As of January 2019, 33 states and Washington, D.C., have legalized recreational or medical marijuana. However, marijuana is still illegal at the federal level and is classified as a Schedule I substance, which means the federal government has ruled that it has a high potential for abuse and no currently accepted medical use in the United States. This conflict between state and federal law poses a number of clinical and legal challenges for health systems.
Because of its restricted federal status, hospitals allowing marijuana use risk violating federal law, thus exposing themselves to potential penalties and even loss of federal funding.
Federal restrictions also limit the availability of information on marijuana’s safety and efficacy. To date, researchers have not conducted any large-scale clinical trials on marijuana—in large part because of onerous review processes. The absence of clear evidence in turn hinders providers’ ability to make informed patient care planning decisions.
Despite the legal and clinical ambiguity surrounding marijuana policy and use, health systems should devise a strategy for managing marijuana in their facilities—both as a risk mitigation strategy and as a patient and employee safety mechanism.