Zero tolerance on cannabis? More like zero-empathy games

The recent, hysterical outcry by a Christian gang hiding behind a campaign of fear, and that by the Malta Employers Association (MEA) echoing previous attempts by the Chamber of Commerce and other professional organisations to categorically stigmatise and label people who consume cannabis as non-responsible workers, parents or members of society, is yet another unfounded attempt to derail a civil rights and social change process aimed at promoting a more just society for all.

By calling for a strict zero tolerance and zero-empathy approach at the workplace, including proposals to introduce registries of people who consume cannabis and mandatory psychiatric analysis, without taking into consideration important scientific evidence and the role of human rights, is unfortunately once more a clear example of rushed and uninformed conclusions.

Without giving the impression that ReLeaf Malta is in favour of promoting the consumption of mind-altering substances at the workplace, calls for a zero-tolerance policy perpetuates a culture of stigma and discrimination created by prohibition and years of criminalising cannabis consumers.

Calls by employers for a total zero-tolerance policy at the workplace could at face value be viewed by many as a logical and a most required step to ensure the safety and well-being of all employees. Random drug-testing is therefore heralded as the ideal approach to sort out the bad apples from the shiny rosy ones and ensure the company can boast of a drug-free environment.

How to achieve this, you may ask? Obviously, have no mercy! Surprise them, line them up, test them and if found positive to cannabis, cocaine, or heroin, dismiss on the spot and inform the police to take criminal action against the person!

This militaristic approach presents a number of problems, primarily: 1) how to safeguard privacy, 2) differences how to quantify and compare impairment and level of toxicity for different drugs, 3) workers’ rights, 4) occupational health and safety considerations for the company as a whole, and 5) cultural bias how to view drugs and accommodate, even at the workplace, the use of some drugs such as alcohol, whilst demonise the private and personal use of other drugs, such as cannabis.

How many employers can declare that they do not offer alcoholic beverages on special occasions, or have stocked fine single malts in their offices for VIPs?

Can the directors of the MEA, Chamber of Commerce, the Maltese Church, Caritas and OASI Foundation confirm that no alcohol or other mind-altering substance is used on their premises?

Even government ministries have budgets to supply alcohol during special events or when hosting important dignitaries. Funnily enough, prior to 2013, even our Honourable MPs in parliament had access to an alcoholic bar during parliamentary sessions. Yet, we never heard the Church or the MEA complain that the presence of alcohol at this most prestigious and important work environment, could jeopardise the Honourable members’ sound judgment and ultimately derail the democratic process.

Therefore, it’s a mystery as to how the fact that zero tolerance for the use of mind-altering substances at the workplace is only now dawning on the employer’s and politician’s imagination. Maybe some vociferous stakeholders with a history of drama, now turned PR humanitarians, might have an idea how to unravel and explain this cobweb of perceived threats, dualistic approaches and made-up security issues.

But, hey who cares? The discussion is about drugs; therefore, alcohol is not in the equation.

There is only one little problem with this approach: metabolisation. Yes – science is once more finding an explanation for the most troubling of situations: how to ensure occupational health and safety at the workplace, whilst respecting privacy and worker’s rights.

Different substances are metabolised differently by the body. For example, alcohol is metabolised by the body differently from cocaine or cannabis. A breathalyser is a useful tool to estimate blood-alcohol concentration, to assess intoxication and ultimately levels of impairment.

On the other hand, tests which actually should detect THC, the major psychoactive component of cannabis, are often built to detect the non-psychoactive, secondary metabolite THC-COOH (tetrahydrocannabinol carboxylic acid). When THC blood levels drop below approximately 10 nanograms per millilitre (ng/mL) a few hours after use, there should be no significant impairment. However, inactive THC-COOH levels are much longer in the blood and even longer in the urine.

Alcohol is metabolised via acetaldehyde to acetic acid (also known as vinegar)... however, trace levels of vinegar in your blood are not making anyone drunk! The same applies to THC. THC is metabolised via THC-OH to THC-COOH. This THC-COOH is as much of concern for impairment as vinegar. Hence, typical urine tests are not fit for purpose.

Many drug tests create false positive and false negative results. A sober person with non-psychoactive metabolites from use a few days ago but also a person consuming hemp-based foods could easily become victim of a false positive test result.

Furthermore, these tests cannot identify an acute intoxication when consumed a few minutes/hours before the test is conducted. This is a false negative. If such a test system fails to identify an acute intoxication, then it should be clear to every employer that these tests are not fit for purpose.

Whilst there are some suppliers offering saliva tests or breathalysers with better false positive/negative ratios, validation is crucial. Tests should not identify occasional or regular cannabis users but identify significant acute impairment. If there is an obvious suspicion, best-practice would be a proper medical examination with blood testing.

Besides cannabis, false positive test results are known for many drugs; certain non-impairing medications but also food products (e.g. poppy seeds) can trigger such test systems.

On the other hand, there are many rather dangerous drugs (ex. novel psychoactive substances) which cannot be identified with typical test systems. It is important to not push people into more harmful drug use due to erroneous drug testing.

The professional careers and personal lives of people who consume cannabis are not feeble commodities which employers and institutions can choose to destroy on the sole reality of testing positive to a particular substance, and without proving impairment, risk to others, and decreased work productivity. Employers, especially in the gaming, financial, catering, building and legal industries could be missing out on prospective star candidates deterred to apply for a job which so clearly invades their privacy and personal lives.

In these, games of zero empathy, false negatives and false positives, employers, experts from the rehabilitation field and other stakeholders vouching to reinstate a witch-hunt for people who consume cannabis, should reconsider their position, and evaluate their conclusions on scientific evidence, leaving enough space for empathy, dignity and respect for all members of society.

Andrew Bonello is president of ReLeaf, Fabian Steinmetz is Senior Toxicologist MSc, QSAR & Computational Expert