High Society: Cannabis in the Workplace Explored at the 61st Annual Workers’ Compensation Symposium in Iowa (Part One of Two)

Des Moines, Iowa - The 61st Annual Workers' Compensation Symposium in Iowa delved into the evolving landscape of cannabis in the workplace during a session titled "High Society: Cannabis in the Workplace." The symposium on June 22, 2023, featured prominent speakers Dr. Chris Iverson from the University of Iowa Hospitals & Clinics and Terri Davis from Shuttleworth & Ingersoll. In Part One of the session, Dr. Iverson discussed the changing landscape of cannabis, its various strains, drug testing methods, and the complexities surrounding impairment.

Dr. Iverson began by explaining the origins of cannabis and its two most common strains: Cannabis sativa and Cannabis indica. He highlighted that both marijuana and hemp are derived from the cannabis plant. The speaker emphasized the presence of cannabinoids in cannabis, with at least 113 identified so far. The most well-known cannabinoid is delta 9 THC (THC), which contributes to the psychoactive effects of cannabis. Another commonly known cannabinoid is cannabidiol (CBD).

Cannabinoids are lipophilic compounds that accumulate in fatty tissues and can persist in the body for weeks to months. Dr. Iverson explained that THC has two major metabolites: 11-OH-THC and THC-COOH. While the former is the initial active metabolite, the latter is inactive but has a longer half-life. Different methods of cannabis consumption were discussed, including smoking, ingestion, vaporization, and medical administration through pills, creams, oils, and nebulizers.

Dr. Iverson also explored the negative health effects of cannabis. In high doses, cannabis can cause paranoia, psychosis, impaired short-term memory, and altered motor coordination. Dr. Iverson highlighted the increased risk of chronic psychosis disorders, cognitive impairment, and symptoms of chronic bronchitis associated with long-term or heavy cannabis use. Moreover, frequent cannabis use during the teenage years was linked to lower IQ, poor educational outcomes, and reduced life satisfaction.

Dr. Iverson shed light on the absorption of THC through the lungs and oral routes. Inhalation leads to efficient pulmonary absorption, with THC blood levels rising immediately and peaking within 3-10 minutes, resulting in a subjective high within minutes. On the other hand, oral absorption involves slower THC delivery to the brain, reaching peak concentrations around 30 minutes after ingestion. While oral ingestion has lower peak concentrations, its effects last longer than inhalation.

The session further addressed drug testing for cannabis in the workplace. Dr. Iverson outlined the various scenarios when drug testing can occur, such as pre-employment, reasonable suspicion, random testing, return-to-duty, follow-up, and post-accident testing. He mentioned different forms of drug testing, including urine, blood, saliva, and hair testing.

Urine drug testing is the most common method to detect cannabis use, primarily targeting the inactive metabolite THC-COOH. Detection periods vary depending on the frequency of use, ranging from 1-5 days for infrequent users to up to 30 days for chronic users. Blood testing allows THC detection for approximately 5 to 8 hours, with levels rising quickly after inhalation and declining within a few hours. Saliva testing has a shorter detection window of 6-12 hours, measuring the parent compound Delta 9 THC. Notably, the US Department of Transportation recently approved oral fluid testing for drug testing, effective June 1, 2023, but it does not replace urine testing.

Hair testing provides the longest detection period, approximately 90 days, with 1.5 inches of hair growth. It measures the inactive metabolite THC-COOH, offering a retrospective view of cannabis use.

The impairment associated with cannabis use was a key focus of Dr. Iverson's presentation. Drawing a comparison to alcohol, he explained that assessing impairment caused by cannabis is more complex due to the pharmacokinetics involved. Vaping or smoking cannabis leads to rapid peak concentrations in the blood, followed by a transient peak. Ingesting cannabis, on the other hand, results in a slower rise in blood concentrations. Interestingly, there is no clear relationship between THC blood concentrations and impairment, as highlighted by a study conducted by Ginsburg in 2019.

Dr. Iverson presented intriguing findings regarding subjective experiences related to cannabis use. He noted that the "pleasant" drug effect increases dose-dependently. At low doses, individuals experienced little change in memory or difficulty with routine tasks compared to their baseline. However, at high doses, subjective measures of impairment, such as memory and routine task performance, significantly increased.

In conclusion, the session on "High Society: Cannabis in the Workplace" at the 61st Annual Workers' Compensation Symposium provided attendees with comprehensive insights into the changing landscape of cannabis. Dr. Chris Iverson's presentation covered various aspects, including the origins of cannabis, strains, consumption methods, the negative health effects, and the complexities of drug testing. The session also highlighted the challenges associated with assessing impairment caused by cannabis use. As cannabis continues to be a subject of evolving legal and social discussions, understanding these aspects becomes crucial for employers and policymakers navigating the intersection of cannabis and the workplace.

The symposium's second part, featuring Terri Davis from Shuttleworth & Ingersoll, will be covered in the next article. Davis will provide additional perspectives on the legal and regulatory implications of cannabis in the workplace, offering attendees a well-rounded understanding of this increasingly relevant topic.

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