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Drug legalization trend continues; safety advocates wary

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Election day saw another wave of marijuana legalization, with voters in four states joining the ranks of the 11 states that had already approved recreational marijuana and voters in two states approving medical marijuana.

While Arizona, Montana, New Jersey and South Dakota are now allowing for recreational marijuana, voters in South Dakota also approved medical marijuana, as did voters in Mississippi.

Psilocybin, often referred to as magic mushrooms, is new to the legalization stage, with Oregon approving the psychedelic drug for mental health conditions and Washington, D.C., decriminalizing its possession or use. Oregon voters also made the possession of small quantities of cocaine, heroin, methamphetamines and other drugs a civil violation subject to a $100 fine, but no jail time.

Workplace safety advocates are calling on employers to take note, as drug test positivity is on the rise. Quest Diagnostics Inc. in August released its annual assessment, finding that the percentage of positive marijuana drug tests among workers rose by 11% across nearly all employee testing categories in 2019 to the highest rate in 16 years.

“Regardless of the legality of the substance — this goes for alcohol, too — any sort of substance use, alcohol or heroin, if it impairs, it is a threat to workplace safety,” said Rachael Cooper, Madison, Wisconsin-based senior program manager of substance abuse for the National Safety Council. “Employers have the right to maintain a substance-free workplace. Period.”

“Our blanket recommendation to employers in any states, whoever your legal person is you must work with them to update drugfree workplace policies,” Ms. Cooper said. “States are going to be building programs as we go, so it’s going to be important to consult with legal.”

Jennifer Mora, San Francisco-based senior counsel in the labor and employment practice of Seyfarth Shaw LLP, said employers can no longer lean on blanket drugfree workplace policies.

“The election this time, with so many states with recreational, it sends a message to employers: They have to start taking note and being mindful of what their policies are,” she said. “You see all kinds of policies; some say, we are a drugfree workplace and we want everybody to be safe, and it is very generic, and some get specific into the state law nuances into drug testing.”

While “everybody’s policy is going to be different,” the latter is where an employer wants to be, Ms. Mora said, adding that when it comes to provisions in state disability discrimination laws, medical marijuana laws complicate the issue.

“With the proliferation of these laws … as employment lawyers we have to partner with accommodation experts, who can look at the disability discrimination laws,” she said.

The courts haven’t been one-sided on whether a worker can be fired for a positive drug test stemming from state-authorized medical marijuana: At least one court decision, in Massachusetts, found the worker is protected by federal ADA, while decisions in other states — Washington, Montana  and California — said no protections exist for a drug that remains illegal on the federal level.

At least one medical marijuana state is attempting to clear the confusion: Pennsylvania lawmakers earlier this month introduced S.B. 1360, a bill that states that an employer may make an adverse employment decision against an employee “if the employee’s use of medical marijuana decreases or lessens the employee’s job performance or ability to perform the employee’s job duties, and the employer shall not be in violation” of the state’s marijuana law.

Those in the workers compensation industry are also bracing for more changes, as the green wave of marijuana legalization continues despite the federal Controlled Substance Act, which classifies marijuana as illegal, with no medicinal value, similar to cocaine and heroin.

A major question on the treatment side is: Are payers going to be on the hook for medical marijuana? It’s a mixed bag, according to the courts. Some states — New Jersey and New Mexico — have indicated yes. Others — Maine and Massachusetts — have said no.

Taking the issue further, New Mexico in 2018 put medical marijuana on the fee schedule and New Jersey lawmakers in October advanced a bill — A.B. 1708 — that would require insurers to cover the costs of medical marijuana.

“When you look at what has already happened and the conversations around the country, there are a large number of (workers comp) payers that are reimbursing voluntarily or open to it, without any state mandate requiring them to do so,” said Mark Pew, Atlanta-based senior vice president of product development and marketing for pharmacy benefits manager Preferred Medical, who has been tracking marijuana’s emergence in the comp realm.

Mr. Pew said that comp payers are finding anecdotally that medical marijuana has replaced other drugs prescribed under workers comp for such issues as pain, and are going case by case on whether they will reimburse.