[MCOH-EH] Marijuana and impairment

[Rudnick, Howard L]

Neither marijuana or narcotics measure impairment. Individuals on narcotics who have a prescription for those narcotics may not be i
Impaired. I. This is true of marijuana and it is true of narcotics and other controlled substance We consider impairment based upon the behavior in the unit and the physical examination at the time the individual is sent for  a fitness for duty A positive marijuana test at that time would not in a self indicate impairment but it would be taken into account in terms of the totality of the circumstances.


Howard

Howard L Rudnick, MD, MHA, FACP
Clinical Professor of Medicine,
Medical Director,
Temple University Health System



From: "mcoh-eh-request at mylist.net<mailto:mcoh-eh-request at mylist.net>" <mcoh-eh-request at mylist.net<mailto:mcoh-eh-request at mylist.net>>
Subject: MCOH-EH Digest, Vol 257, Issue 164
Date: 04 August 2022 15:00
To: "mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>" <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>

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Today's Topics:

1. Cannabis testing reply (Jonathan Rosen)


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Message: 1
Date: Wed, 3 Aug 2022 18:53:59 -0400
From: Jonathan Rosen
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Subject: [MCOH-EH] Cannabis testing reply
Message-ID:

Content-Type: text/plain; charset="utf-8"

Cannabis testing does not measure impairment. The fact that the federal
government has listed Cannabis as a Schedule 1 controlled substance has
stifled research including on impairment. Best estimates are that
impairment lasts from 2 to 24 hours after smoking. Furthermore, other
sources of impairment include occupational factors that are not even
considered in assessing impairment. For example fatigue from working long
hours, 12 hour or double shifts, mandatory overtime can be very impairing.
Studies have shown fatigue to have similar effects to alcohol intoxication.
Work related pain such as low back pain from inadequate patient
transferring programs may also cause impairment. Stress from workplace
bullying, patient or visitor aggression, and chronic understaffing can also
cause significant impacts on worker health, well being, and performance.
Decades of evidence shows that increasing RN to patient staffing improves
patient outcomes, and yet California is the only state to have mandatory
ratios. A study by Leigh revealed a reduction in RN injuries after that
legislation passed. If we are really concerned with impairment, let's do
something about the root causes instead of blaming the victim. Cannabis,
unless it is used at work or a person has Cannabis Use Disorder, is low on
the list of factors that may impair healthcare workers.

--
*Jonathan Rosen, MS CIH*
AJ Rosen & Associates LLC
110 Benjamin St
Schenectady, NY 12303
Jrosen396 at gmail.com<mailto:Jrosen396 at gmail.com>
(518)225-0882
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