The people being fired for using medical cannabis are the ones who need it the most.

After the Ocean City Fire Department in New Jersey initiated a cannabis drug testing policy, Brad Wiltshire was left choosing between his job and his health. Medical cannabis is legal in New Jersey, and it was recommended to him by his neurologist. Wiltshire was diagnosed with dystonia, a movement disorder that causes uncontrollable muscle spasms that result in intense pain.

Wiltshire has been a firefighter for 20 years, and was involved in 9/11 recovery, which by itself has caused a host of illnesses, associated with the debris and environment that emergency workers had to endure. By all accounts, he was an exemplary member of the team. He explained to his chief that he uses medical cannabis to treat his condition, knowing from experience that it does not affect his ability to do his job. But he was suspended. The best the chief could provide was paid sick leave with his accompanying medical benefits in tact. He’s now waiting for the city to determine his future as a firefighter.

“The emotional impact on me and my family — you’re almost going to make me tear up here — it’s the hardest thing I’ve ever gone through in my life. I have a disease, and it’s so fucking hard,” said Wiltshire. “It’s wrecked my family. We’re so close, but we’re so depressed. It’s such an unhappy house.”

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Brad Wiltshire (Jessica Kourkounis photo/BuzzFeed News)

Wiltshire is fighting the decision through a lawsuit against the city, which asks for his job back as well as the freedom to use medical cannabis when off-duty. The lawsuit specifies that denying him the use of medical cannabis is “in direct violation of the letter, spirit, and intent of the New Jersey Compassionate Use of Marijuana Act,” and he is requesting compensation as a result of the policy.

The majority of cannabis legislation, both recreational and medical, leaves the door open for employers to continue to drug test and terminate employment based on a positive result. While many white collar working environments choose not to have such policies, jobs that require heavy lifting, the operation of heavy machinery, emergency personnel, airline workers, and truck drivers are subject to drug testing, regardless of medical marijuana laws. While these policies are meant to ensure the safety of these employees and the people and property around them, they are more likely to suffer from ailments and injuries due to the physical aspect of their work. After a 1991 train crash that killed 16 people and injured 174 people, Congress made drug testing mandatory for “safety-sensitive” workers, after it was determined by the National Transportation and Safety Board that an engineer was using marijuana to the point of impairment.

Many of these employees are left to suffer or use prescription opioids, which are causing a public health crisis. According to the CDC, as many as one in four people who are prescribed opioid painkillers for chronic pain conditions develop addiction behaviors. Drug overdoses alone decreased the life expectancy of Americans for the first time in over 20 years.

If the concern is that medical marijuana will impair a person’s physical and mental abilities, then the alternative is just as dangerous.

Wiltshire was prescribed muscle relaxers that came with plenty of cautionary literature that advised against driving and operating heavy machinery. As with many tranquilizers, they lose effectiveness over time and are not a long-term solution. Wiltshire eventually switched to medical cannabis when his prescription drugs failed, and it proved to be a more effective treatment.

His case is not unique. The ACLU filed a lawsuit against Walmart in 2010 on behalf of an employee who was injured on the job. Joseph Casias was suffering from a brain tumor and cancer while working at Walmart, but his injury required that he undergo a drug test. “No one should have to choose between pain relief and gainful employment,” the ACLU wrote. “No employer should ever have to tolerate on-duty drug use or intoxication, but employees who legally use medical marijuana to treat the symptoms of painful and debilitating diseases should not be fired for doing so.” The lawsuit was unsuccessful, and similar cases tend to favor the employer.

While employers may want to accommodate medical cannabis during non-business hours, the issue of determining impairment has still evaded scientists. Devices similar to an alcohol breathalyzer are being developed to determine cannabis impairment, but they are still in the testing phase and not ready to be used in court. Instead, employers and law enforcement rely on blood tests. But cannabis can remain in the blood up to a month after the last date of consumption, which in no way determines impairment. In addition, medical marijuana users are more likely to develop a tolerance from ongoing cannabis use to treat chronic conditions.

But Ocean City officials may not be aware of cannabis tolerances, or what constitutes impairment for a regular medical cannabis patient. In response to Wiltshire’s suit, the city responded in a brief defending the fire department’s policy on medical cannabis. “Any argument that the lack of an incident during this period speaks to the Plaintiff’s ability to function while medicated is fallacious, like the argument that a drunk driver who has not been in a crash can safely drive,” the brief said.

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