Rethinking workplace safety in legal cannabis era

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Gone are the days when a company in New Jersey can sack an employee simply for testing positive on a random cannabis drug test. Today, 130,000 people in the state legally use medicinal cannabis to treat conditions such as chronic pain, multiple sclerosis, epilepsy, cancer and ALS. And since April 21, all adults in the state can legally purchase cannabis. Adult-use sales generated $24 million in just the first month of legalization, according to the New Jersey Cannabis Regulatory Commission.

The change in the cannabis landscape creates challenges for companies that want to create or maintain a safe workspace while also respecting the rights of their employees. At the Cannabis Education and Research Institute, where I serve on the board of trustees, we are calling for a new roadmap for the future of workplace safety — one that recognizes medicinal cannabis as any other medicine.

Singling out and stigmatizing cannabis as something in its own category will not make workplaces safer, especially since cannabis can show up in the urine five to seven days after it has been used, long after a person would still be impaired.

And cannabis is not the only substance that people take that could impair work performance. For example, patients with chronic pain may be prescribed opioids; patients with seizure disorder may take anti-seizure medications that could cause impairment. There are also medications for treating anxiety or allergies that could affect performance at work. Some other conditions, even without medication use, can cause impairment, such as hypoglycemia (low blood sugar), fatigue or insomnia, to mention a few

New policies must focus less on drug tests and more on the truly critical question: Is an employee fit for duty? Can the employee perform the essential function of his/her job safely? Conscientious companies want safe workplaces. So does the public. New policies, we believe, can recognize employees’ right to health care privacy and keep workplaces safe in this new era.

New Jersey has an opportunity now to write a new script. Under the state law legalizing adult sales of cannabis, employers cannot take adverse action against an employee, absent any reason to believe the employee is impaired, simply because the employee consumes cannabis — or because a test finds cannabis in the employee’s blood or urine. Employers are, not surprisingly, concerned about the path forward. I have spent my career in workplace health, published research on the topic, and served as chief medical officer for a global pharmaceutical manufacturing and health care company. I understand the challenges employers face in this new age.

I also support CERI, which advocates for medicinal patients to use cannabis as they would any other medication. My views are not in opposition. Again, we must focus on whether an employee is fit for duty and or exhibiting signs and symptoms of functional impairment. Alcohol, for instance, is legal. But an individual consuming alcohol at lunch is not fit to operate machinery.

New Jersey now requires a Certified Workplace Impairment Recognition Expert (WIRE) to determine if a worker is impaired at work and then the company can test for substances. Employers are eagerly waiting for the regulations to determine what training is needed for someone to become a WIRE and how the system will work. At CERI, we want to see regulations that ensure that WIREs are well-trained and understand objective signs of impairment. We cannot allow preconceived notions based on how a person dresses or speaks, or their racial or ethnic background, to cause them to be unfairly targeted.

A physician working with CERI shared a story about a patient with Tourette syndrome whose use of low THC cannabis (tetrahydrocannabinol or THC is the psychoactive component) greatly reduced his tics. He tested positive in a random drug screening and was punished with a lower-paying position. The new law could protect patients like this.

Companies, along with regulators, need to establish clear policies. The need for education is great — education for company leadership and the human resources community as well as for employees.

Patients must know their rights and companies must know they can act appropriately against impaired workers. Education supported by evidence-based research will be key as we change the conversation about workplace safety and what it means to be fit for duty.

A multistakeholder engagement including regulators, employers, employees, payers and health care providers is essential in addressing these pressing issues that affect workplace safety

Dr. Fikry Isaac is chief executive officer of WellWorld Consulting and is a former vice president of Global Health Services for Johnson & Johnson, where he also served as the chief medical officer for Johnson & Johnson’s Health and Wellness Solutions. Isaac is a researcher and published author in the field of workplace health.