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Medical Cannabis and Employment

Written by Rob Eckwall | Mar 26, 2025 6:30:00 PM

Missouri Amendment 2 passed on Election Day 2018, legalizing the use of medical cannabis for qualifying patients. At the time, Missouri was one of 33 states permitting its use. As of February 2025, medical cannabis is now legal in 39 states. However, this shift in legalization raises important questions about medical cannabis in the workplace, workplace safety and compliance.

In this Ask the Expert, I’ll answer employers’ most frequently asked questions about the effects of medical cannabis on workplace safety and productivity.

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Does Marijuana Use Increase Workplace Injuries?

Employers cite safety as one of their top concerns when evaluating the impact of medical cannabis and employment policies. Marijuana affects the central nervous system, altering sensory perception, thought formation, short-term memory and cognitive processing.

Physically, it impairs motor coordination, balance and reaction time. Some individuals may also experience hallucinations, anxiety or panic attacks.

According to the Occupational Safety and Health Administration (OSHA), multiple studies link cannabis use to an increased risk of workplace injuries. 

How many people are injured or die from cannabis? 

Research suggests that positive cannabis tests after workplace accidents have risen steadily since legalization. In 2023, post-accident cannabis positivity in the U.S. workforce reached 7.5%, the highest rate on record.

Further research into cannabis’s effects on workplace safety reveals that cognitive impairment can last up to 10 hours, depending on consumption method and potency. A prescription for medical cannabis does not grant an employee the right to compromise workplace safety.

What Does Marijuana Limit the Body’s Ability to Do?

Marijuana impacts various physical and cognitive functions critical to workplace safety. Some of the most concerning effects for employers include:

  • Impaired judgment and problem-solving

  • Reduced motor coordination and slower reaction times

  • Decreased ability to judge distance and space

  • Sedation and drowsiness

  • Increased risk of anxiety, panic attacks or hallucinations

These limitations pose significant safety risks, particularly in industries that require operating machinery, driving or handling hazardous materials.

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Can Employees Consume Medical Cannabis in the Workplace?

No. According to Fisher Phillips, Missouri law explicitly prohibits public cannabis consumption in any form, including smoking, vaping, edibles or oils. Workplace policies should clearly outline this restriction to ensure compliance and minimize liability.

Can Employers Maintain a Drug-Free Workplace?

Yes, Missouri employers can still maintain a drug-free workplace, even if some employees have medical marijuana prescription cards. 

Fisher Phillips explains, “Amendment 2 provides a safety net for employers, prohibiting employees from filing claims against Missouri businesses for wrongful discharge, discrimination or similar actions based on the employer prohibiting the employee from being under the influence of marijuana while at work or disciplining the employee for working or attempting to work while under the influence of marijuana.”

Additionally, employment and medical cannabis regulations apply to specific industries:

  • Department of Transportation (DOT) Employees: Marijuana use is strictly prohibited, both on and off duty.

  • Federal Contractors: Must comply with the Federal Drug-Free Workplace Act.

  • Safety-Sensitive Positions: Employees in roles where impairment could endanger lives must remain free from any impairing substances, including legal prescriptions.

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Are Medical Cannabis Users Protected by the ADA?

No. Since cannabis remains illegal under federal law, it is not covered under the Americans with Disabilities Act (ADA). Even in states where medical cannabis is legal, employers are not required to accommodate its use.

A Final Note

With evolving attitudes and laws surrounding medical cannabis, employees may underestimate cannabis’s risks. However, when it comes to employment policies and medical cannabis, workplace safety remains paramount. Employers should proactively update policies, educate employees, and enforce safety regulations to mitigate risks.

Axcet HR Solutions is your trusted partner for navigating workplace safety and compliance in a changing legal landscape.

No Legal Advice

This content is for informational purposes only and does not constitute legal advice. For specific legal concerns, consult a qualified attorney familiar with employment law and medical cannabis regulations.