Since California became the first state to legalize medical marijuana in 1996, 35 states now allow recreational or medical marijuana use. But there are legal issues that pharmacists, pharmacy technicians, dentists, dental hygienists, and all licensed healthcare professionals must keep in mind before they smoke weed, hash, pot, CBD oil, or other cannabis products containing THC.
Marijuana remains illegal under federal law, even with a medical card in legal states, such as California, Colorado, and Washington. And employers in all states have the right to establish a drug-free workplace. Our pharmacist license defense attorney has created this guide to review what professionals need to know to avoid employer or license board disciplinary actions.
Marijuana, CBD, pharmacy, and dental license FAQ
Here are seven common questions licensed professionals have about medical marijuana, cannabis, tetrahydrocannabinol (THC), medical cards, and cannabidiol (CBD):
Pharmacists and pharmacy technicians can smoke weed in legal states, like California and Colorado, so long as:
the pharmacist is not impaired when working,
they follow their employer workplace drug policies, and
they do not violate DUI or other drug criminal laws.
The biggest issue is that most pharmacy employers prohibit marijuana use, even when legal. Employers have the right to establish a drug-free workplace policy under OSHA and state laws. Every employer sets its own policy, and you must consult your human resources department to review yours. Employers can fire pharmacists who fail a drug test and can require a drug screening test before hiring.
Pharmacy regulations make it a criminal act to work as a pharmacist while drug-impaired. For example, in California BPC § 4327 makes practicing pharmacy while impaired a criminal act punishable by a fine and/or imprisonment for up to one year:
“Any person who, while on duty, sells, dispenses or compounds any drug while under the influence of any dangerous drug or alcoholic beverages shall be guilty of a misdemeanor.”
The challenge for employers is that proving marijuana impairment is difficult because drug tests cannot reliably determine if someone is currently impaired. Unlike alcohol impairment, a pharmacist can test positive for cannabis use weeks after their last usage. If an employer suspects work impairment, they typically order a drug test and then discipline or fire the employee for violating a drug-free workplace policy.
In legal states, marijuana usage does not necessarily lead to the revocation of your pharmacist license. Typically the Board of Pharmacy would need additional factors to initiate discipline, such as
Drug use interfering with your work as a pharmacist.
When marijuana usage turns into a substance abuse problem that interferes with a pharmacist’s work performance, the Pharmacy Board can initiate disciplinary actions and offer enrollment in a Pharmacist Recovery Program.
Dentists, registered dental assistants, and dental hygienists can smoke weed in legal states, like California and Colorado, if:
they do not treat patients while impaired,
they follow their employer drug policies, and
they do not violate DUI or other drug criminal laws.
Dental boards and dental hygiene boards essentially treat the legal use of cannabis like alcohol; they only care about it when a dentist is impaired while working. For example, the Dental Board of California (DBC) does not have rules regarding a dentist’s recreational or medical marijuana use. But the DBC has strict rules prohibiting practicing while impaired and professional conduct (BPC § 1681). If the DBC receives an impaired dentist complaint, the Division of Investigation will likely investigate.
Employers have the right to establish a drug-free workplace policy, and most do in safety-sensitive healthcare workplaces. Employers can fire you for failing a drug test and require a pre-employment drug screen test. Since dentists are typically self-employed in solo practices, they control their own workplace rules. If you are not self-employed, it is crucial to consult HR to understand your employer’s policies.
If a dentist becomes aware an investigation has been initiated for drug impairment, it is essential to consult a qualified dental license defense lawyer for guidance. A lawyer with expertise in resolving dental board investigations should review responses to board inquiries to consider any legal ramifications.
In legal states, marijuana usage does not usually lead to the revocation of a dental license. The board would usually require aggravating factors to trigger discipline, such as
Working with patients while impaired,
Arrest for DUI marijuana, or
Arrest for marijuana drug-related crimes.
Dental boards offer Diversion Programs for dentists, registered dental assistants, and dental hygienists whose marijuana or other drug use turns into a substance abuse problem. The American Dental Association (ADA) has created an informative Dentist Well-Being Programs Handbook for dentists dealing personal impairment.
The ADA recommends that dental offices adopt a drug-free workplace policy to help manage office safety and provide more tools for managing office staff drug-related issues. They have created a sample policy for dental offices.
3) Can pharmacies or pharmacists sell medical marijuana?
Even though medical marijuana usage is legal in 35 states, pharmacies do not dispense whole-plant cannabis and cannabis extracts. Pharmacies steer clear of medical marijuana, except for U.S. Food and Drug Administration (FDA) approved prescription drugs such as Epidiolex, which are derived from cannabis.
The main reason is that cannabis is still an illegal Schedule I controlled substance under federal law. Under this classification, the federal government defines cannabis and its derivatives as “drugs with no currently accepted medical use and a high potential for abuse.” This designation prevents pharmacies from becoming involved with medical marijuana.
The Drug Enforcement Agency (DEA) licenses pharmacies, not pharmacists. Pharmacies are required to obtain and comply with the regulations governing their DEA license. Theoretically, the DEA could revoke a pharmacy license due to violating federal law for controlled substances. This conflict between state and federal laws keeps pharmacies out of the medical marijuana business. The federal government will have to reclassify cannabis before pharmacies can safely enter.
On the other hand, pharmacists can be involved in the sale and dispensing of medical marijuana in legal states. A growing number of pharmacists are moving to medical cannabis dispensaries as the industry matures and dispensaries work to differentiate themselves in the market. Pharmacists are well equipped to develop endocannabinoid expertise due to their pharmacology training. And many medical cannabis patients seek out this expertise to help guide them.
Map of the United States showing the level of cannabis regulation in all 50 states and Washington D.C. Source: National Conference of State Legislatures.
4) Where is marijuana legal in the U.S.?
State laws are rapidly evolving throughout the United States. Recreational use of marijuana is currently legal for people 21 years and older in 15 states and Washington, D.C.: Alaska, Arizona, California, Colorado, Illinois, Maine, Massachusetts, Michigan, Montana, Nevada, New Jersey, Oregon, South Dakota, Vermont, Washington and the District of Columbia.
The medical use of cannabis is legal in 35 states with a doctor’s recommendation, including the above listed states, plus: Arkansas, Connecticut, Delaware, Florida, Hawaii, Louisiana, Maryland, Minnesota, Mississippi, Missouri, New Hampshire, New Mexico, New York, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, Utah, and West Virginia.
5) Can pharmacists or dentists use CBD oil?
Cannabidiol (CBD) oil is one of over 100 chemical cannabinoids found in marijuana plants. CBD oil has been shown to relieve chronic pain, alleviate cancer-related symptoms, reduce anxiety, relieve depression, and help other medical conditions. All states have legalized the use of hemp-based CBD products. Hemp plants are required to have a THC content of 0.3 percent or less.
Pharmacists and dentists can legally use hemp-based CBD oil in all states, as long as the oil is THC-free. But researchers are finding that some CBD oils contain THC even though they’re labeled THC-free. One study by Dr. Mallory Loflin published in JAMA discovered that 21 percent of the 84 CBD oils they tested contained THC.
If a pharmacist or dentist uses CBD oil with THC, there is a risk that could trigger a positive drug test. If your state or employer prohibits marijuana use, you could be fired, refused employment, or disciplined for a failed drug test.
For those who work in a drug-free workplace or live in a state that prohibits marijuana use, it is essential to research the CBD products you use to ensure they don’t contain THC. The FDA does not regulate CBD, and packaging claims can be unreliable. Vaping or otherwise using certain CBD oils with THC in them could put your license and career at risk.
6) Do dental and pharmacy colleges require drug tests?
Most pharmacist and dental school programs require drug screen testing during the admission enrollment process or later before clinical rotations. The requirement stems from the fact that schools must maintain compliance with the Joint Commission on Accreditation of Healthcare Organizations.
U.S. pharmacy colleges and schools usually also obtain a criminal background check of applicants once they’ve been given conditional acceptance. The American Association of Colleges of Pharmacy has developed a PharmCAS-facilitated pharmacy drug screening program through Certiphi Screening, Inc. The list of participating pharmacy colleges can be found here.
Because dental school programs include clinical rotations that involve students in the delivery of health care, dentist students are required to pass a drug screening test to participate. Students with a positive drug screen can be barred from clinical rotations that would make it impossible to fulfill the requirements to obtain their degree.
Some colleges perform hair follicle drug tests to search for longer-term drug use. Positive tests involving prescribed medications typically require a review of the supporting prescription.
7) Can a pharmacist or dentist with a green card or visa use marijuana?
Dentists and pharmacists that are visa or green card holders are prohibited from legally using marijuana because of federal immigration laws, even when legal under state law. Noncitizens are subject to federal law that considers possession or use of marijuana illegal, even with a medical card.
While legal states do not require that marijuana users are U.S. citizens, using marijuana can put your federal permanent resident status at risk. If convicted for a violation of federal law relating to marijuana use or any other controlled substance (except simple possession of 30g or less of marijuana), green card and visa holders can become deportable. (USCIS policy)
The firm provides compassionate and effective license defense for all healthcare workers, including dentists, pharmacists, doctors, nurses, and chiropractors.
Attorney Robert Weinberg is a former government prosecutor with over 50 years experience handling professional license, DEA, federal, and state criminal matters. Robert is an authority in the complex intersection of administrative licensing and criminal law for professional licensees and healthcare corporations. He has handled more than 5,000 cases, administrative hearings and court trials.
This information does not constitute legal advice and does not create an attorney/client relationship. No representations are made as to the accuracy of this information, and appropriate legal counsel should be consulted before taking any actions. Contact us for a consultation regarding your case facts.
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