What is the difference between medical marijuana and recreational marijuana legalization?

By Suzanne Ball | Last updated: January 17, 2019

As more states vote to allow recreational use of marijuana, employers may be rightfully confused about the differences between how recreational and medical marijuana are regulated by the states. It is important to note that the federal stance on marijuana for any purpose has not changed.

It’s important to note that there is no difference in the strength of the two types of marijuana. In fact, they are the same plant. Marijuana is a plant with over 100 different compounds, called cannabinoids. The two used in medicine are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC improves mood and appetite, while CBD seems to relieve nausea and seizure activity. THC also produces the high feeling that recreational users enjoy.

Marijuana, or cannabis, has been successfully used for certain medical conditions since 1996, when the California Proposition was passed by 56% of voters. At the end of 2016, 28 states and the District of Columbia have ratified medical marijuana for individual patient use.

Some of the reasons to use marijuana to treat physical symptoms include:

  • Severe or chronic pain that does not respond to standard medical therapy
  • Cancer, multiple sclerosis, HIV, seizure or spasticity disorders
  • Glaucoma that does not respond to standard medical therapy
  • Crohn’s disease, a painful and debilitating intestinal disorder
  • Cachexia, a loss of appetite and wasting away that can include nausea and vomiting
  • Traumatic brain injury
  • Post-traumatic stress disorder

After a physician has recommended (it is federally illegal to prescribe cannabis) that a patient could benefit from marijuana, that patient can follow the state’s specific legal process to register and obtain an ID card that permits buying and possessing the amount and form of marijuana allowed by the state. All states place a limit on how much a patient can possess, but they vary widely in how patients can obtain medical marijuana. Many states have dispensaries with pure, sealed packaging that meets the legal requirements. Other states only allow patients to grow and harvest a certain number of marijuana plants. At least one state prohibits smoking medical marijuana.

Medical marijuana can be taken several ways:

  • Smoked
  • In food, such as candy or cookies
  • Liquid form
  • Capsules
  • Vaporized (heated until the active ingredients are released)

Recreational marijuana is regulated differently from its medical counterpart. Although it comes from the same plant, its purpose is to create a pleasant experience by altering the user’s mood. Perhaps because marijuana is the most popular drug in the world, states began to consider allowing controlled use of it, with several important differences from a state medical marijuana registry:

  1. Recreational use is heavily taxed. Washington State currently imposes a hefty 37% tax on marijuana purchases. In Oregon, medical patients are exempt from tax, while recreational users pay 25%.
  2. Legal amounts are significantly smaller for recreational use. Both purchase and total possession amounts are strictly limited. For example, Colorado medical patients can keep up to two ounces, while recreational users are limited to one ounce. Recreational users can only purchase 8 grams (about ¼ ounce) at a time.
  3. Marijuana may only be purchased at a state-approved recreational dispensary. It is not to be shared or used in public.
  4. Even though recreational use may be legal in a state, an employee can still be fired for using or for a positive drug screen.

It is important for both employers and employees to recognize that while marijuana may be legal for medical or recreational use, the law only allows an individual to posses and consume it according to state statutes. The person is not exempt from any other laws, such as driving under the influence or public use and intoxication laws. Likewise, at the workplace, a worker cannot be under the influence of the drug at work just because consumption is legal, much like an employee can not be under the influence of alcohol (although legal to consume) on the job. Employees are still subject to the company's policies regarding drug testing, termination, and filing for unemployment or workers' compensation.

Employers should be familiar with their state laws. Establishing specific policies around marijuana use is recommended by the National Association of Attorney Generals.

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Written by Suzanne Ball

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Suzanne Ball is an experienced Registered Nurse with a Masters Degree in Health Sciences. She has worked in a variety of settings, including acute care, quality improvement, and research. She is a freelance writer who specializes in writing about medical and health topics.

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