How to manage workers on prescribed medical cannabis?

Risk Matters - Spring 2023

Picture of Emma Horsefield

Emma Horsefield

LGIS People Risk Manager
Emma leads and is responsible for the management of the People Risk Program at LGIS. This includes setting the direction of the program in response to member, sector and industry trends. Emma’s extensive industry experience and knowledge covers the development and implementation of workplace health and safety (WHS) initiatives aimed at improving safety behaviours and reducing workplace injuries.

Medicinal cannabis is a therapy that has generated increased national attention over the past two years. The use and acceptance of medicinal cannabis continues to evolve, as shown by the growing number of states now permitting its use for specific medical conditions. Most medicinal cannabis formulations are legal to use in Australia, but they are still classified as ‘unapproved therapeutic goods’, which means they have not been assessed by the Therapeutic Goods Administration (TGA) for safety, quality or effectiveness and are not included on the Australian Register of Therapeutic Goods (ARTG).

Medicinal cannabis and its health implications

Medicinal cannabis is a prescribed medication that is derived from the cannabis plant and is used most often for the treatment of chronic pain (for lower back, neck or neuropathic), anxiety, epilepsy and insomnia.

Medicinal cannabis differs from recreational cannabis (marijuana) as medicinal cannabis is developed to meet defined criteria and control parameters. Whereas marijuana is classed as an illegal drug where the active ingredients and other impurities are unknown.

Medicinal cannabis is usually taken by inhalation (smoking) or by oral ingestion by oils or capsules. Depending on the way it is taken, it will affect the time of onset of the medication and the duration of the medication within the body.

There are two primary compounds within medicinal cannabis – tetrahydrocannabinol (THC) and cannabidiol (CBD), with THC compound having the potential to impair neurocognitive function. There are multiple factors that impact the level of impairment including the frequency, dosage, and the time of the day taken. These factors can result in the worker being in a higher risk when undertaking driving and safety-sensitive activities such as high-risk work.

There are also other known side-effects from medicinal cannabis treatment (both CBD and THC) that include fatigue and sedation, vertigo, nausea and vomiting, fever, decreased or increased appetite, dry mouth, and diarrhoea. THC (and products high in THC) have also been associated with convulsions, feeling high or feeling dissatisfied, depression, confusion, hallucinations, paranoid delusions, psychosis, and cognitive distortion (having thoughts that are not true).

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Legal obligations for both workers and local governments

Using medicinal cannabis that has been prescribed by a medical professional is not illegal in WA, however it is an offence under the Road Traffic Act (WA) to be driving a vehicle with any level of THC in your system.

Road Traffic Act (WA)

  • Offence: section 63(1)(b) driving under influence of drugs incapable of proper control of vehicle
  • Offence section 64AB: driving while impaired by drugs
  • Misuse of Drugs Act (WA): cannabis “illicit drug”
  • Road Traffic Drug Driving Reg 2007 (WA) – Reg 3: driving with prescribed “illicit drug”.

If an employee (or any person authorised to operate a vehicle/ plant) caused an accident and if they were impaired by the medicinal cannabis then the Motor Protection Policy exclusion would be triggered and would not cover the employee’s (and local government’s) liability – in other words, they should not be driving if they are using medicinal cannabis and have THC in their system.

In addition to the Road Traffic Act, local governments and workers have a legal obligation under the Work Health and Safety Act 2020 in regards to maintaining a safe workplace.

Workers have a duty under the WHS Act 2020 to:

  • Take reasonable care for the worker’s own health and safety.
  • Take reasonable care that the worker’s acts or omissions do not adversely affect the health and safety of other persons.
  • Comply, so far as the worker is reasonably able, with any reasonable instruction that is given by the person conducting the business.
  • Cooperate with any reasonable policy or procedure of the person conducting the business or undertaking relating to health or safety at the workplace.

This duty includes reporting to the local government (PCBU) any medication that may have an increased safety risk to the worker or others as a result of any impairment from taking the medication.

Local governments have a duty of care, so far as is reasonably practicable, under the WHS Act 2020:

  • Must ensure the health and safety of workers while the workers are at work.
  • Must ensure the health and safety of other persons is not put at risk from work carried out.
  • Must ensure the provision and maintenance of a work environment without risks to health and safety and the provision and maintenance of safe systems of work.

To meet these legislative duties, when a worker declares that they are using prescribed medicinal cannabis, the local government will need to consider potential safety risks associated with the usage of the medication, particularly in regards to driving/operating plant and carrying out any high risk work activity.

Step-by-step on how to manage workers on prescribed medication

1. Risk assessment

Local governments should undertake a formal risk assessment based on the individual circumstances of the worker.

The risk assessment should consider:

  • Identification of work activities that may increase safety risks like operating local government vehicles or mobile plant, carrying out high risk work activities or working alone.
  • Consideration of the frequency and duration of work that may increase safety risks and if reasonable adjustments
    to these duties can be made, or identification of alternate duties. This should be done in consultation with the worker.
  • Local governments must also consider not subjecting the worker to discrimination.


2. Consult an expert

Once the initial risk assessment is carried out, local governments should then consult an occupational physician to determine:

  • Inherent requirements of the worker’s role and any driving/ mobile plant or high risk work activities vs predominately desk based work.
  • The type, dosage and frequency of use requirements of the medication.
  • Safety risks from medical disability/impairment and/or medications.
  • Reasonable adjustments available considering the role and medication.


3. Keep records of all elements in the process

To ensure that the local government is managing individual cases effectively and consistently, it should have documented processes in place. These include:

  • Fitness for work procedures that define how to manage declared medications.
  • Processes for consultation between the worker, supervisor and other parties.
  • Ensure confidentiality regarding the worker’s medical condition and medication use.
  • Ensure that additional processes are in place to manage other legislative obligations
    (Including Industrial Relations Act (WA) 1979, Workers’ Compensation and Injury Management Act (WA) 1981,
    Fair Work Act 2009 (Cth) Section 772, Equal Opportunity Act (WA) 1984 and Disability Discrimination Act 1992 (Cth).

Quick tips

To know more about managing your workers who are on prescribed drugs, please speak to the LGIS People Risk Team or your regional risk coordinator.

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