Recreational Marijuana

by Jay Luxenberg, MD

Although it's been said many times, many ways, there are still going to be many questions from our residents about the implications of the looming implementation of California’s decriminalization of the recreational use of marijuana for adults. Under state law, adults will be allowed to possess and use up to an ounce of marijuana starting January 1st. Facilities that rely on federal dollars will have little choice - Section 1819(d)(4) of the Social Security Act (42 U.S.C. 1395i-e(d)(4)) provides that "[a] skilled nursing facility must operate and provide services in compliance with all applicable Federal, State, and local laws and regulations . . . ." Marijuana is a Schedule I controlled substance under the Controlled Substance Act (CSA), 21 U.S.C. 801, 812. The manufacture, distribution, or possession of marijuana a criminal offense, CSA sections 841(a)(1), 844(a). Clearly at this time a skilled nursing facility would not be in compliance with those federal laws if marijuana was stored or distributed to a resident. It will be interesting to see how facilities will handle requests from residents that purchase edible marijuana products, for example. Would they be allowed to store personally purchased products in their rooms like they currently store candy or other snacks? Will we be thinking about this possibility as we analyze falls or changes in cognitive function? We live in interesting times!

Facilities that do not rely on federal dollars may experience more leeway as they develop policies. Many California RCFEs already have confronted the challenges with residents that use medical marijuana, which was decriminalized in 1996. Now it soon will be time where recreational marijuana policies will need to be developed. The situation is complicated when the marijuana is smoked rather than consumed orally – then there are fire safety issues and issues of “contact high” for staff and other residents.

The WAVE hopes our readers will share their challenges and experiences in the next few months.