Got A Positive Drug Test? Who Has The Final Word On Medical Marijuana?

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If one gets tested for marijuana, the Medical Review Officers (MROs) have the final say in declaration whether the person was consuming marijuana or not. Another essential role of an MRO is to verify any legal explanation a person provides for consumption of marijuana, for example, a prescription by a certified doctor for a specific medical condition.


All drug tests mandated federally (e.g., under the Department of Transportation regulations) involve an MRO for their defensibility and employee privacy protections. The steps of federal testing protocols include the following steps:

  1. An employee has to provide a urine specimen at a constrained collection site.
  2. The specimen is sent to the federally certified laboratory under specific protocols for testing. A portion of the sample undergoes a scientific analysis that is 92-98% accurate.
  3. Suppose the specimen is positive at this initial level of analysis. In that case, it goes through a final testing process called gas chromatography/mass spectrometry (GC/MS) to scan for the chemical impression of the drugs indicated in the examination. If the drug or its remnants are present at or above the average level, then the specimen is declared positive for the drug.
  4. However, before informing the employer or the employee about the scientific results, one final check is performed. An MRO reaches out to the employee and asks him/her if s/he has a verifiable reason for the drug in question in the employee's system. And verify if the cause is legitimate and valid. The test will be declared "negative" if the employee has a verifiable, legitimate reason and positive if not.

For the drug testing for marijuana, the variance of medical marijuana laws complicates the idea for employers. Marijuana is still illegal under governmental law, state, and even local laws. What could be considered a legitimate reason for having marijuana in one's system can be pretty confusing. However, the MRO's role for a federally required test remains the same. If the MRO can verify the reason for marijuana intake by the employee, the test is declared negative.

But in the case of non-mandatory tests in a state that has legalized medical marijuana, employers should have a detailed written protocol for their employee's position and medical use. The supervisors and employees get to know their companies policies regarding drug use, drug testing, and outcomes.

If a non-mandated workplace wishes to jump marijuana test for employees with a medical prescription of marijuana, they have got two options. First, the organization can drop marijuana testing from the list of drugs to be tested. And second, they could keep marijuana testing on the list and, in case of a positive test, follow the actions stated in their policy for responding to an employee's claim of using marijuana because of medical advice.

MROs don't wish to open themselves up to potential liability involving medical marijuana. Because of the significant variations between federal, state, and local regulations, accurately verify a medical marijuana prescription's credibility can become a very involving task for the MRO.

For non-mandated testing in a workplace, employers must adopt a 3-step protocol. Two steps of this protocol mimic federal testing requirements, i.e., testing for marijuana in the system and waiting for an MRO to review. Additional policy and procedural directives in writing address the organization's stand on marijuana along with these steps.

  1. Keep marijuana in the testing panel.From a safety perspective, keeping marijuana in the testing panel is a responsible action. Marijuana abuse is getting prevalent these days, and as everyone knows, marijuana abuse can have serious results. To restrict and contain exposure, employers need to continue testing for marijuana to show diligence in their efforts to provide a safe workplace.
  2. Invest in an MRO in the test review process.Involving an MRO in the test review process limits the information an employer receives directly from the employee. Following a positive test, the test will be ruled positive without a confidential exchange between the employee and the MRO. Unfortunately, when employees are informed about their positive test, they often panic and yell out about the medical illnesses being treated with the drug. This can set the employer at risk for various complications like confidentiality, prejudice, and responsibilities for agreement among them – because they now know of a medical condition that the employer may not have a business-related reason to know. Hearing this information and discerning its business importance is best done by a medical professional, the MRO.
  3. Specific guidelines enunciated, in writing, about actions that will result following an MRO declaration of a positive marijuana test. Non-mandated employers willing to accept a medical marijuana prescription and excuse the positive test need to engage, in writing, steps to be taken after the positive test result. These guidelines will likely denote marijuana prohibition for any safety-sensitive positions or activities in the organization. For other employee roles, organizations should include policies around receiving and confidentially filing a copy of the patient's verification card along with documentation around these questions:
  • Is it required for the employee to have marijuana measurably in his/her system during working hours?
  • Have other alternatives like talking to the employee and his/her physician to find alternative treatments that are federally legal?
  • Does the type and stage of the disease require other accommodations, such as reduced or altered duties or a reduction in employment status?
  • What is the company's legal responsibility in accordance with their state's marijuana laws?
  • The effect of request to accommodate medical marijuana on other employees?
  • What are the implications if the organization refuses to accept a medical marijuana prescription?

Can you pass a drug test with a medical card?

The legal use of marijuana, be it medically or recreationally, varies from state to state. It is however still illegal according to federal law. In 36 states, including the District of Columbia, and the territories of Guam, Puerto Rico, and the U.S. Virgin Islands, use of marijuana for medical reasons legally is permitted for those dealing with epilepsy or certain other illnesses. In order to use marijuana legally, one needs a recommendation or prescription from a certified doctor, legally appointed by the state to prescribe medical marijuana & nbsp.

In some states like Alaska, Arizona, Californiaadults can legally use cannabis recreationally.

These evolving laws regarding marijuana use can create challenges for lawmakers and employers who test applicants and employees for drug use.

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