Preparing For Legal Cannabis

Authored By: Carleen Kay | Publish Date: October 11, 2018

Employers are facing new challenges when it comes to substances used by employees both in and out of the workplace. What employers should consider in ensuring a safe workplace and that employees go home safely each day was the focus of a CPBI Alberta South session focused on the science of cannabis and the employer’s role in managing absence and disability related to substance use disorders.

Canada will be joining 20 other countries worldwide with the legalization of cannabis on October 17. The subject of cannabis use, however, is not new. Psychoactive drugs have been dated back to the 9th Century where they were used for religious, medicinal, and recreational purposes.

Stored In Fat Cells

The science behind how we metabolize alcohol and cannabis are very different. Alcohol is metabolized by the liver and blood alcohol reaches a peak level after 30 to 45 minutes of consumption. Cannabis is metabolized by the blood and is stored in fat cells. The brain is the fattest organ in our body. Peak levels of cannabis vary based on how it is consumed. Inhalation or oral ingestion range from a few minutes to a few hours. Delayed impairment can also occur days or weeks after consuming cannabis, during a heightened anxiety experience, which would release THC within your brain.

There are several types of strains of cannabis plants for medical and recreational use which include varying degrees of THC and CBD. THC is the psycho-active ingredient in cannabis which prompts hunger and euphoria, as well as relief for pain and nausea symptoms. CBD provides clear-headed relief of pain, mild anxiety, insomnia, and inflammation, however, still contains a small level of THC. THC impairs judgement, regardless of level.

We know that employee education is paramount in understanding how cannabis and alcohol are metabolized in our bodies as they are very different processes. This is evidenced by a recent study where 43.7 per cent of driver fatalities in 2016 were attributed to drug use, where fatalities attributed to alcohol use were 27.5 per cent.

Testing for cannabis currently only verifies THC presence, not impairment. A positive THC urine test provides no measure of the amount of drug exposure, no timing of when exposure occurred, and no measure of the degree of impairment.

So, what is the employer’s role in managing absence and disability as it pertains to substance use disorders? The following areas should be considered:

  • Policy Considerations: Clear terms relative to both employment contract and benefits provision; update policy language relative to recreational versus prescriber cannabis; zero tolerance is not reasonable to include in the policy as testing only captures presence, not impairment; employers have a duty to accommodate; allow provisions for employee disclosure without repercussions; supervisors have a duty to inquire with an employee as to how they are doing if they notice a change in behaviours and to recommend support where applicable; any policy needs to be applied consistently
  • Assessment: Important to conduct a substance abuse assessment to understand the severity and determine the correct course for treatment; assessment should be completed by a substance abuse professional and/or psychiatrist
  • Case Management: Many cases do not present as a substance abuse issue; the current Disability and Statistical Manual of Mental Disorders (DSM-5) includes 11 criteria for substance use disorders, which include abuse and dependence; consider co-morbidity conditions and focus on the level of function (i.e. what is the employee able to do; return-to-work integration is very important, especially the social support received at work versus staying at home
  • Treatment: Employers need to do more than make benefits available to employees; substance abuse should be treated as any other chronic condition; ongoing treatment and after care treatment is equally important; clear conditions for funding of treatment should be clear to both parties
  • Support Programs: Employees require support following treatment of substance abuse to support ongoing health recovery and to maintain safe workplaces; consider a relapse prevention program
  • Monitoring: To ensure ongoing health recovery, abstinence, and a safe workplace, monitoring should continue for at least two years in length

In the event of workplace impairment, be sure to fully document details. Remove the employee safely from the workplace and ensure they arrive home.

Dual Lens

Investigate the issue from a dual lens. Consider if the medical issue contributed to impairment or workplace incident. Recognize past work experience and expertise of the employee, including accountability of behaviours. Evaluate using a competent assessment by substance abuse expert.

Ensure the benefits program covers initial and ongoing treatment. Hold employees accountable for maintaining their own health and to seek support if good health changes. Continue to monitor and test as recovery support, not as ‘job-jeopardy.’ Be certain to outline expectations for ongoing work performance.

Substance use and abuse are not new territories. The methods in which employers support employees, to ensure a safe workplace for all, continue to evolve.

Carleen Kay is co-chair of the CPBI Alberta South program committee.

 


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