobs that do not include the direct handling of patients, driving, or operating machinery have lesser restrictions placed upon them and are less likely to be considered safety-sensitive positions. Nevertheless, each employer’s particular drug policy should be checked for any exceptions.
