We have all heard it before. The classic argument. “If you can go home and have a glass of wine or a beer after work, why can’t I smoke a joint? Why can’t I have an edible?” We tend to roll our eyes when we hear this from clients who may be minimizing their marijuana use or its effects. But what do you do when you hear that argument from your colleague, or from a supervisee?
Many therapists have been discussing the impact of marijuana use with clients for years, but have only recently begun to question using themselves. With the increasing number of states legalizing medical and recreational marijuana, therapists now must consider the impact that using marijuana can have on themselves and therapy. While the legalization of marijuana does not appear to lead to increased use, those therapists and counselors who have been using marijuana all along may now be able to be more open in discussing it.
Of course, it is inappropriate for therapists to hold sessions while under the influence of any substance. And every professional organization in mental health has clear ethical standards prohibiting continued practice when a therapist or counselor is impaired due to substance use.
But what about therapists who use marijuana medicinally or recreationally? Do clients, employers, or licensing boards have any cause for concern?
Individual users are responsible for understanding how marijuana impacts them personally. Therapists who use marijuana should be aware of the onset and duration of marijuana’s effects on them. Even so, judging what exactly constitutes impairment under our ethical codes can be difficult. According to the Centers for Disease Control and Prevention, the most common negative effects of marijuana use include poor attention, difficulty regulating hunger, physical health concerns (cancer, heart attack, etc.) and memory impairment. Most therapists could realistically learn to manage at least some of those negative effects. However, effects like sleepiness, poor attention, and memory impairment appear more likely to have an impact on the therapy process.
If those effects emerge, it would appear that therapists have a professional responsibility to either mitigate the impact of marijuana use on their practice, or stop providing therapy. These effects can also help explain why, even in states where recreational use has been legalized, employers typically retain the right to fire (or refuse to initially hire) employees who fail a drug test due to marijuana use.
For licensing boards, the story is similar. As is the case with alcohol, boards are unlikely to act against a licensee simply on the basis of that therapist using marijuana, especially when such use is allowed by state law. But if the therapist’s work is impaired due to substance use, or if the therapist is using with clients in session, that is grounds for a licensure board to act, regardless of whether the drug itself is legal to possess and use.
Most therapists and counselors can have a beer after work, or smoke a joint for that matter, without particular cause for concern. But with either drug, the moment its impact shows up in session, the therapist is in dangerous waters.
– Jeffrey Liebert is a Licensed Marriage and Family Therapist in Cupertino, California (#93108). You can find him at jeffreyliebert.com. He also serves as our Director of Continuing Education at Ben Caldwell Labs.