On a daily basis, we face many challenges in EMS; from budgets to customer complaints to employee issues, there is no shortage of problems for managers and chiefs to deal with. One more issue that’s recently been added to our plates is so complicated and still evolving that many agencies haven’t even thought about it: medical marijuana.
As of January 2012, 16 states and the District of Columbia have legalized medical marijuana. However, it remains illegal at the federal level, placing these state laws in direct conflict with federal laws.
Because I live in a state where it has been legalized, I had a number of questions about how this could affect my agency and personnel. There are three general areas where medical marijuana poses significant challenges to fire and EMS personnel:
- The patient-care issue associated with the use of medical marijuana
- Issues with responding to scenes that may be grow houses or dispensaries
- What you’re going to do if your personnel are legally using medical marijuana
Unfortunately, because this issue is still evolving, we don’t have all the answers yet; but I can share some of the answers I have found through research and my department’s own experience in hopes that they will help others.
Patient Care
My agency, along with many others, has not experienced any significant increase in patients using medical marijuana. We initially thought we might see an increase in patients due to the ready availability and patients being less fearful of law enforcement action if they called 911 for a medical problem.
This increase has failed to materialize, and EMS business has continued as usual.
Responding to Grow Houses and Dispensaries
Responding to grow houses may set up physical hazards, such as modified electrical systems, oxygen-deficient atmospheres, structural changes to the building and hazardous materials that may be stored on site. These issues were addressed in the article “Marijuana: A Growing Hazard on the Fireground” (August Vernon, Firehouse: July 2009).
However, I also questioned whether our personnel could be exposed to enough medical marijuana through the course of their normal duties that they would test positive in a drug screen. The short answer is yes, but they would have to be exposed to an extremely significant amount.
The bigger issue here, though, is that testing for tetrahydrocannabinol (THC), the main chemical in marijuana, can’t differentiate between exposure and usage.
Personnel Use
That leads us to the last and probably the most important issue. What are you going to do with an employee who tests positive for THC but says they have a prescription for it?
Very few fire and EMS agencies have adopted policies specific to medical marijuana, and when the question was directed to some state and federal agencies, they also had no policies in place.
One way to address this in states where it has been legalized is to treat it like any other prescription medication.
Chances are you do have employees who either qualify for a prescription or have used medical marijuana for an existing condition. In my agency alone, we’ve had a member with throat cancer, one who died from ALS and another with a significant eye issue that required surgery. In all three cases, if the member had sought a prescription to alleviate the symptoms, they would have probably received it. Treating medical marijuana in the same manner as you would a prescribed narcotic could prevent problems for everyone involved. Except …
Except when it comes to the federal government. As stated earlier, the federal government considers medical marijuana a Schedule I controlled substance, which is on par with heroin and LSD, and they don’t consider it to have any medical benefit. So, while your agency and state may be okay with this, the feds certainly are not.
With this in mind, the problem can be even further complicated if your employee is injured or killed in the line of duty or they injure or kill someone else and test positive for THC. Will your insurance cover the claim? I can tell you that the Public Safety Officers Benefit can deny a claim if the member tests positive and some insurance companies will do the same.
Who knew that there were so many issues with medical marijuana? The patient care and response issues look easy when compared to dealing with an employee who tests positive. Medical marijuana is not making our lives as leaders any easier, and the last time I checked, being a fire or EMS chief or manager doesn’t qualify you for a prescription either.
Norris W. Croom III, EFO, CMO, is the deputy chief of operations for the Castle Rock (Colo.) Fire and Rescue Department. He’s been a member of the EMS Section since 1998 and currently serves as the section’s director at large.