Cannabis, Medical Cannabis and CBD

The Office for National Statistics estimated in their most recent survey (March 2023) that 7.6% of people aged 16 – 59 (approximately 2.5 million people) reported using cannabis. This shows a significant rise compared to March 2020, where 6.3% of that age bracket were estimated to be using cannabis. Cannabis is the biggest illegal drug consumed by the wider population.

It is important to distinguish between recreational and medicinal use of cannabis. Many people who require cannabis for medical reasons will be able to drive safely and legally. However, this is not a “get out of jail free” card, and users of Cannabis-Based Products for Medicinal use (“CBPMs”) must ensure they are not impaired while driving. Driving while impaired by any medication, including CBPMs, is a criminal offence.  

With the use of recreational and medical cannabis in the workplace becoming more prevalent, the road transport sector must be alive to the effects of the drugs on drivers’ day-to-day activities. Operators must have effective systems in place to manage the risks of impaired driving in the business to uphold their Operator’s Licence undertaking and protect the safety of their drivers and the public. 

Cannabis: Implications for commercial vehicle drivers and operators

Cannabis belongs predominantly to the depressant drug group. This means it slows down the activity of the central nervous system. It can affect drivers by causing:

• reduced concentration,
• difficulty processing information and decision making,
• difficulty multi-tasking,
• drowsiness; and
• fatigue.

A 2012 survey found that drivers who use cannabis up to three hours before driving are twice as likely to have a fatal or serious injury crash. Bear in mind that this study was before the legalisation of medicinal cannabis in the UK and may not account for low dosage, responsible use of CBPMs.

Super strength cannabis, however, can create stimulant effects and, in some people, can even create hallucinogenic effects.

Further, the use of cannabis could have the following consequences for the wider business:

• Breach of the Operator’s Licence undertaking - it is an undertaking on every Operator’s Licence that operators and transport managers will ensure their drivers comply with all laws relating to the driving and operation of vehicles. This requires operators to have an effective system to manage the risk of drug (and drink) driving within their business. If a driver commits a drug driving offence, the operator has an obligation to report any convictions to the Traffic Commissioner within 28 days of the date of the conviction. Once notified of the offence, the Traffic Commissioner may scrutinise the operator’s drug driving risk management systems and procedures. 
• Increased insurance costs - insurance companies actively audit their clients to check if they have proactive screening and policies in place. If an operator has issues with illicit drug users at work, that will lead to an increased risk of collisions/accidents when driving. As a result, operators will be subject to higher insurance premiums. Further, repeated cannabis abuse can lead to health complications, leading to higher healthcare costs and premiums. 
• Decreased productivity – Impairment of drivers’ focus and decision-making caused by cannabis abuse can lead to mistakes, poor quality work or slower output.
• Reputational damage – news of drivers’ illicit drug use could severely damage the business’ image, client trust and professional relationships. If drug misuse proves particularly prevalent amongst drivers, the operator may lose out on contracts of service with clients and deter investors and future employees.

What operators need to consider when managing the risk of drug driving

The major contention between cannabis use and road safety derives from the chemical compound Tetrahydrocannabinol (“THC”) found in the cannabis plant. This is the psychoactive compound of the drug and will appear on a drug test if present in a person’s system. Higher doses of THC can increase the user’s impairment on the road.

If the operator is made aware that a driver could be misusing substances such as cannabis, the best practice to address the issue is: 

• Protect the driver, their colleagues and the public – suspend the driver from their duties whilst an investigation is undertaken. If drug abuse is suspected, then they could be a risk to themselves, colleagues and the wider business.
• Thoroughly review and familiarise yourself with the Drug and Alcohol Policy – establish what the next step is in accordance with the businesses’ policy. This may require getting an HR team member/external party involved in the fact-finding and well-being process. The driver should only be directly contacted about the issue by an HR representative or their line manager.
• Implement Policy and Processes – this may involve conducting a screening procedure as part of the investigation and/or referral to a support or wellbeing team.  

We advise operators utilise the below practical strategies to manage the risk of drug driving.

Develop clear and thorough drug policies

• Set out clearly the business’ stance on drug use. Highlight that the use of illicit drugs is strictly prohibited at work or during working hours.
• Implement a drug testing policy that states how and when workers will be tested. This could either be in the form of random testing, on suspicion, pre-employment testing and/ or post-incident testing. It is highly recommended that, due to the prevalence of use, a random testing system is implemented in conjunction with testing on suspicion. 
• Clearly express the consequences of infringement of the drug policy. Outline resulting disciplinary actions if drivers are found to be misusing substances, such as the potential termination of their employment. Ensure details of options for rehabilitation and support for drug abuse are also provided. 
• Incorporate practical provisions for workers seeking help for drug abuse, such as permitted leave for rehabilitation or counselling sessions.

Management training and staff supervision

• Train managers and supervisors on how to identify the physical and behavioural signs of drug misuse.
• Teach managers techniques to intervene in potential cases of drug misuse in a supportive and calm manner. Communicate to managers that the purpose of the intervention is to guide workers to the appropriate help and resources.  
• Adopt a supportive workplace culture. For example, operators could implement wellness programs that encourage physical and mental well-being throughout the workforce.
• Promote open conversations within the workplace so workers feel safe to discuss issues with drug use. 

Enforce a zero-tolerance policy

• Implement a strict zero-tolerance policy on drug misuse for drivers.
• Clearly state to drivers that any behaviour that endangers the safety of their colleagues and the wider public will result in immediate suspension, disciplinary action and/or dismissal. 
• Promote education and awareness
• Conduct regular drug abuse awareness training to educate workers about the risks of drug abuse, the signs of addiction and support available.
• Implement workplace prevention programs that focus on the prevention of substance abuse and suggest strategies to maintain a drug-free lifestyle.
• Ensure your policies and procedures are up to date with best practices and legal/regulatory changes regarding substance use in the workplace. 

CBPMs: Risk management considerations for operators

Operators must be alive to the broader consumption of cannabis in modern society. Although typically thought of as a “street” drug, components/variations of the cannabis plant can be sourced legally by way of CBPM and Cannabidiol (CBD) products.

Medical cannabis

The only cannabis product in the UK that is subject to regulatory approval is medical cannabis. Very few people are prescribed it on the NHS. 

People with certain severe forms/cases of the following can be prescribed CBPMs through the NHS:

• Epilepsy as found in young children 
• Chemotherapy 
• Multiple sclerosis

Specialist NHS clinicians can also prescribe CBPMs where there is an exceptional clinical need and where the benefits outweigh any potential risks. This will be very rare.

There are no restrictions on which conditions CBPMs can be prescribed for on a private basis, and it is estimated that 350,000 private prescriptions were issued for medicinal cannabis in 2024. 

As mentioned above, use of cannabis, including CBPMs, can affect drivers by causing reduced concentration, difficulty in decision making and multi-tasking, drowsiness and fatigue. This can increase the likelihood of causing an accident.

In their “Medical Cannabis and Road Safety” report published in June 2021, the government estimated that CBPM users tend to be older, take lower, controlled doses, and are less likely to have a substance use disorder. This reduces the risk.

Nonetheless, driving while impaired by any medication, including CBPMs, is a criminal offence and a safety risk. 

If operators are made aware that a driver is using CBPMs, we advise that they have an open conversation with the worker about their level of use and the risk posed to themselves and other road users.  

Operators should also conduct a risk assessment.

CBD

There is a growing demand for products such as CBD oil, extract, vapourised liquid and capsules. 

• CBD is a chemical found in the cannabis plant. It does not cause impairment and will not show up on a drug test; however, it does carry some risks. For instance, it can be unregulated as it is primarily marketed as a supplement, not as medication. Therefore, very few CBD products have passed any formal accreditation or assessment. Quite simply, consumers cannot be certain of exactly what they are buying and its side effects. 
• There is a risk that CBD products can be falsely labelled and, in fact, contain THC. This raises the concern that drivers may be unknowingly driving whilst impaired.
• CBD can also cause the following side effects:
• Nausea 
• Fatigue
• Irritability
• Increase the level of blood thinning
• None of the above effects is conducive to a workplace environment or good driving practices. We therefore advise operators encourage staff to declare usage of CBD products. If a driver confirms they use CBD products, the operator should ask them:
• where they bought the product (i.e. was it from a reputable source?); and 
• whether they are certain that CBD is the main ingredient of it. 

Drugs and Alcohol Policy

Ultimately, the basis of any system is the policy that binds it together. A robust and specific drugs and alcohol policy that sets out the provisions for testing and support that is specific to your work type is key.