Ten Implications of Cannabis Legalization for Regulators

The predominant reaction of regulators to the legalization of cannabis for recreational use has been that nothing has changed. And to a large extent that is correct. Prescribing cannabis for medical purposes is still restricted to physicians and nurse practitioners. In many respects the professional expectations about its use will be similar to the consumption of alcohol or the consuming of prescription drugs which are also both legal and can impair function. However, there are a number of aspects to the legalization of cannabis that may create issues regulators may have to address in the coming months and years. A preliminary list includes the following:

  1. Is there a difference between a practitioner prescribing cannabis and a practitioner recommending patients obtain recreational cannabis on their own for therapeutic use?
  2. If so, is such a recommendation within the scope of practice of the profession?
  3. Even if making recommendations about the use of cannabis is not within the scope of practice of the profession, is there a duty on practitioners to be generally aware of the risks of cannabis use and to provide this information to clients who indicate they are using cannabis?
  4. While administering a substance by inhalation and injection is a controlled act (in Ontario), administering it topically is not. In what circumstances could topical administration of cannabis oil or other products be acceptable?
  5. Informed consent to treatment may not be possible if a client is under the influence of cannabis. Issues may arise as to whether a practitioner should have recognized a client’s impairment or disregarded such an impairment.
  6. It is professional misconduct for practitioners to practise while under the influence of a substance that impairs judgment. Issues may arise with regard to allegations about inappropriate conduct by the practitioner during the treatment.
  7. For many professions there is a duty to report colleagues who are impaired. There may be a duty on practitioners to report where a colleague appears to be impaired or is observed using cannabis while or just before working.
  8. How should regulators consider previous convictions related to cannabis, for example on an application for registration? Are those convictions irrelevant now (i.e., was the person just a bit ahead of their time?) or is it still significant as it involved a breach of the law as it existed at the time (e.g., tax avoidance is still tax avoidance even if the tax laws later change)?
  9. How should regulators deal with information on the public register related to cannabis use? Is that information still relevant for the public to know?
  10. Should regulators have policies about the use of cannabis by their staff and Board and committee members? If so, is anything other than “don’t-arrive-impaired” appropriate?

As regulators are formulating their policies and practices relating to cannabis, they should be aware that the landscape will likely evolve over time as society adapts to these new rules and government potentially refines or expands upon the law. With more experience and guidance, regulators should be prepared to review their cannabis policies at regular intervals.

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