Employment rights: Workplace equality for medical cannabis patients

In this article, Releaf takes a look at medical cannabis in the workplace, where we speak to the experts and answer common questions about medical cannabis and employment. 

This is an interview with Mohammad Wasway of Sanskara Platform and the Cannabis Industry Council on the Employment Rights Report. We speak to him about medical cannabis at work and medical discrimination laws.

One of the direct ways that the CIC are working to benefit the lives of patients prescribed medical cannabis is to provide harm reduction information in areas where there is a potential infringement on their rights. This information may inform patients of their rights and how to exercise them. However, it also provides relative legal information to people in a position of authority to consider when making decisions that may affect patients. 

Making a difference

The most recent publication from the CIC in this area of its campaigning work is the paper published on the 7th of September 2023 titled "The Use of Prescription Cannabis at Work - Guidance for Employees and Employers". This paper aims to encourage both patients who are employees and employers of patients with a legal medical cannabis prescription to cooperate. It suggests to employees how to talk to their employers and how much information they are legally required to disclose. 

The paper indicates which laws specifically relate to patients' rights when using medical cannabis whilst at work, how employers can avoid discrimination, how reasonable adjustments can be made and what they might look like. These boil down to The Equality Act 2010, protecting disability; the Misuse of Drugs Act 1971, which has provisions to allow people to possess controlled substances with a legal prescription; and the Health and Safety at Work Act 1974, which puts the burden of responsibility on the employer to create a safe work environment. 

"Under the Equality Act 2010[3.5], employers have a legal obligation to make reasonable adjustments for an employee who is disabled in certain circumstances. The Equality Act 2010 defines when a person is disabled. However, ultimately, only an Employment Tribunal can definitively determine whether a person is disabled within the meaning of the legislation. If there is a duty to make a reasonable adjustment, this may include using prescribed medicines at work. Where an employee is disabled and put at a substantial disadvantage due to particular circumstances in comparison to a person who is not disabled, an employer must take such steps that are reasonable to avoid the disadvantage or to provide relevant auxiliary aid. Employers must also comply with health and safety obligations and other regulatory requirements. An employer must also act with trust and confidence towards an employee."

We spoke with one of the report writers, Mohammad Wasway, from The Sanskara Platform, to learn more about the motivation behind the initiative and what kind of interactions patients have been having with their employers in the five years of legal medical cannabis. 

Medical cannabis and work: The Interview

What inspired you and Guy to write the report?

"When I started working part-time in a new retail job, I was concerned about mentioning it to my employer. Eventually, I did, and he took it upon himself to make sure he was willing to learn what he needed, go the extra mile, and take the additional training so he was fully aware of the legal parameters he needed to adhere to and knew what to do. I was inspired by this and decided that putting the information together for other employers and employees would be a good idea. There were many distressing stories from patients who had not had the same experience. I wanted to do something to prevent any harm and assist them in having a safer place of employment. If this outcome can occur for me, it can also happen for many others."

How did you approach writing the report?

"I started with reasonable adjustments and the Equality Act; that's where the ball started rolling. When I chatted with Guy Coxall from Seed Our Future, he included the human rights angles. He suggested other laws that needed to be considered. Ricardo Geada, a lawyer in the CIC, gave us a lot of specific legal advice to ensure the information we were passing on was legally accurate. The idea is to empower employers, not make them feel like this is an issue."  

Was there anything you learned that was empowering for patients whilst putting the paper together?

"There shouldn't be any differences in how patients with a medical cannabis prescription are treated based on their medications compared to any other patient. So many patients are taking medications that aren't cannabis-based that can be a lot more impairing than cannabis, and don't face the same stigma or scrutiny, so we just wanted to ensure that people get the same outcomes across the board.

I didn't learn anything new from writing the report per se, but when we were putting it together, it did reaffirm my belief in what we were doing; it's so important and needed for so many people. 

Employers have a legal responsibility to ensure the place of work's health and safety is adequate and legal and the right conditions are met for the employee - it's to ensure the employee doesn't come to harm. Ultimately, it is up to the employee to decide if they want to disclose the information. Many patients will fear that disclosing the information will potentially work against them; in reality, it could create a better work situation for patients because employers are often compassionate and want their employees to be happy because that is good for productivity.

I think there will still be discrimination even with this paper available. We can't police everything, but it should provide a tool to help employers provide the right provisions to create a better workplace for patients prescribed medical cannabis. And if people do suffer discrimination, hopefully, they will come across this paper, which can try and navigate the situation into a mutually agreed and legally acceptable outcome. 

It's a challenging subject when it comes to jobs involving driving or heavy machinery where drug testing is a legal requirement. Prescribers advise not to operate heavy machinery or drive when taking medical cannabis, but it can also come down to an impairment judgment. Employers can do risk assessments to see if they believe any reasonable adjustments need to be made, which could look like finding another role in the company for the employee if it is possible. Employers should state in job applications if they are unable to accept people on certain medications, which would make it hard for them to legally do the job due to insurance purposes."

Report realisations

Are there any anecdotal cases you can tell us about that had a positive outcome?

"From what I am hearing, there are a lot of cases where the disability protected under The Equality Act is being breached, and it's leaving a lot of employers dumbfounded on how to deal with it - but that's why we have provided this information. 

Employers can take on equality and discrimination training; we would like to implement the report as another training material and are happy to liaise with HR departments trying to become prescription cannabis literate. We want to ensure they can make a smooth transition should any of their employees require a prescription.

My advice is to be open. Think about it: if you need to administer during working hours and it isn't on your break, and you haven't told anyone, you can see that there will potentially be an issue where people mistake your use as illegal, and it creates a disturbance. It all comes down to the reasonable adjustments which can be more easily made than you might think. 

When speaking to employers, being confident about your medicine is best. We still have a long way to go in removing the stigma and normalising medical cannabis prescription use, but hiding it doesn't help. We need to help employers see cannabis as a normal prescription medicine. We don't need people being thought of as stoners by their employees because we are too scared to talk to them about it. They don't think you are into an illicit lifestyle if prescribed codeine, valium or Xanax. However, with cannabis, there is still the stigma that it is an illegal drug - but open conversations can reduce those associations. 

I advise people to give their employers to talk to HR and let them know what kind of training they can undertake. Give the CIC report to HR to open a dialogue with them and your employers, as this has all the relevant information. We have included a flowchart on how they can assess what actions need to be taken when an employee presents as needing reasonable adjustments for their legal medical cannabis prescription."

And another thing…

One last question before we wrap this up...Releaf have created a medical cannabis card for patients prescribed by us. The card contains all the details needed to satisfy someone in a position of authority, such as an employer or the police, that the cannabis patients have is legal and medical. What are your thoughts on this?

I feel like clinics needed cards a long time ago; it's just another tool for patients to prove they are legal despite the fact they aren't a legal requirement. The fact a clinic is providing a card is acceptable and is in line with what I've been informed by the Home Office. 

The future of medical cannabis in employment

Greater numbers of patients with a private medical cannabis prescription are expected in the next 18 months. The number of legally prescribed cannabis patients sits between 20 and 30,000 currently, but this could likely increase threefold by next year if industry expectations are met. With around 100,000 legal patients in the UK receiving mostly flower prescriptions, this will certainly increase the number of companies needing to assess conditions and adjust medical cannabis administration on work premises. 

FAQs about medical cannabis and employment. 

Can you use medical cannabis working in the UK?

Yes, you can use medical cannabis when working in the UK. You will need to have a prescription from a specialist doctor, and a dispensing pharmacy must supply the medical cannabis. 

Is it legal to do medical cannabis drug testing at work?

You must sign up for a drug testing policy at work for your employer to make you take a drug test. Even so, if you reject a test without a drug testing policy in place, it can still make your employer suspicious. If you have a prescription for medical cannabis, The Equality Act 2010 gives you rights that your employer must act by. If you drive to work, you should tell your employer. 

Is it safe to raise medical cannabis awareness among employees?

You are not obligated to tell your colleagues about your medical cannabis prescription, and you may wish to keep the information private if there is no need to disclose it. You may want other employees to know so they do not suspect you are involved in illegal activity, which may result in them reporting you to a manager. Some patients are advocates for medical cannabis and want to let other employees know so that they may take advantage of the law change. This is perfectly fine, but it isn’t for everyone, so be respectful of other people's opinions and don’t take offence if people pass judgement. Medical cannabis was previously illegal for over 50 years, and there is still a stigma that society needs to overcome. 

Is getting a job with a medical card in the UK possible?

Anyone who is legally prescribed medical cannabis in the UK can work legally. You do not need a card to get medical cannabis in the UK. Instead, you must book an appointment with a specialist doctor who will assess your need and prescribe cannabis-based medical products if they believe it is suitable to treat your diagnosis. 

Is there medical cannabis employee protection available?

Patients prescribed medical cannabis by a doctor in the UK are protected under The Equality Act 2010. The Equality Act defines when a person has a disability and requires employers to make reasonable adjustments to ensure patients can safely take their medicine according to other company policies and the health and safety of other employees. Employees who feel their employer is in breach of the Equality Act may take the case to an Employment Tribuanal. 

If medical cannabis is legal, can employers test for it?

If you have a job that requires you to drive or operate heavy machinery, your employer may want you to take a drug test to screen for multiple substances, one of which is THC. If you take a cannabis-based medicine daily, THC will more than likely show up on the screen as a positive. You should inform your employer that you have a prescription and provide the evidence before you are wrongly accused of taking an illicit substance. As a patient, you have rights protected by The Equality Act 2010, and your employer has the right to maintain health and safety at work. 

Does medical cannabis show up on a background check?

Having a medical cannabis prescription will not show up on any background checks or DBS searches.

Do I need a prescription to get a medical cannabis job in the UK?

You do not need to be a patient to work in the UK’s legal cannabis industry. Many companies in the medical cannabis sector welcome the experience that patients have to offer, but it is not a defining factor for getting a job in a legal medical cannabis company. 

Do you have to declare medical conditions to your employer?

Only if your condition affects your ability to do your job safely.

Can you lose your job on medical grounds?

If a long-term health condition prevents you from actually doing your job, or doing it safely, then your employer may have the right to fire you.

Employers must stick to fair procedures and consider reasonable adjustments (such as changing work hours or duties) before dismissal is discussed. This should be a last resort for employers and they must follow a fair process before taking any action.

Do I have to tell my employer about medical cannabis?

Just like with other prescribed medications, you don't have to tell your employer about your medical cannabis prescription unless your job specifically requires it. If your employer conducts drug testing, keep in mind that the THC in your prescribed medication will probably show up in the results.

Can I be fired for medical cannabis in the UK?

If you have a legal prescription, dismissal solely for taking medical cannabis will most likely be deemed discriminatory. Medical cannabis is protected under the Equality Act 2010, which requires employers to consider reasonable adjustments for health conditions, so they should treat it like any other prescription.

That said, if your medical cannabis prescription affects your ability to do your job or raises safety issues, your boss may have grounds to assess your capability.

Can employers see if you have a medical cannabis card or prescription?

No, employers cannot see if you have a medical cannabis card or prescription, but you may wish to tell your employer if you have a legal prescription if you think it will prevent any negative assumptions or action against you. The Equality Act 2010 provides protections for patients in the workplace. 

At Releaf, we believe that access to medical cannabis is important. That's why we offer tailored monthly packages based on your cannabis prescription, specialist consultations for medical cannabis, and a unique medical cannabis card for protection.