Medics with prescribed marijuana

[anonymou55]

Here's a good one I've read from medics both American and Canadian. A current medic is prescribed medical marijuana by his MD for insomnia/sleep-aid due to stress. And it is used as prescribed (sleep aid ) i.e.: never before a shift. Appropriately. Would they suffer any consequences? Considering your MD suggested it for you, no different than being prescribed pills.

Opinions from medics working in Canada?

 

[Anjel]

Here's a good one I've read from medics both American and Canadian. A current medic is prescribed medical marijuana by his MD for insomnia/sleep-aid due to stress. And it is used as prescribed (sleep aid ) i.e.: never before a shift. Appropriately. Would they suffer any consequences? Considering your MD suggested it for you, no different than being prescribed pills.



Opinions from medics working in Canada?

This should probably have it's own thread so it doesn't get lost.

 

[Chimpie]

This should probably have it's own thread so it doesn't get lost.

Done.

Here's a good one I've read from medics both American and Canadian. A current medic is prescribed medical marijuana by his MD for insomnia/sleep-aid due to stress. And it is used as prescribed (sleep aid ) i.e.: never before a shift. Appropriately. Would they suffer any consequences? Considering your MD suggested it for you, no different than being prescribed pills.

Opinions from medics working in Canada?

This is borderline asking for legal advice which is against our rules...

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... but I'll allow it for the time being since this is a relevant time for the discussion. As marijuana becomes more legally available, all employers (inside and outside the EMS industry) will have to start discussing this and start writing policies.

 

[TransportJockey]

As it stands if you test positive for it, with our without a script, you're probably going to be terminated.

 

[Drax]

As it stands if you test positive for it, with our without a script, you're probably going to be terminated.

Citizens would question the provider's ability to make sound judgments and treat patients appropriately. Even more so if the paramedic was a firefighter as well. It is the media and also tradition, regardless of its use (and benefits-if there are any), that will prevent this from being acceptable.

Can one be tested for immediate marijuana use? Like a comparable BAC? If not, besides the provider, or who is to prove that it was used prior to a specified time constraint or after?

Personally, I think the purpose it was prescribed for can be and has been treated by other means.

 

[TransportJockey]

Citizens would question the provider's ability to make sound judgments and treat patients appropriately. Even more so if the paramedic was a firefighter as well. It is the media and also tradition, regardless of its use (and benefits-if there are any), that will prevent this from being acceptable.

Can one be tested for immediate marijuana use? Like a comparable BAC? If not, besides the provider, or who is to prove that it was used prior to a specified time constraint or after?

Personally, I think the purpose it was prescribed for can be and has been treated by other means.

It also is not under the FDA system as anything other than a schedule 1, so federally it's illegal. And we do fall under some federal regs, like DOT.

 

[Anjel]

Let's say it was federally legal.

What's the difference between people taking Vicodin and working or those smoking marijuana the day before a shift.

I think it's gonna be a huge grey area. EMS providers should probably try and avoid marijuana use at all costs. There are other alternatives that just aren't as "cool".

 

[Tigger]

Citizens would question the provider's ability to make sound judgments and treat patients appropriately. Even more so if the paramedic was a firefighter as well. It is the media and also tradition, regardless of its use (and benefits-if there are any), that will prevent this from being acceptable.

Can one be tested for immediate marijuana use? Like a comparable BAC? If not, besides the provider, or who is to prove that it was used prior to a specified time constraint or after?

Personally, I think the purpose it was prescribed for can be and has been treated by other means.

I'm not sure how being a firefighter makes it any better or worse...

That said, there is a swab test in development to show current levels but there is no incentive for anyone to begin using it. It's still Schedule 1, so any trace of it in your system is considered illicit.

Most companies drug test in the way their insurance wants it done, and I doubt a huge company like VFIS or something would develop separate plans for 2/48 states.

 

[PotatoMedic]

Some employers test for nicotine because while employed for them they are not allowed to use it. It is perfectly legal drug. Over the counter even! But the employer can say yes or no to it. Also let's say you had teeth pulled. Your Dr gives you a script for hydromorphone. You take it and not before :censored::censored::censored::censored:. If something happens and you test positive your still at fault. Even though it was legal.

I know a lot of PD that refuse to take narcotics for pain because they cannot work if there is even a trace of the medication in their system.

TLR. Don't do drugs and work. Even legal ones.

 

[anonymou55]

Exactly, medical marijuana is increasingly becoming more acceptable and available. I know in the US the federal laws trump a states legal standpoint. However in Canada medical marijuana is quickly gaining popularity as it is a natural plant opposed to taking pharmaceuticals. As a medic I believe in the wonders of modern day medicine, however when a natural substance works then, why choose man made. After all, as someone mentioned above taking a Vicodin the day before a shift should be no different then using a small amount of medical marijuana to alleviate stress. I'm sure a lot of medics enjoy a cold beer after a hard shift, alcohol has worse long term effects on the body. Again, presuming in the future when medical marijuana is available nation wide or even as far as regulated/taxed as alcohol. Some people had mentioned the medics reliability would be questioned. He/she would not be under the influence while on duty, presuming they use strictly as prescribed. I personally don't see anything wrong with this. Again presuming it is treated appropriately there for not effecting their duties.

 

[Drax]

Let's say it was federally legal.

What's the difference between people taking Vicodin and working or those smoking marijuana the day before a shift.

I think it's gonna be a huge grey area. EMS providers should probably try and avoid marijuana use at all costs. There are other alternatives that just aren't as "cool".

To answer your question, you're not even really supposed to take Vicodin and work.

"This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages." - WebMD

 

[Drax]

Exactly, medical marijuana is increasingly becoming more acceptable and available. I know in the US the federal laws trump a states legal standpoint. However in Canada medical marijuana is quickly gaining popularity as it is a natural plant opposed to taking pharmaceuticals. As a medic I believe in the wonders of modern day medicine, however when a natural substance works then, why choose man made. After all, as someone mentioned above taking a Vicodin the day before a shift should be no different then using a small amount of medical marijuana to alleviate stress. I'm sure a lot of medics enjoy a cold beer after a hard shift, alcohol has worse long term effects on the body. Again, presuming in the future when medical marijuana is available nation wide or even as far as regulated/taxed as alcohol. Some people had mentioned the medics reliability would be questioned. He/she would not be under the influence while on duty, presuming they use strictly as prescribed. I personally don't see anything wrong with this. Again presuming it is treated appropriately there for not effecting their duties.

Why would natural be better for you than man made? I mean I can think of situations for preference of either forms of medicine. Smoke is still smoke. Honestly, I'll take the same stance on alcohol as anything else. A little bit, may not do a lot of damage, but a great deal of anything certainly can. Even cigarettes or caffeine.

I'm not saying this should be a disqualifier or application for termination of employment, but if you are a chronic user of OTC medications, controlled substances/medications (including alcohol), or the addicted to legal substances and drugs, you really should take a step back and do a simple self eval for being fit for duty. After determining that under this circumstance that you're good to go, do you think 10 times out of 10 the next guy would be? Would you feel completely ok with admitting to doing these things at a physical health examination or is it something you would not bring up even if asked?

As previously stated, no one SHOULD be taking vicodin before a shift, it is as negligent as having a beer before taking a drive. Under the influence is under the influence and should not be based on levels in blood, urine, saliva, or otherwise. You know what you're doing is wrong-there isn't a grey area.

Professionalism isn't limited to EMS for me. Would taking vicodin or medicinal marijuana be acceptable for all professions? Say 8 hours before flying a passenger airplane? 12 hours before engaging in a fire fight against an enemy in combat?

My answer is, I would prefer someone to not be reliant on any particular substance/medication/drug at all.

 

[Drax]

I'm not sure how being a firefighter makes it any better or worse...

That said, there is a swab test in development to show current levels but there is no incentive for anyone to begin using it. It's still Schedule 1, so any trace of it in your system is considered illicit.

Most companies drug test in the way their insurance wants it done, and I doubt a huge company like VFIS or something would develop separate plans for 2/48 states.

Doesn't make it any better or worse in terms of responsibility, just the concept that fire is paramilitary and it is more of a media thing. Private companies versus government. One doing drugs makes the company look bad as opposed to the entire public safety/government system looking bad. In the end, it is equally as bad, just difference in public view.

 

[Anjel]

No but here if you test positive for narcotics and have a script it is ok. People work while taking pain medication all the time.

Same with adderall. You will test positive for amphetamines. But it's ok if you have a script.

 

[Drax]

No but here if you test positive for narcotics and have a script it is ok. People work while taking pain medication all the time.

Same with adderall. You will test positive for amphetamines. But it's ok if you have a script.

Right, well, I don't honestly don't know the situation with Adderall or amphetamine salts. My guess, since it is given to students and to professional football players, it is probably more welcome in the work place.

But yeah you're right, if you get tested and you have opiates in your system, in most cases, nothing comes of it if you have a prescription for it, at least, in the military.

It should probably accompany a serious injury or recent dental work though. I would be shocked to find a work place that relied on individuals to be in their best physical condition as a condition of employment to accept chronic use of narcotics.

 

[DrankTheKoolaid]

Your going to get termed with or without a recommendation from an MD.

Due to a lack of a fail safe method of testing for acute intoxication vs chronic storage of the metabolite any positive will be construed as acutely under the influence

 

[Tigger]

Doesn't make it any better or worse in terms of responsibility, just the concept that fire is paramilitary and it is more of a media thing. Private companies versus government. One doing drugs makes the company look bad as opposed to the entire public safety/government system looking bad. In the end, it is equally as bad, just difference in public view.

I work for a government agency with a rank structure. We don't do anything fire related. I have many friends who work for similar systems.

The public view is the same, there is no difference.

Sorry, I'm just sick of people talking about how much more the public cares about the FD. Here they care about EMS first, fire second, and for good reason.

 

[LACoGurneyjockey]

I know a medic who is constantly on a significant amount of opiate pain medication for a lingering back injury. This is when he's working, when he's at home, when he's driving, and the very rare occasion he operates heavy machinery...
Why is it that this is acceptable but someone smoking marijuana before, or in this case during, a shift is unacceptable. Personally, I don't think either have any place in this industry, and if that's what you need to function thru a shift you shouldn't be working. That's a career ending back injury, not a reason to be constantly in a diluted mental state.
And god forbid he doesn't have his norco for a few hours, as there's just no way he can function even as a marginally competent medic without it. Why is this even a discussion? Does anyone think it's ok to be drunk at work, even if I'm just a little buzzed? But because a doctor prescribed it (maybe the same doctor that was doing compressions on a conscious patient last week) there's nothing anyone can do about it.

Sorry, I'm just sick of people talking about how much more the public cares about the FD. Here they care about EMS first, fire second, and for good reason.

Drax, Tigger, can this be a separate thread where we just blatantly and unprofessionally bash firefighters? In good taste, of course... Strange how few of our calls actually involve a patient on fire.

 

[Drax]

I know a medic who is constantly on a significant amount of opiate pain medication for a lingering back injury. This is when he's working, when he's at home, when he's driving, and the very rare occasion he operates heavy machinery...
Why is it that this is acceptable but someone smoking marijuana before, or in this case during, a shift is unacceptable. Personally, I don't think either have any place in this industry, and if that's what you need to function thru a shift you shouldn't be working. That's a career ending back injury, not a reason to be constantly in a diluted mental state.
And god forbid he doesn't have his norco for a few hours, as there's just no way he can function even as a marginally competent medic without it. Why is this even a discussion? Does anyone think it's ok to be drunk at work, even if I'm just a little buzzed? But because a doctor prescribed it (maybe the same doctor that was doing compressions on a conscious patient last week) there's nothing anyone can do about it.

There should be a company physician (for every type of agency) who screens any member taking medication that was not prescribed by that physician. That physician should make the fit for duty call. If you were placed on narcotics by an outside provider, you should then, be upfront about it.

Additionally as a means to deter this from being kept quiet by the individual. Randomized mandatory drug screening. A positive finding followed by a request for records from an outside provider by the company physician if not prescribed by him. This should be a condition of employment.

 

[Drax]

I work for a government agency with a rank structure. We don't do anything fire related. I have many friends who work for similar systems.

The public view is the same, there is no difference.

Sorry, I'm just sick of people talking about how much more the public cares about the FD. Here they care about EMS first, fire second, and for good reason.

I am referring to any government owned agency, it is just the standard, at least where I am from and many places I'm familiar with do not have government owned EMS except through Fire.

I even clarified here that I was referencing privately owned EMS:

Doesn't make it any better or worse in terms of responsibility, just the concept that fire is paramilitary and it is more of a media thing. Private companies versus government. One doing drugs makes the company look bad as opposed to the entire public safety/government system looking bad. In the end, it is equally as bad, just difference in public view.

If you were government owned, it would look just as bad.

If two articles were to be published in the paper, one being drug/substance abuse by an EMT working for a private agency and another by a member of a fire department who was an EMT, which do you think would gain the most attention by the public?