Medical cannabis and employment: what you need to know

Once treatment is stabilised, medical cannabis patients usually experience very few or minimal side effects. And, in addition to symptom improvement, numerous observational patient studies have also noted improvements in patient’s quality of life and general wellbeing after cannabis-based treatment starts. 

For most, this also translates into their work life, because when employees are at their best and are able to effectively manage their health, they can typically do their job to the best of their ability, and so, in turn, their employers also benefit. 

But, understandably, many medical cannabis patients are concerned about how their employers may respond to their use of medical cannabis, and if their choice of medication could impact their employment. 

So, we’ve decided to explore patient's rights in the workplace, touching on medical cannabis UK law, employers’ rights and responsibilities, and workplace drug testing, so that you’re equipped with the right information about medical cannabis in employment settings.

Although thorough research has been undertaken to create this blog, please note it should only be used as guidance, and does not constitute legal advice. 

Patient rights in the workplace 

Finding the right treatment to manage your health condition can feel like a massive weight has been lifted, especially if conventional approaches have previously failed. However, for some, the thought of discussing, or having to take medical cannabis at work, adds extra pressure because of the stigma associated with cannabis-based medicines. 

But, it is important that all employees are treated fairly. 

Those using prescribed medical cannabis, in accordance with their prescription, must be treated in accordance with employment regulations and law, in the same way that other employees taking prescribed medications are. 

The Equality Act 2010

In the UK, The Equality Act 2010 prohibits discrimination in the workplace and in wider society, and details how individuals with disabilities should be treated lawfully. This Act allows people who have health conditions that qualify as a disability, to request reasonable adjustments are made to their employment setting.

For some medical cannabis patients, reasonable adjustments may include altering your job role to avoid driving or using heavy machinery, or being allocated extra breaks to administer your medication. 

However, it is important to emphasise: not every medical cannabis patient will be automatically entitled to reasonable adjustments in their employment setting.

Reasonable adjustment criteria:

 For reasonable adjustments to be made, the following three criteria must be met:

1. The person seeking reasonable adjustments must have a disability
2. The disability the person has puts them at a substantial disadvantage in comparison to non-disabled colleges due to workplace policies, rules, or physical features. 
3. The employer is aware of the employee’s disability. 

Declaring medical cannabis use to your employer

As a medical cannabis clinic, we’re frequently asked ‘do I have to tell my employer about prescribed cannabis use?’, and the answer is (technically) no. 

In the UK, employers can not force their employees to reveal any information about their health conditions, diagnosis, or use of medication - but they can request this information. 

For certain jobs that hold higher safety concerns - such as operating heavy machinery, or working at heights - refusing to disclose this information may result in the employer obtaining a medical report. Employers can do this under the Data Protection Act 2018, to ensure there is a safe working environment for everyone involved. 

Although employers cannot force their employees to declare this information, if employees fail to do so, they may not be eligible for reasonable adjustments under the Equality Act. 

The Equality Act’s code of practice ensures that employers do ‘all they reasonably can be expected to do’ to determine whether an employee has a disability that may affect their work, and if so, implement reasonable adjustments like those aforementioned. 

Taking your medication in the workplace

Under section 5 of the Misuse of Drugs Act 1971, (which restricts the possession of controlled drugs) patients who have been prescribed medical cannabis are lawfully permitted to possess or carry their medication - including at their workplace. 

However, the use of cannabis-based medicinal products must comply with the Health and Safety at Work Act of 1974 (HASWA). This Act ensures employees, and anyone impacted by their work or actions, are not exposed to anything that may risk their health, safety, or wellbeing. 

Health and Safety considerations

In their guidance for employees and employers regarding medical cannabis at work, the Cannabis Industry Council explain:

“Employers must carry out and keep up-to-date comprehensive risk assessments to identify risk, and then, so far as reasonably practicable, put in place effective control measures to eliminate or reduce risk.”

Administration

In these risk assessments, medication administration method may be taken into account. Although some employers may have an issue with medical cannabis flower being vaporised in the workplace, the vapour emitted is non-toxic, and does not usually affect others in the vicinity. 

It is important to note that medical cannabis vaporisers are also excluded from current indoor smoking and vaping bans, which fall under the Health Act 2006 , because they are designed to be a safe method of medication administration. 

Impairment

However, medical cannabis can cause impairment, and this is where risk assessments should focus their attention. 

Job roles that involve operating heavy machinery, or driving, have strict regulatory requirements and employees cannot be impaired while carrying out these duties for health and safety reasons. 

General guidance given for a lot of controlled medications, including cannabis based medical products, is that these activities should not be undertaken when impaired. However, in reality, once treatment has been stabilised, and the patient is taking their medication in accordance with their prescription, they are not usually ‘impaired.’

For more information about medical cannabis and driving, read our blog on the Cannabis Industry Council’s guidance here. 

Workplace drug testing 

Often the main reasons for drug testing in the workplace centre around health and safety concerns, and they’re more routinely carried out in companies that carry out safety critical work. 

But, employers can only conduct drug tests if their employees have agreed to be tested. This may appear in their employment contract, or in a staff handbook, and employees should always be allowed access to the employer's drug testing policy. 

Medical cannabis and employer drug testing

Because some companies do routinely drug test their employees, another question we’re frequently asked is ‘does medical cannabis show up on a drug test?’, and the answer is mostly, yes. 

Medical cannabis is very likely to show up on standard drug tests if you take cannabis medicinally on a daily basis. But, if your employer is aware of this, it should not be surprising, and if they have already made reasonable adjustments, this should not be a cause for concern. 

Because THC is a prohibited substance in the UK unless prescribed to an individual for medicinal application, and there is no way to differentiate between prescribed cannabis and recreational cannabis use in these tests, medical cannabis patients are highly likely to test positive for a ‘prohibited’ substance.

If passing these tests is mandatory part of your employment, a reasonable adjustment could be requested to adapt your role to one that will not cause a safety concern if THC is present in your system, but for certain roles this may not always be possible. 

How long does cannabis stay in the system?

The length of time cannabis lasts in the system, or can be detected in the system for, can vary depending on a number of factors. 

Biological factors about the individual (such as their rate of metabolism), the dosage of cannabis, and the administration method used, all affect how long cannabis stays present in our bodies, or ‘the system’. 

There are also variants in the tests used to detect cannabis. For example, saliva tests can usually detect whether cannabis has been used within the last 8 hours, but they have still shown positive readings 24 hours after cannabis has been used. 

On the other hand, urine and hair samples can determine whether cannabis has been used in the last 90 days, and for patients who use THC containing medicines it is unlikely they will ‘pass’ these tests. 

Talking to your employer 

If you have decided to declare the use of medicinal cannabis to your employer, be open and honest, and approach the conversation with professionalism, and discretion. It's important to know your rights, and remember that you’re not only advocating for yourself - you’re educating your employer about the realities of prescribed cannabis. 

It’s unlikely that change will come about overnight, but it is essential that these decisions are made fairly and that no discrimination ensues. Communication is key to making change happen, and your voice is powerful - so make sure it's heard. 

Know your rights

When having conversations with your employer about your use of prescribed medical cannabis, it is extremely important to be aware of your rights, but also, to be aware of your responsibilities to your employer. 

This blog was designed to act as a springboard to further information, and does not constitute legal advice. For a more in depth explanation of medical cannabis patient rights in the workplace, we’d recommend reading the Cannabis Industry Council’s guidance for employees and employers, and Drug Science’s ‘Know Your Rights: Medical Cannabis’ patient legal guide. 

Each employer will also have their own policies, handbooks, and employment contracts.  Before speaking with your employer about your status as a medical cannabis patient, or requesting reasonable adjustments, we’d also recommend you read through these thoroughly, so you’re equipped with every piece of information. 

Advocate for yourself 

Last year we spoke to Mohammed Wasway, founder of The Sanskara Platform, about his instrumental role in creating the Cannabis Industry Council paper ‘The use of prescription cannabis at work - guidance for employees and employers’.

Mohammed said:

"There shouldn't be any differences in how patients with a medical cannabis prescription are treated compared to any other patient. So many patients are taking medications that aren't cannabis-based, but they can be a lot more impairing than cannabis, and they don't face the same stigma or scrutiny….

They don’t think you [have] an illicit lifestyle if you’re prescribed codeine, or Valium, or Xanax, however, with cannabis there is still the stigma that it is an illegal drug. But, open discussions can reduce these associations.”

“I’d advise people to talk to their employers… or give the CIC report to HR to open a dialogue with them and your employers, as this has all the relevant information. We have even included a flowchart on how they can assess what actions need to be taken when an employee presents needing reasonable adjustments for their legal medical cannabis prescription.”

FAQs

Can an employer drug test without notice in the UK?

Yes, but only if the employee has agreed to such terms in their employment contract. 

If not, the employer must provide reasonable notice and have a valid reason for conducting the drug test, such as safety concerns or suspicion of drug use in the workplace - and even then, notice must be given. 

What drugs are usually tested for in a workplace drug test in the UK?

Urine testing is the most common form of workplace drug testing in the UK. Most urine tests will screen for a range of drugs, including THC (the psychoactive compound in cannabis), cocaine, amphetamines, opioids, and benzodiazepines.

Is ACAS advice free?

Yes, ACAS (Advisory, Conciliation and Arbitration Service) is a UK organisation that offers free legal advice to employees and employers on workplace rights, policies, and disputes.