Written by W. Ronald Moffitt, M.D.
CBD (cannabidiol) and marijuana use is a hot topic in the workplace right now. Pardee @Work recently hosted a well-attended seminar for employers on this subject.
According to some recent surveys, one in 13 workers reports using CBD products. CBD use is growing so rapidly it is going to affect nearly every industry in some fashion. Researchers estimate it will be a $22 billion industry by 2022, and that 10 percent of the United States population will use CBD by 2025.
According to the most recent federal study on drug use (from 2015), 33 million American adults have used marijuana in the last year. This number may be higher since 33 states have now legalized marijuana either for medical or recreational use.
In North Carolina marijuana is still illegal, while CBD derived from hemp is legal, provided it isn’t packaged in food products or sold with specific health claims.
What is the Difference Between CBD and Marijuana?
It’s important to note the difference between CBD and a substance called tetrahydrocannabinol (THC). Both CBD and THC are found in cannabis plants. THC is the main psychoactive component of marijuana, which gives people a “high.” CBD, while also an active ingredient in marijuana, does not cause the euphoria or intoxication.
There are two cultivars of cannabis: hemp, which contains more CBD and less than 0.3 percent THC; and marijuana, which contains less CBD and more than 10 to 20 percent THC.
CBD products can be legally produced from the hemp plant, while marijuana comes from the marijuana plant.
Why is CBD so Popular?
People use CBD for pain, anxiety, depression, cancer, acne, heart disease, substance abuse, insomnia, and anti-inflammatory purposes. While there is evidence that CBD helps treat certain forms of epilepsy, more research is needed to know if CBD is beneficial for other conditions.
CBD comes in dietary supplements and other preparations, including oils, creams, lotions, capsules, pills, edibles (like gummy candies), and vaping liquids. There is also one FDA-approved medication called EPIDIOLEX for specific types of childhood epilepsy.
One thing to consider, though, is that we don’t know if CBD can alleviate health issues. There is little substantive data to prove it works.
What are the Risks of using CBD Products?
Along with the lack of research on CBD’s purported benefits, there is a lack of regulation, oversight, and uniform controls of CBD products. Other than EPIDIOLEX, CBD products are not regulated by the FDA. This means there is a wide variation in quality and differences in the extraction process.
My advice is, “buyer and user beware.” It’s an uncontrolled industry right now.
Many CBD products are inaccurately labeled, meaning they could potentially contain higher levels of THC than listed, which could lead to a positive drug test. In a 2017 study published in the Journal of the American Medical Association (JAMA), researchers found that out of 84 samples of CBD products, 18 contained significant amounts of THC.
Additionally, this study found that 43 percent had less than the labeled amount of CBD, 26 percent had more than the labeled amount of CBD, and only 31 percent were accurate as to the amount on the label.
Fortunately, few side effects are reported with low doses of CBD. Most products contain doses that are quite small because CBD is so expensive. When people experience adverse effects, the symptoms are usually nausea, diarrhea, or headache. Drug interactions with prescription medications or liver abnormalities are possible with higher CBD doses.
Can CBD use Lead to a Positive Drug Test?
This is a major concern for employees and employers alike.
Generally speaking, if an employee uses a CBD product and then undergoes a drug screening, it is highly unlikely they will test positive for marijuana. The drug test detects the compound the body creates after exposure to THC. That said, as noted above, some CBD products contain more THC than they indicate on the label. While rare, studies have shown it is possible for lower levels of THC to build up in the body over time, which could lead to a failed drug test.
One local industry did their own testing of CBD products with a few employees who use CBD, and indeed, one employee had a positive drug test for marijuana.
The window for a positive THC test is two to three days after a single marijuana use, two to five days if you use it three times per week, and two to four weeks if you use it daily.
Marijuana: To Test or Not to test?
We are seeing a trend of employers discontinuing drug screenings for marijuana. While marijuana is still illegal in North Carolina, many industries are reconsidering their policies because it costs them too many employees. With a low unemployment rate, it’s hard for many businesses to find new employees these days.
There are pros and cons for employers who discontinue drug testing. Some industries with workers in high-risk positions (such as interstate truck drivers) are required to continue testing. Additionally, employees in high-risk or safety-sensitive positions may be at risk for injury or accidents with marijuana use.
Marijuana can stay in the system much longer than alcohol. One single use can still be detected in a urine screening three days later. So, if an employee smokes marijuana on Friday night, they could have a positive test on Monday. Employers have to ask if they want to fire an employee in that situation.
Making this issue even more complex is the fact that it is difficult to establish a norm for marijuana-related intoxication levels because marijuana’s effects vary from person to person, depending on how often they use the substance.
There are no published guidelines for the quantitative levels of THC in the blood. While we know a blood alcohol content of .08 percent means a person is legally intoxicated, there is no correlation between blood THC levels and impairment.
It is a Complicated Issue.
As marijuana is legalized in more states, either for medical or recreational use, legal questions arise regarding testing in the workplace for a legal substance, with different interpretations regarding state laws versus federal laws.
This issue is going to be difficult for employers and lawmakers to sort through. It will be interesting to see how CBD and marijuana laws and regulations develop in the future.
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