Employers donât have to be operating in states where marijuana is now legal to be impacted by its changing status. Cannabidiol, a compound derived from the cannabis plant, is already available legally in every U.S. state. CBD oil and products containing CBD are impacting workplace drug policies in ways that are still unclear.
Confirm BioSciences, a national provider of drug testing supplies and laboratory services, has issued a report on the effect of CBD. As the medical review officer of the organization, here I answer the most common questions employers ask about this increasingly popular substance.
Q: What exactly is CBD?
A: CBD, the shortened name for cannabidiol, is an extract from cannabis, the plant that produces marijuana. It can also be obtained from the hemp plant, another form of cannabis that has extremely low levels of THC, the substance that instills a high. Hemp became legal to grow commercially in every U.S. state in 2018.
Q: What are the legitimate uses for CBD? Are there any uses that can be prescribed by a physician?
A: From a scientific perspective, the only medical condition for which CBD has been approved is a certain type of seizure disorder. The medication is called Epidiolex, and it was approved in 2018. As far as other conditions for which medical providers may recommend CBD oil, the problem is that there have been a very limited number of medical studies, with conflicting results. Weâre simply not there yet in terms of scientific support.
Q: Will using CBD compromise employee performance in any way?
A; To answer this, we run into the question of whether the CBD is 100 percent pure, which is defined as containing less than 0.3 percent THC. If a product contains pure CBD, there should not be any employee performance issues. The challenge is that the vast majority of CBD products are not pure. Up to 70 percent of CBD products are mislabeled. According to a recent Journal of the American Medical Association study in which 84 different CBD products were analyzed, THC was present in 18 of the products in varying amounts.
Q: Are there any circumstances or occupations in which CBD should never be used by employees?
A: If the product used by the employee meets CBD purity standards, there should be no physical or mental impairment. The real issue is purity.
Q: How long will CBD stay in a personâs system?
A: It depends on the individual. For some, CBD oil will remain in the system for two to five days. For others it can take weeks to resolve. The typical time is around one to two weeks.
Q: If CBD is legal, why are workers using CBD-infused products failing drug tests?
A; The challenge with CBD in the workplace is that, either knowingly or unknowingly, people are using CBD tainted with THC. So people might be buying a product with CBD to help them sleep, and if that product also contains THC, it may be the THC that is impacting their sleep instead of the CBD.
Q: What can be done to ensure that CBD-infused products are pure and donât contain THC?
A: Currently no governing or regulatory body is tasked with ensuring the purity of CBD. The oversight just isnât there to ensure that when people are buying a CBD product, they are getting pure CBD oil. For workers and employers to be adequately protected, this situation has to change.
Q: If an employee using a CBD, or a CBD-infused product, fails a drug test, what then? Whose responsibility is it to determine if the employee hasnât violated workplace policies?
A: Itâs not the employerâs responsibility to ensure that drugs do not show up on an employeeâs drug screen. The employerâs role is simply to make sure that the chain of custody is intact. If the individual has signed documentation confirming that the sample provided is theirs and the sample was sealed in their presence, the employer should not be held liable.
There is another issue, however, due to the changing legality at the state level for recreational and medicinal marijuana. In states where marijuana is legal, a company may still be able to have a zero-tolerance policy (please refer to your state’s specific law regarding recreational and/or medical marijuana use). And for companies subject to federal standards, marijuana is still a Schedule 1 drug under the U.S. Controlled Substances Act. Itâs in those states in which marijuana has been legalized recreationally that a many employers look for guidance.
Q: What steps should employers be taking in regard to CBD?
A: For employers with a stated drug policy, it makes sense to educate their workers about the risks inherent in CBD oil. If they donât feel comfortable providing that information firsthand, they should partner with a qualified third party who can provide it. The employer should never put itself in the position of contradicting an employeeâs physician. That way if an employee is considering using a CBD product, they can discuss their employerâs drug testing program with their doctor.Â
Q: Should employers be concerned about the proliferation of CBD as a legal substance?
A: It would be wise for employers to educate their workers about CBD. The ultimate responsibility, however, lies with the employee. Itâs up to every individual to know exactly what theyâre putting in their body and what may happen as a result.
The phrase âdrugs in the workplaceâ understandably elicits an alarmed reaction from employers. But the truth is the amount of substances that are considered drugs are many and varied, and many are commonplace for an employeeâs daily routine.
Substance use abounds in the workplace â and thatâs just legal substances. Employees roll into work and canât get anything done without their daily dose of caffeine. Colleagues meet in the break room with cases of beer to partake in the regular happy hour. Someone anxious about an upcoming deadline picks up a CBD-infused coffee at breakfast or a CBD-infused burger for lunch. And donât forget about that roll of antacids or bottle of ibuprofen in the desk drawer or an energy drink in the fridge for a mid-afternoon pick-me-up.
In short, regulating substance use among employees is not simple and straightforward. Drugs like caffeine and alcohol are legal, but employers may get into trouble if an employeeâs alcohol consumption leads them to cause problems during the employee get-together.
Cannabis is still illegal federally in the United States as more states legalize it for medical and recreational purposes, causing confusion for employers who canât keep compliance straight among the constant changes. And, a recent surge of âsmart drugsâ â substances taken to improve creativity, attention, executive function and working memory â poses major ethical questions about whether itâs OK to take a mental steroid to be productive at work.
PRODUCTIVITY
Much has been made about college students taking medication to stay productive and awake, but that habit doesnât end at graduation.
People use cognitive enhancing drugs â also referred to as âsmart drugsâ â to improve their creativity, attention, executive function and memory. Much like athletes may use performance-enhancing drugs to improve speed and endurance, employees may use smart drugs to be productive at work.
âSome people start using them in college and then theyâre carrying that habit with them into the workforce. And things donât get easier when you go from college to the workforce,â said Nick Heudecker, vice president of research-data & analytics at Gartner.
The use of smart drugs isnât limited to an industry or economic status, Heudecker said. Even though Silicon Valley workers taking microdoses of lysergic acid diethylamide â more commonly known as the hallucinogenic LSD â to stay focused has received media attention, knowledge workers arenât the only ones taking part. âEvery workforce population is engaging in cognitive enhancement in some way,â Heudecker said.
ADHD drug Adderall is by far the most common smart drug, he said, followed by Ritalin, or methylphenidate. Modafinil, a narcolepsy drug, is another common cognitive enhancer. Energy drinks and caffeine â common parts of many peopleâs daily routines â are also considered smart drugs, according to Heudecker. And the over-the-counter dietary supplements called nootropics claim to improve peopleâs cognitive abilities, as well. Nootropics alone, according to Grand View Research, Inc., is a $2.17 billion market as of 2018 and expected to be a $4.94 billion market by 2025. Meanwhile, microdosing LSD means that the user takes about 1/10th of a dose as a way to âbreak down cognitive barriers and help them be more creative,â Heudecker said, adding there is no research on how microdosing LSD impacts usersâ health.
The nickname âsmart drugâ is a misnomer. âThese drugs donât make you smarter. They allow you to better use the facilities you already have,â Heudecker said. They do so by helping people stay more focused or awake. Users may have that âfeeling of being in the zoneâ for longer.Â
The use of these substances âis becoming more prevalent, not less,â he said, adding that too few employers are thinking practically about how they will address smart drug use in their workforce.
Why People Take Them: In 2018, The European Agency for Safety and Health at Work, or EU-OSHA, released the report âManaging Performance Enhancing Drugs in the Workplace: An Occupational Safety and Health Perspectiveâ to explore the trend of smart drug use among workers.
Employees take them for âincreased monitoring of employee health, stress levels, alertness and fitness,â especially when these measures are used to judge an employeesâ ability to do their jobs. âIt is possible to anticipate that employees under this level of scrutiny may turn to various pharmacological means to allow some control over biometric readings,â the report noted.
Workers in low-paid jobs that are not protected under standard labor laws may feel increased pressure to hit certain productivity levels, especially since they are increasingly being monitored by their employers. Not wanting to lose a job they rely on, they may turn to smart drugs. âElectronic means of monitoring employees are likely to be accompanied by an increase in the stresses on workers,â the article noted.
Employers in general donât seem aware that this trend is happening, Heudecker said. âItâs not like someone goes out for lunch, has a few martinis, and their speech is slurred. It looks like, âIâve got a really productive worker.â Youâre not going to ask questions because itâs a positive outcome,â he said.
While employers may appreciate that their employees are being more productive, if employees must turn to drugs to reach those performance goals, then the employer should consider how the company culture or policy drove them there, Heudecker said.
âThereâs a lot of demand to always be on, so you need to give your employees permission to be off,â he said. His 2017 Gartner report âCognitive Enhancement Drugs Are Changing Your Businessâ also explored the main reasons that push employees to take these substances. Basically, employees either view smart drugs as an opportunity to push the boundaries of what they can accomplish in the workplace or feel coerced into taking them to maintain performance and keep up with their workload.
If employees feel forced, that has the potential to get employers in trouble. âThis may expose organizations to legal risk if CED users obtain drugs illegally because they felt forced by colleagues or management,â the report noted.Â
Employer Response: Brian McPherson, labor and employment attorney at Florida-based law firm Gunster, has never had an employer raise the issue of smart drugs.
Medical cannabis is legal in Florida and thatâs received all the attention, he said. â[Employers donât have] the time or capacity to focus on the other issue that is brewing somewhat underneath.â
Studies support the increased use of Adderall, Ritalin and other drugs for performance, he said. Still, most employers try to stay away from getting involved in the prescription drugs employees are taking, and they assume they are complying with their physiciansâ directions.
âWe know itâs happening on a grand scale, at least more than it has in the past, but employers arenât really talking about or dealing with it,â McPherson said.
Heudecker suggested policies companies can adopt to directly address smart drugs. A chief human resources officer can work with other leaders to draft a policy around cognitive enhancer use in the workforce. They also can support ânon-pharmaceutical cognitive enhancementâ â practices that naturally help people be more productive by âimproving work-life balance, adjusting work schedules, promoting physical activity and educating employees on healthy nutrition and sleep practices,â Heudecker said.
An employerâs response also has to respect the fact that many smart drugs are prescription drugs that people need. âYou donât want to alienate people who need something for their ADHD,â Heudecker said.
THE LEGAL LANDSCAPE
The substance that employers mostly ask about is cannabis, said McPherson. Since medical cannabis is legal in the Florida, McPherson has fielded many questions about its use.
All indications point to cannabis laws continuing to progress in more states, he said. Once states approve it for medicinal purposes, the âfloodgate starts to openâ and there is a âgeneral march toward recreational use.â Currently, 33 states, the District of Columbia and Puerto Rico have passed laws broadly legalizing marijuana in some form. As of Jan. 1, 2020, 11 states â Alaska, California, Colorado, Illinois, Maine, Massachusetts, Michigan, Nevada, Oregon, Vermont and Washington â and the District of Columbia have adopted laws legalizing marijuana for recreational use.
âAs long as marijuana remains illegal under federal law, employers are getting a comfort level that they can still enforce the drug-free workplace tests for marijuana,â he said. âIf it ever becomes legal under federal law, that will really change the landscape, and it will become a much more complex situation.â
Drug use among many U.S. sectors is growing, according to the Quest Diagnostics 2019 âDrug Testing Index.â The data involved in this analysis come from pre-employment testing for safety-sensitive positions or drug-free workplaces, said Barry Sample, senior director of science and technology at Quest Diagnostics, which has been annually analyzing workplace drug testing data since 1988.
Cannabis is the most commonly detected drug in the workplace, according to the âDrug Testing Index.â Positive tests have increased in most sectors. Meanwhile, positive test rates have declined for cocaine, heroin and opiates.
Interestingly, the inclusion of cannabis in testing panels may vary by state, the index showed. In almost all states, 95 percent of organizations still test for it when they have the option. Colorado and Washington, the states where recreational use has been legal for the longest time, saw a 4 percent decrease in organizations testing for cannabis between 2015 and 2018.
There may be differences by industry, Sample added. âWhere there are generally less skilled workers, employers are having difficulties finding employees that will pass all the background screening, including drug testing,â he said. âThey may be making a risk-based judgment on their part that âWeâre going to take the chance and ignore the use of marijuana, because we really need people on board.â â
Meanwhile, two organizations have announced more nuanced drug tests for cannabis that may hit the market in 2020, according to Business Insurance. A research team at the Swanson School of Engineering at the University of Pittsburgh has developed a breathalyzer prototype, and Oakland, California-based Hounds Labs Inc. plans on bringing a breathalyzer to market in 2020.
Such tools could help detect marijuana use, which can stay in a personâs system up to 30 days after consumption, McPherson said. âThe employers Iâve talked to about these tests are excited and hopeful about them,â he said.
Dan Harrah, senior associate at Mercer and a consultant specializing in behavioral health and health care operations, is skeptical about these tests. âThe science of impairment is not settled yet. Thereâs a lot of subjectivity,â he said.
There will need to be a way to review these tests and see how effective they actually are, he added.
Psychedelic Legislation: While laws regarding cannabis use is moving rapidly, legislation on psychedelics is slower, said McPherson. Two cities â Oakland and Denver â have decriminalized psychedelics such as magic mushrooms, and the Chicago City Council in October 2019 approved a resolution that experts say could pave the way to decriminalizing them. The resolution uses the term âentheogenic substances,â defined as any range of natural plants or fungi âthat can inspire personal and spiritual well-being,â as well as other psychological and physical benefits.
âThe most alert employers are watching whatâs going on with the psychedelics and they are concerned,â McPherson said.
Regardless of the substance, he advises employers to stay informed.
ADDICTION
A person with an addiction is hyper-focused on obtaining their drug of choice and getting that high, which can affect their hygiene, sleep, basic social behaviors and work performance, said Andrea Elkon, clinical psychologist and director of behavioral health for Alliance Spine and Pain Centers. This hyper-focus applies to substances such as nicotine, alcohol or opioids as well as behaviors like gambling or shopping.
An employee struggling with a serious substance addiction is fairly obvious to spot, Elkon said. They may consistently come in late, leave early or not show up to work at all, take extended lunch breaks or exhibit erratic behavior such as falling asleep at their desk or acting more emotional than usual.
In such cases, managers need to be assertive, Elkon said. It may be an uncomfortable subject, but not enough people know how to handle it, she said. Managers should learn how to take action â sooner rather than later â while still showing concern toward the addicted employee.
When an employee does not yet have a serious addiction but is on the path toward one, managers can still notice behavior patterns like absenteeism that may point to a substance problem. âThat is a way to address the early signs, to focus specifically on the behaviors that are disruptive to the workplace,â Elkon said.
Employer Communication: Many employers have benefits programs in place to address addiction but not an environment that allows for open conversations about substance use, Harrah said.
âWhen it comes to behavioral health, everybody is able to talk about [how they] didnât sleep well last night, and thereâs no stigma around that. But nobody says, âIâm really thinking about cutting down on my drinking.â Thereâs more stigma around that statement.â he said.
More employers have been taking on behavioral stigma, but thereâs still work to be done. And the lack of communication around substance use benefits can lead employees down the wrong road, Harrah said. For example, if someone with an addiction realizes they need help, oftentimes the first thing they do is Google treatments. While the employer plan may include in-network carriers with good programs for addiction, a simple internet search can lead to low quality, out-of-network care, he said.
âOne of the things that I caution my clients on is you can have these supportive conversations, but you better understand what programs are in place. Because once you start having those conversations, your employees start to come to you, whether for themselves or a family member,â Harrah said.
Substance abuse and mental health benefits also belong in open enrollment conversations, said Morgan Young, vice president of client services, employee benefits at insurance brokerage Holmes Murphy. Young didnât mention mental health and substance abuse benefits in a recent open enrollment meeting, and an employee later asked if the company covered mental health benefits. Young was reminded of how important it is to share that message to employees.
Substance abuse benefits should go beyond the employee assistance program, she added. Employers consistently see low utilization of EAPs and try to convince employees to use them more, but theyâre not going to be the only solution, she said.
âWe need to understand that while an EAP may be a good tool for some, itâs not going to dissolve all the needs we have. We need to come up with different tools, resources and policies and make them available to employees,â she said.
Elkon suggested resources that could help employees or dependents with addictions. One of the first steps is sending them for a substance abuse risk evaluation, she said. These evaluations can tell employers about the employeeâs risk of substance abuse problems and treatment options.
If an employee does have a problem, employers can respond by showing concern and having treatment resources available, Elkon said. The employee could use a leave of absence to get the necessary treatment, with the assurance that they wonât lose their job while theyâre getting treatment.
âIf someone is showing any signs of addiction, itâs important to show concern but be firm with that person sooner rather than later because it could spiral and affect other co-workers.â she said.