What Legalized Cannabis Means for Hospitals
The rise of marijuana as a legal substance has been steady over the past several years. Today, cannabis is now legal for medical applications in 46 states and the District of Columbia. It’s even legal recreationally in 10 states. While Cannabis is still listed as a Schedule 1 drug, there are signs that the federal government might be changing its tune. While the federal government remains stubbornly convinced that marijuana is an addictive substance similar to heroin, there are signs that even the feds are wavering; in July, KevinMD reported some Democrats were working on bringing national rules in line with the state activity around cannabis.
Considerable controversy still exists regarding the public health impact of these changes. What does all this mean for hospitals and healthcare facilities?
Legal Marijuana and Your Hospital
One of the largest issues is the double-edged sword in the states where cannabis can be prescribed for medicinal purposes. HFMA quotes one Florida lawyer who suggests it’s a “damned if you do—damned if you don’t” situation, “If the patient does not use or is not permitted to use medical marijuana while in the hospital and his or her condition worsens, is the hospital liable for the patient’s diminished health?” Conversely, if a doctor with privileges at the local hospital prescribes cannabis to an admitted patient and they have an adverse reaction, is the hospital liable?
This presents a gap in procedure when a state legalizes cannabis. HFMA suggests that when the drug is allowed by local law hospitals follow these guidelines:
- Develop protocols to confirm the patient’s registration in the state medical marijuana program and how prescriptions and administration will be handled.
- Determine which medical professionals are allowed to acquire and dispense the drug.
- Set policies for where these drugs will be stored and dispensed.
- Establish rules that will prevent drug diversion.
- If medical cannabis is part of research, set institutional review board protocols for approval or denial.
The HFMA also recommend each hospital address the potential liability of post-discharge, particularly for patients who live out-of-state. Under federal law, transportation across state lines is a federal offense. The laws and procedures are hard enough for each provider to understand and expect recovering patients to understand every law is a tall order. If you fail to counsel the patient on the ramifications of crossing state lines, is your hospital liable if they are arrested?
Further, your facility should address the issue from the perspective of an employer. For example, if medical marijuana is prescribed in its inhaled form, does that violate the no-smoking or drug use policy of your facility?
Finally, consider accreditation. The Joint Commission requires safe control of any medications brought into your facility. But how “safe” is a Schedule I drug under federal law?
Given the increasing legality and subsequent availability of marijuana as a medication, your hospital will need to carefully consider policies in light of shifting state and federal rules.
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