Can Healthcare Workers Smoke Weed in New York

Dr. Clare Cherco | January 16, 2026

Can Healthcare Workers Smoke Weed in New York?

The passage of the Marijuana Regulation and Taxation Act (MRTA) represented a radical departure from the past in New York State’s approach to cannabis use among adults; however, the healthcare industry is still trying to catch up with the new state rights regarding medical marijuana use while adhering to existing regulatory safety standards.

While most New York State residents can now legally enjoy using cannabis (similar to having a glass of wine after work), the laws surrounding cannabis usage for healthcare professionals are more complicated than for non-healthcare professionals. Healthcare professionals, including nurses, physicians, and members of the clinical staff, face unique challenges with regard to their roles within the healthcare system because of how closely linked their jobs are to public safety. The consequences of an individual making a poor decision as a healthcare provider can have dire consequences for patients, potentially leading to serious medical errors.

Understanding how to balance both your rights under the New York State Labor Laws and the responsibilities you have to your employer will be instrumental in successfully navigating your career as a healthcare professional.

Is Marijuana Legal in New York?

As of 2021, the recreational use of cannabis is a legal activity under New York state law. Anyone 21 years of age or older can possess and use cannabis outside their job. Typically, New York state law prohibits employers from firing or disciplining an employee for an off-the-job activity.

Even though State Law allows you to possess & use cannabis, it does not mean that ‘you have a license to smoke’ while on the job. Furthermore, employers have the authority to establish a drug-free workplace and forbid any consumption of cannabis during the time worked at work hours.

Medical Marijuana vs. Recreational Use

New York’s Medical Cannabis Program provides a higher tier of protection. Under the law, certified medical marijuana patients are considered to have a “disability” under the New York State Human Rights Law.

Recreational: Protected under NY Labor Law §201-D for off-duty use, akin to other legal activities.
Medical: Protected as a medical necessity, potentially requiring employers to provide “reasonable accommodations.”

In healthcare, however, even a medical card isn’t a “get out of jail free” card if the use interferes with patient safety.

Can Healthcare Workers Legally Smoke Weed in New York?

Healthcare Worker

New York Labor Law Section 201-D prohibits employers from discriminating against an employee for using marijuana during their free time and away from the employer’s property. The terms of Section 201-D specifically state that it does not matter if the cannabis was used at a specified location (such as the employee’s home), as long as the substance was not consumed on the job or while using the employer’s equipment.

The “Impairment” clause: allows employers to take action against an employee for “articulable symptoms of impairment” while on the job. If an employee appears to be intoxicated or unable to do their job due to cannabis use, then the employer may take action against that employee, even though the employee may have been using cannabis legally before coming to work.

Does Legal Use Mean Job Protection?

For healthcare workers, the answer is often no. Many healthcare professionals and others will typically say “no” to this question. Just because something is legal does not mean that people will have immunity from prosecution or similar actions, because employers (hospitals and clinics) are highly regulated environments. Often, employers establish rules that are stricter than those typically found in a standard office setting.

Healthcare Workers and Drug Testing in New York

Yes. Despite the MRTA, healthcare workers are still frequently drug tested.

Pre-employment: Many hospitals still require a “clean” screen before hiring.
Post-incident: If a medication error occurs or a patient is injured, a drug test is a standard procedure.
Random Testing: Still common in high-stakes environments like the ER or OR.

Can Employers Test for Marijuana in New York?

The NY Department of Labor (DOL) issued guidance stating that most employers cannot test for cannabis as a condition of employment unless a specific exception applies. The Exceptions:

Federal Mandate: If a federal law (like DOT regulations) requires testing.
Federal Funding: If the employer loses a federal contract or funding by not testing.
Safety-Sensitive Roles: While “safety-sensitive” is a broad term, healthcare employers often argue that clinical roles fall into this category to justify testing.

Safety-Sensitive Positions in Healthcare

In New York, a safety-sensitive role is one where impairment could lead to immediate physical harm or death. This includes:

Registered Nurses (RNs) and LPNs.
Physicians and Surgeons.
EMTs and Paramedics.
Radiology and Surgical Technicians.
Pharmacists.

Why Cannabis Use Is Treated Differently in These Roles

Primarily, patient safety motivates this approach. In contrast to alcohol, which can be metabolized rapidly from the system, THC is present in the user’s body long after consumption. While cannabis breathalyzers are emerging (e.g., for roadside use), they’re not standard in workplaces. Hence, hospitals rely on urine/blood tests detecting past use, hospitals have opted to enact a zero-tolerance policy toward employees who use marijuana or have a history of use.

Federal Law vs. New York State Law

Cannabis at the federal level was reclassified as a Schedule III drug bythe DEA in 2024/2025. Even though this reclassification reduces some of the stigma associated with federal prohibition, it does not resolve all of the conflicts between state law and federal healthcare funding rules or other areas. As a result, there is a considerable discrepancy in federal-state law as it relates to cannabis regulation.

Impact on Federally Regulated Healthcare Jobs

The majority of hospitals accept payment for services through both Medicare and Medicaid and must adhere to the Drug-Free Workplace Act of 1988 to retain these forms of funding. If a hospital has any concerns that permitting marijuana use by their employees, even while not on duty, would be a violation of their obligations under federal law, such hospitals will choose to comply with federal law and, in doing so, forego any obligations under state laws that protect the rights of employees.

Medical Marijuana Protections for Healthcare Workers

Using a medical card in New York provides users with the legal protection associated with having a disability and requires employers to go through an interactive process with employees to determine whether or not they can provide them with accommodations.

Situations Where Employers Can Still Take Action

An accommodation does not allow you to be impaired in the workplace. If your doctor-prescribed medication causes you to test positive on a drug screening and you work in an area where drug-free is a legitimate job requirement (a surgeon, for example), your employer can lawfully fire you.

Professional Licensing and Cannabis Use

The New York State Education Department (NYSED) oversees the licensing of Registered Nurses through its Office of Professions; while the state has taken steps to safeguard licensees with regard to their use of cannabis for non-medical purposes, the definition of “professional misconduct” remains expansive.

Reporting: If a hospital fires you for a positive test, they may be required to report you to the state board.
Discipline: If the board determines your use poses a “risk to the public,” they can suspend or revoke your license.

Boards and Regulatory Oversight

As of 2026, many boards are becoming more lenient toward off-duty recreational use, but they remain strictly against any use that results in workplace impairment.

Hospital and Employer Policies on Marijuana Use

Many major New York hospital systems (like NYU Langone, Northwell, or Mount Sinai) maintain zero-tolerance policies. Their employee handbooks often state that any detectable amount of THC is a violation of policy.

Employer Rights vs. Employee Rights

Internal hospital policies often “override” personal use rights because the employee voluntarily agreed to the policy as a condition of employment. Always read your specific hospital’s policy on “Substance Abuse and Drug Testing” before assuming you are safe.

What Happens If a Healthcare Worker Tests Positive?

Immediate Termination: The most common outcome for clinical staff.
Suspension: Often pending an investigation or completion of a drug rehab program.
Nurses to PAP: physicians to IPAS (Impaired Physicians Program) or similar.

Appeals and Legal Options

Under NY Labor Law 201-D, any New Yorker who believes their employer terminated their employment without a federally mandated reason may pursue an action for wrongful termination against their employer, provided that they are not impaired by means of disability at the time of termination. In most cases, pursuing a wrongful termination action against a major healthcare system requires significant funds and time, which may not be available to the average employee.

Conclusion

As New York legalized cannabis, the healthcare industry continues to designate a “high-risk” environment for users. The difference between the State and Federal protections creates a grey area where the employer often has an upper hand legally.

In summary: Unless there are changes to federal law or the healthcare sector adopts an “impairment-based” test rather than a “presence-based” test, healthcare sector workers must be proactive and very careful when using cannabis or any cannabis product, and protecting their licenses or careers, which are their greatest assets, should be of utmost importance.