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EXPLAINED: Why employers need to wrap their heads around medicinal cannabis

EXPLAINED: Why employers need to wrap their heads around medicinal cannabis

Thursday 22 April 2021

EXPLAINED: Why employers need to wrap their heads around medicinal cannabis

Thursday 22 April 2021

A local doctor explains why he thinks it's high time for employers to understand medicinal cannabis.

Dr Chris Edmond, Medical Director of occupational health specialists WorkHealth Jersey, had this to say….

Legalisation of cannabis for medicinal purposes came into force in Jersey on 1st January 2019, with the first local licences for the commercial cultivation of medicinal cannabis issued in December 2020. Legislation in Jersey differs from the UK as cannabis can be prescribed by Jersey General Practitioners, whereas in the UK prescribing is limited to hospital specialists (and on the NHS is limited to few specialist conditions). As a result of our local legislation, it is anticipated that a far greater number of patients will be using the drug to treat their ailments. Already over the past six months, three separate GP-led clinics have launched in Jersey offering cannabis on prescription, reporting an "incredible response" from patients.

A significant number of companies in Jersey are already launching in the areas of cannabis cultivation, research and testing. Although local employment law has not seen any changes in regard to these developments, employers need to familiarise themselves with the basics of medicinal cannabis use.

What is medicinal cannabis?

Medicinal cannabis is a broad term used to define any cannabis-based medicine that is prescribed to patients for symptom relief. There are two main strains of wild cannabis, Sativa and Indica, which have been used to treat ailments for thousands of years.

The cannabis plant has two main active ingredients, CBD (which is not a controlled drug and has no psychoactive effects) and THC (the psychoactive ingredient which gives users a ‘high’), which are more commonly known as cannabinoids. In total however there are well over 100 active ingredients in cannabis plants, with each strain offering slightly different proportions and therefore medical effects. Most treatments combine different ratios of THC and CBD, and treatments that combine the two tend to have a better effect than those with just one active ingredient.

How does it work?

The endocannabinoid system (ECS) is a naturally occurring cannabis system within the human body, that exists even if you don’t use cannabis. The ECS plays a role in regulating bodily functions like sleep, mood, and appetite. It also influences our modulation of pain and movement control.

The cannabinoids found in cannabis are similar to chemicals produced by the ECS which can ease a wide range of symptoms. Research suggests the benefits of medicinal cannabis use can include:

  • Reduced inflammation and pain
  • Relaxing tight muscles in people with MS
  • Increased appetite
  • Controlling nausea caused by chemotherapy
  • Reducing seizures in people with certain types of epilepsy 

Cannabis has also been shown to help stabilise mood disorders like anxiety and depression and help manage other mental health conditions like post-traumatic stress disorder and schizophrenia.

Is it legal?

While cannabis prescribed for medicinal reasons is essentially the same product as non-medicinal cannabis, recreational use is still prohibited. Cannabis should only be used as a ‘last resort’ treatment once a person has exhausted traditional treatments.

Medicinal cannabis is a controlled drug so clinicians must adhere to a rigid set of standards. Prescriptions must have a 30-day maximum duration and the dose and method of consumption will be agreed upon depending on the condition being treated.

Prescriptions for controlled drugs are only to be used by the person to whom they are prescribed, and it is a criminal offence to sell or give your prescribed cannabis to another person.

Smoking medicinal cannabis remains illegal, as burning cannabis in a pipe, ‘joint’, or ‘bong’ typically releases harmful chemicals similar to smoking tobacco. Most medicinal cannabis users are recommended to use a medical-grade vaporiser (which are very different to typical nicotine ‘vapes’) to provide a consistent level of the active drug as they have been prescribed. Many people also use CBD oils and other products., with very low levels of psychoactive THC, and these can already be purchased without a prescription. Some patients may be prescribed specific medical products (such as ‘Sativex’, a licensed oral cannabis spray).

What do employers need to know?

There is significant evidence that medicinal cannabis can have therapeutic benefits for some patients, and those patients could potentially be your employees. The first thing to remember is that cannabis is not illegal in Jersey so long as it has been prescribed by a qualified clinician. 

As mentioned earlier, Jersey’s employment legislation has not been changed to take medicinal cannabis into account. Some jurisdictions have extended a specific protection to employees dismissed or adversely treated due to their use of medicinal cannabis.

However, under Jersey’s discrimination legislation there may already be some protection. Medicinal cannabis is typically used to treat medical conditions that can be considered a disability under our discrimination law.

Business owners may need to review policies that address drug and alcohol use, and impairment at work, taking into consideration two specific competing obligations. Employers have a duty to make reasonable adjustments to accommodate employees with a disability, but they must also take reasonable precautions to ensure the safety of their staff and workplace.

Possible side effects of cannabis use should be taken into consideration when identifying safety in the workplace - using cannabis or any cannabis product can impair your

concentration, your ability to think and make decisions, and your reaction time and coordination. This can affect your motor skills, including your ability to drive. It can also increase anxiety and cause panic attacks, and in some cases cause paranoia and hallucinations. In safety-critical roles it is likely to be appropriate to prohibit use either at work or completely.

It is in the employer’s interest to ensure individuals can substantiate a prescription if an employee raises the fact that they have been prescribed medicinal cannabis. A discussion about when and on what basis the individual will be taking the prescribed product during work hours will be required, with appropriate deliberation on whether it may pose a risk in the workplace. Care must be taken not to expose other employees to second-hand vapours.

The usual rules should be applied when a situation involving the use of medicinal cannabis arises. Proper investigation and verification will be necessary if an employee fails a drug test and attributes it to the use of medicinal cannabis.

It may be appropriate to make an exception to any drug and alcohol use policy as a reasonable adjustment for an employee whose prescription of medicinal cannabis relates to a condition which constitutes a disability.

Employers are required to attempt to find reasonable adjustments for employees with a disability, including those with a prescription for medicinal cannabis. Employers may want to consider additional or alternative accommodations such as altering the employee’s duties dependent on the situation.

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