Medical doctors and people interested in getting into the medical field are in a difficult position when it comes to medical or recreational marijuana consumption. Prospective medical students and weed consumers may search online for "do doctors get drug tested" just to have some peace of mind. Patients, on the other hand, may worry that marijuana use among their physicians could lead to dangerous situations.
As of this moment, 11 states have legalized recreational use (plus Washington, D.C.) while 33 states, Puerto Rico, and Guam have passed medical marijuana laws. Despite performing life-or-death medical procedures, most doctors are not required to undergo drug testing because they are not technically employees of the hospital or medical group they work at.
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The Case for Drug Testing Doctors
Many proponents for drug testing medical doctors cite federal law that subjects some transportation workers or people working in safety-sensitive areas to random drug tests. Pilots, flight attendants, truck drivers, school bus drivers, and subway operators all must be ready to undergo a drug test at any moment.
Currently, at least 15 states require drug testing for people applying for public assistance programs. Some of these are blanket laws that apply to every applicant, while other laws require drug testing on people believed to have a substance abuse problem. If these populations need drug testing, why not doctors?
California Fought for Drug Testing for Doctors
In November 2014, California voters were tasked with the monumental decision to vote yes or no on Proposition 46, which would require doctors to submit to random drug and alcohol tests. Naturally, Prop 46 was denounced by doctors, hospitals, and medical insurance companies. The measure would have made California the first state to pass such a law.
The law would have also required positive drug tests to be public. The law was part of a bigger measure that would have increased the malpractice award cap from $250,000 to $1.1 million, but the medical industry soundly defeated the bill with a $35 million campaign.
The Medical Industry Opposes Drug Testing
Cynically, and perhaps rightly so, some doctors believe that drug testing laws are a benefit to trial lawyers who could stand to make more money with these cases. Besides ulterior motives by attorneys, some doctors argue that the industry can self-regulate. Doctors also mention a worry about false positives that could potentially ruin physicians' careers.
According to some statistics, 5 to 10 percent of cases are false positives and 10 to 15 percent are false negatives. Some doctors view random drug testing as an invasion of privacy and hospitals don't want to sully relationships with medical staff by imposing a clear policy.
Is Drug Testing Ineffective?
Most drug tests are urine tests due to their affordability and effectiveness. They can test for 10 drugs or more, but only marijuana can be found for more than a month after use. Drugs like cocaine and amphetamines can be detected for about 4 days. Alcohol can be detected no more than 12 hours after use. Drug testing could catch physicians using marijuana, but might leave those with other substance abuse disorders relatively unscathed.
Even though drug testing has its flaws, drug testing has been shown to be effective at curbing physicians' drug abuse. In 2004, Massachusetts General Hospital enacted a drug testing requirement for anesthesiology residents due to substance abuse problems, which effectively eliminated positive tests, suggesting drug testing may correlate with a reduction in substance abuse.
How Big of a Problem is Substance Abuse Among Physicians?
Generally, the rate of addiction among physicians is around the same as the general population, which is about 10 percent. Sometimes, signs of substance abuse among doctors can be dismissed as a doctor being tired or feeling stressed.
Recently, the case of USC's former medical school dean Dr. Carmen Puliafito made headlines. Puliafito's license was revoked for using methamphetamine and heroin. USC's drug-free policy does not explicitly discuss drug testing.
Another case involved David Kwiatkowski, a medical technician that stole fentanyl syringes from patients and re-filled them with saline. In the process, he contaminated 45 people over the course of 10 years with hepatitis C, which resulted in 2 deaths. He would flee the state after medical staff called police suspecting him of drug use.
Because regulations differ among states and medical institutions, it can be hard to keep track of a problem doctor or nurse. A lot of the time, many doctors don't even report suspicious activity. A 2010 JAMA study of 2,000 physicians found that 17 percent knew of a physician that worked under the influence in the past three years, but only 67 percent reported the problem.
Do Any Medical Students Get Drug Tested?
Despite a lack of random drug testing, certain medical students and doctors may be subject to drug testing. For example, medical students have been known to undergo urine testing during orientation or before clinical rotations and residency. Medical schools' policies on drug testing vary. Many testing cases target individuals suspected of drug abuse.
Do Doctors Get Drug Tested: Medical Board Policies on Marijuana Use
Colorado was the first state to create a policy regarding medical marijuana use. The Colorado Physicians Health Program deemed any physicians who used medical marijuana unsafe to practice. Many medical boards like the Medical Board of California don’t have a specific policy on medical or recreational marijuana use, but follow federal law.
If a doctor is found to be impaired with any substance including cannabis or is arrested driving under the influence, the medical board can discipline the physician, even if the doctor has a medical card. In 2017-2018, the Medical Board of California took 59 actions against physicians with drug problems revoking 9 licenses, surrendering 17, putting 29 on probation, and more.
Like many other healthcare policies, Los Angeles County's Public Health Department tests their doctors if they are suspected to be under the influence when practicing medicine. At the Children's Hospital in Los Angeles, they drug test new employees, interns, and volunteers.
Protecting Patient Safety
There isn't a uniform method of protecting patient safety across the medical industry. Many experts believe more surveillance around drug storage areas and increased tracking of drugs could reduce addiction among doctors. Drug testing is only part of the solution. Doctor groups want to help physicians with substance abuse problems instead of punishing them.
State health treatment programs can help monitor physicians in lieu of disciplinary action. A 2008 BMJ study found that 65 percent of 802 doctors that were monitored for five years remained drug and alcohol-free under a substance abuse program. To many, this means a continuous monitoring program might work.
Can Doctors Get a Marijuana Card?
Medical marijuana's legality has made doctors wary of using cannabis or getting a medical recommendation. Doctors that work in a hospital would be violating drug-free policies that overrule state laws. While doctors can and most likely have gotten medical cards, it's unclear how their consumption outside of work could affect patient safety.
Because marijuana, in particular, is a Schedule I drug, many doctors aren't risking their license by using cannabis, even if it might help their medical condition. Other, more serious substance disorders, have prompted some stricter drug testing policies, but the medical industry still largely regulates itself. Individuals can report any suspicious activity to the state medical board. More cannabis research will guide future drug testing policies in the medical workplace.
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