Medical cannabis was rescheduled in the UK over four years ago (November 1st 2018) allowing for it to be prescribed for eligible patients by a specialist prescriber on the General Medical Council’s specialist register. Since then, it has seen an increase year on year in the numbers of patients it is being prescribed for. Cannabis-based medicinal products (CBMPs) can only be started by specialist doctors if alternative treatments have been tried without providing adequate symptom relief.
Whilst the true figure is not known, it is estimated that approximately 20,000 people in the UK are accessing medical cannabis on prescription in the UK. Data from the UK Medical Cannabis Registry suggests that over 60% of prescriptions for medical cannabis in the UK are for chronic pain (1).
However sadly, patients being prescribed medical cannabis, may face a lack of understanding and stigma from society including family, friends, employers and even from healthcare professionals. In fact, a study we performed in conjunction with colleagues at the University of the West of Scotland highlighted that 84.4% of surveyed medical cannabis patients perceived themselves to be subject to stigma. It is commonly accepted that this stigma can reduce utilisation of healthcare services and can negatively impact care. Whilst the situation is continuing to improve all the time it’s important for us all to understand more about medical cannabis, including the rights of patients in the workplace.
What’s the legality around medicinal cannabis at work?
There are statutory safeguards to allow people to take prescribed medication at work if required, and this includes medical cannabis. However, medical cannabis must always be taken as prescribed by an appropriately trained clinician.
As an employer has a duty of care to not just the patient but their co-workers too, whilst patients are permitted to administer their medical cannabis at work as prescribed, a patient should let their employer know if medication is likely to have an impact on safety in the workplace. In most cases, unless a medical condition or medication presents a health and safety risk to the individual who has been prescribed medical cannabis or others at work, they are under no obligation to disclose their medical condition or medication for that condition. However, at Sapphire Medical Clinics we encourage those who feel able to speak with their employer, even if there are no obvious safety concerns, to ensure reasonable adjustments and risk assessments are undertaken if required and that they are not at risk of being perceived to be in violation of any company policy on alcohol and drugs in the workplace.
Medical cannabis has the potential to cause impairment, particularly when starting the medication for the first time, after a change in dose or type of product prescribed, or indeed if an individual is particularly sensitive to side effects. Patients who feel impaired after administering their medication should not drive or operate heavy machinery.
How to prepare for an employer/employee meeting on the issue of medical cannabis?
It can be helpful for both parties to be transparent and have an honest discussion around a person’s prescription of medical cannabis in order to manage expectations. We recommend that an employee prepares for the meeting and brings a series of background information with them including;
- An outline of their medical history
- The prescribed medication, including a copy of a prescription
- An outline of how often they take medication and what’s involved
- Information on any side effects that may be relevant to the job
- Ideas of reasonable adjustments they might need (e.g a patient may feel impaired after administering their medication so it is important not to drive or operate heavy machinery)
An employer might like to suggest the idea of follow up check-in meetings, in order to provide the employee with continued support.
Chris Cowan, a 45-year-old account manager and patient at Sapphire Medical Clinics comments; “I have built up a career in professional film and photography and have previously felt really apprehensive about talking to my employer about my diagnosis of depression. Since having a medical cannabis prescription in February this year, I now feel a huge sense of relief and am in a position to share my situation openly with my employer. I recently sat down and talked to the HR department and found them to be extremely helpful and empathetic.”
Will medical cannabis show up during routine drug testing?
For some individuals, such as heavy goods vehicle drivers or pilots, medical cannabis is typically not prescribed due to the potential risk that may be involved if the medication does result in impairment.
If an employer undertakes drug testing as part of its workplace procedures, the THC from medicinal cannabis would likely produce a positive result. Even if a person is unaffected by their medication, many individuals still test positive for over 28 days after administration.
In these instances, we recommend that a patient informs their employer before seeking to start medical cannabis, so they are aware of any implications this may have on their ability to continue work. Often it may be necessary for a formal occupational health assessment to be conducted with relevant adjustments made as necessary in conjunction with human resources and an individuals line manager.
For additional advice on medical cannabis visit: www.release.org.uk/helpline
(1) Ergisi M, Erridge S, Harris M, Kawka M, Nimalan D, Salazar O, et al. An updated analysis of clinical outcome measures across patients from the UK Medical Cannabis Registry. Cannabis and cannabinoid research. 2022;
