Can doctors smoke marijuana?

To date, only 10 states have legalized the sale and use of recreational marijuana, including California, which is the nation’s most populous. In total, 33 states, the District of Columbia, Guam, and Puerto Rico have approved comprehensive public medical marijuana programs.

In states like California, anyone—including a physician—can walk into a dispensary, present their driver’s license, and buy various iterations of indica and sativa, the two main strains of cannabis. But most people can’t imagine their physicians smoking pot.

Undoubtedly, some physicians have likely taken a personal interest in the recreational consumption of marijuana. The question then becomes: What do medical licensure organizations think of such recreational drug use? Fortunately, the California Medical Board went out on a limb and answered our questions (Spoiler: As with alcohol, physicians can smoke marijuana as long as they are not impaired while seeing patients, driving, and so forth).

MDLinx: Does the Board have a formal policy regarding marijuana use by physicians? To your knowledge, do the national boards have such a policy?

Medical Board of California: The Medical Board of California (Board) does not have a policy regarding a physician’s use of cannabis for medicinal and/or recreational purposes. The Board must follow the law, which states if a physician is impaired, the Board can take disciplinary action. A doctor cannot be impaired when treating patients, whether or not the medication is prescribed to them or not. The Board is not aware of any national boards’ policies on this matter and would recommend you contact them directly. [A request from MDLinx to speak with the American Board of Internal Medicine on this topic went unanswered.]

MDLinx:What is the Medical Board of California’s view regarding the legalization of marijuana?

Board: The Board has no view regarding the legalization of recreational marijuana. Since cannabis is a permissible treatment modality in California under qualifying circumstances, the Board has developed Guidelines for the Recommendation of Cannabis for Medical Purposes that can be reviewed [for more detail].

MDLinx: If a physician smokes marijuana recreationally, will that result in loss of licensure?

Board: A physician cannot be impaired when practicing medicine whether they are using cannabis for medical purposes or for recreational use. If the physician is impaired from cannabis and/or any other controlled substance or alcohol, the doctor puts their patient at risk and the Board would look into any physician who is practicing medicine while impaired. The discipline that the Board can impose if it can prove that a physician has violated the Medical Practice Act can be as severe as license revocation.

MDLinx: If a physician were to smoke marijuana, what would be the timing before this person could see patients again?

Board: The Board cannot provide information regarding this question other than to note that the response to Question 3 would apply.

MDLinx: What happens to licensure if a physician is caught driving under the influence of marijuana?

Board: The mission of the Medical Board of California is consumer protection. The Board would treat this arrest/conviction as is it does with all crimes committed by physicians: The Board would look into the circumstances surrounding the arrest/conviction and take the appropriate action to protect the public.

MDLinx: Is marijuana use, as well as the use of other street drugs, an increasing concern of the Board?

Board: The Medical Board of California (Board) is concerned with any violation and enforces the law, including the Medical Practice Act. There are two sections related to physician impairment. Business and Professions Code sections 822 and 2239 authorize the Board to take action against a doctor who is impaired.

In Fiscal Year 2016-2017, the Board took 68 actions against doctors for self-abuse of drugs and alcohol (6 license revocations, 10 surrendered licenses, 2 licensees placed on probation with suspension, 39 licensees placed on probation, and 11 public reprimands were issued). In Fiscal Year 2017-2018, the Board took 59 actions against doctors for self-abuse of drugs and alcohol (9 license revocations, 17 surrendered licenses, 1 licensee placed on probation with suspension, 29 licensees placed on probation, and 3 public reprimands were issued).

MDLinx: How does the Board treat medical marijuana use by physicians?

Board: See response to Question 3

MDLinx: Is marijuana misuse becoming a focus of the Board’s efforts to address substance use disorder among members?

Board: The Board investigates all complaints (including cannabis use—medical or recreational) it receives regarding a doctor who may be impaired. The Board must determine if a physician is impaired, which may require an evaluation pursuant to Business and Professions Code section 820. If it is determined through the investigative process that it would be dangerous to allow the doctor to continue practicing, the Board can petition for an Interim Suspension Order on the doctor's license preventing the doctor from practicing medicine pending resolution of the matter. If the Board determines a doctor is impaired, appropriate disciplinary action will be taken.

MDLinx: In the eyes of the Board, how does marijuana use compare with alcohol use?

Board: As explained above, they are no different. A physician cannot be impaired pursuant to Business and Professions Code sections 822 and 2239.

MDLinx: I understand that physicians in California can prescribe marijuana. Have you noticed that physicians who prescribe the drug use it, too?

Board: The Board is unable to provide information regarding this question as the Board does not track the number of doctors who recommend cannabis. Also, cannabis is not a prescription, it is a recommendation that a physician can make for the treatment of certain conditions.

MDLinx: Has the California Board worked with other state and national licensing authorities to address marijuana use among member physicians?

Board: At this time, the Board has not worked with other states or national licensing authorities to specifically address the use of cannabis for medicinal and/or recreational purposes among physicians.

Please note that California is only one state, and the Medical Board of California can provide information only regarding licensed California physicians. Nevertheless, their answers offer insight into whether physicians can smoke marijuana.