Thursday, January 11, 2018

Marijuana in a Digital Age: A Potentially Unconscious Impairment

As the US government reviews enforcement of marijuana laws, the rest of the country is legalizing use state by state. The legalization of marijuana in some form spans 30 of our states with at least 12 more potentially on the horizon for 2018. As social workers, we need to traverse this changing landscape to help our clients, but what about ourselves? Legalization presents ethical issues for personal use by social workers. What do social workers need to know about technology and marijuana.

This might seem like a non-issue for social work professionals, after all, substance impairment during social work practice is against our ethical standards. I address this issue because of the ease in which technology allows social workers to practice even when not at a physical place of work and the new addition of a mood altering drug which may fly under the radar of professionals unfamiliar with its effects. The legal opening in some states and healing effects touted by people using THC make an attractive package for those never privy to this illegal substance. Some people who never used illegal substances may be curious. Others live memories of substance use in bygone days of yesteryear. These are not the substances being sold today.

Availability of THC opens the door for medical, psychological, and recreational use by social workers. Legalization paves the way for smoking, tinctures, edibles, and concentrates to an entire new market. While alcohol stays in the blood for 12 hours, THC can be in the blood for up to 336 hours.The high from smoking marijuana only lasts a couple of hours depending upon the amount used.  Ingestible THC stays in the system for a longer period of time with a more intense effect. A high from ingesting THC can last hours with the peak up to four hours after consumption. Documentation of effects, depending on the chemical composition, can last up to 24 hours.



Texting, emails, and HIPAA compliant phone apps and therapy online, open communication with clients more than the standard nine to five work day.  The effects of THC and a reduction in the standard boundaries technology affords us could open the door for mistakes on social media, or worse with a client. Before use be aware of the potential effects of use. SAMHSA describes the short-term effects of marijuana use which include "problems with memory and learning, distorted perception, difficulty in thinking and problem-solving, and loss of coordination." Addressing crisis situations by text or phone may be diminished. Auto-correct is a bad enough problem with normal texting. If there is a loss of coordination what message could be sent which could inadvertently cause harm? If emails and texts are a part of the client record everything you send has a potential for review or subpoena.

Due to the illegality of THC on a federal level, workplace law makes it a terminating offense to test positive on a drug screen. If there is a workplace incident, many organizations use drug testing to protect themselves from liability. It doesn't matter if you used marijuana medically over the weekend or socially the night before. If the result for THC is positive there will be consequences. Social workers will need to utilize a cost benefit analysis if they choose to use THC. Is it worth the cost? Only each individual can answer this until THC is legalized federally. Check the rules at your organization to be fully educated on the consequences. 

Self check ideas when using medically or socially:
1. Educate yourself on the pharmacological differences of THC, CBD, and marijuana strains.
2. Educate yourself on the physical, psychological, and mental effects of marijuana.
3. Use your knowledge of research to study yourself on the drug. How much has what effect? What do you notice as changes to your cognition (but remember, this study is biased!)What are other changes you notice? Have someone (not using) test your mental, physical and psychological acuity every half hour and write down the results.
4. Remember, as with any substance, you may have an inflated sense of being competent while using, when you actually are not.   
5. Do you have a back up plan in case a client reaches out to you in an emergency? 

Valid reasons exist to use THC; stress reduction, anti-anxiety, pain reduction, or recreation. The is not a post about the issues with addiction or using marijuana. Research and anecdotal evidence support significant relief of certain medical and psychological conditions.  This information is to remind us about being educated and mindful when we use any mind altering substance. Eliminate interactions using technology both professionally and personally during this time. Do not engage with clients or social media. No client wants should receive a text meant for someone else nor do you want your claim to fame to be "the Twitter Donald Trump of social work". The Internet's long memory is not one you want to become a part of in a negative way. Setting up standards for yourself if you choose to partake in any substance reduces risk for yourself and the populations you serve.