While CBD oil is legal for medical use in Australia, there are still some questions about its use, such as ‘will CBD show up on a drug test’.
It’s a new world for Australia’s workforce as cannabis medications are being increasingly prescribed by medical practitioners across Australia for a number of different conditions, potentially reducing or replacing a lot of other drugs like benzodiazepines and opioids.
There are a lot of unknowns when it comes to drug testing, impairment and what that means while working or driving. The current system, unfortunately, puts a lot of uneducated patients at risk of heavy fines, losing their license, job or having to defend themselves in court for their medical use of cannabis products.
The Therapeutic Goods Administration (TGA) and State Health Departments require physicians to consent their patients to not drive or perform safety sensitive tasks while they are taking medicines containing THC (delta-9 tetrahydrocannabinol) – but what about CBD (cannabidiol)? And is it safe to drive or work while taking THC or CBD medications?
First, let’s look at THC, the cannabinoid that can cause impairment.
A study completed by The Lambert Institute here in Australia, which was published in the journal of Journal of Psychopharmacology, found that THC-dominant and THC/CBD balanced cannabis medications ingested by trial participants led to greater lane-weaving and leaving large gaps in between other cars.
In this study from Canada, people given THC showed signs of impairment, centering the car poorly in its lane and driving inappropriately slowly. However, after 24 and 48 hours the THC group showed no signs of impairment, though they still tested positive for THC.
In Australia, it is illegal to drive with any amount of THC in your system – that means that the roadside tests which are used (saliva swabs, blood, and urine tests) are not testing for impairment, but simply the presence of THC.
What if a THC medication is taken at nighttime, and someone drives or works the next day? Will THC show up in a drug test?
Although the current saliva test used by Australian police is very inaccurate for detecting THC (read another study by the Lambert Institute published in the journal Drug Testing and Analysis), it is still possible, and technically, you would be breaking the law.
The Lambert Institute Study showed false negative rates were 9 percent and 16 percent for the two devices tested, but they also sometimes gave a positive result when saliva THC concentrations were very low or negligible (false positive rate of 5 percent and 10 percent). That said, if you’re using THC products, you may pass a saliva swab, but THC is definitely going to show up in your urine or blood and can potentially impact your insurance policy if an accident were to occur.
What we know is that THC is lipophilic (fat-loving) which means it can be stored in your fat cells – sometimes for up to a month, depending on frequency and levels of use, which could lead to the potential for a failed drug test weeks after your last dose. This puts a lot of patients in a tough spot – if THC medications are the best for your condition, do you forgo THC medications altogether (and use other pharmaceutical drugs) or give up driving? Alternatively, some patients can achieve the same results with CBD medications depending on their condition, but this is often in much larger amounts which can mean more expensive treatment.
Managing Anxiety Disorders
Anxiety disorders can be effectively managed, and the first step is a diagnosis in partnership with your trusted medical practitioner. This can be a challenging step as symptoms can be both physical and psychological, can coexist with other conditions such as depression, and be exacerbated by lifestyle factors and stressful situations. Anxiety disorders are often chronic and relapsing, and management strategies are most beneficial when they are practised long term.
The first strategy to manage anxiety often involves partnering with a practitioner trained in support therapies, such as eTherapy or cognitive behavioural therapy (CBT). Cognitive approaches can be as effective as medication, and have fewer adverse effects, especially for those with mild-to-moderate disorders. Strategies such as physical exercise, a balanced diet, reduction of alcohol, caffeine and sugar intake, mindfulness, adequate sleep, and self-care have all been shown to reduce anxiety, which in turn allows optimal immune system function.
People with more severe or persistent anxiety disorders, however, may require medication in addition to lifestyle strategies and cognitive approaches.
But what about CBD in Australia?
In roadside and workplace drug tests, police and employers aren’t looking for CBD, as CBD is non-intoxicating and is not known to affect cognitive abilities like motor skills or judgement. However, a number of medicines in Australia which are CBD dominant sometimes have THC present, sometimes up to 2 mg/mL which can cause impairment in some patients depending on dose. For example, full-spectrum CBD products can still contain trace or measurable amounts of THC.
Over a period of time, THC can accumulate in the body even in trace amounts, and deposit in fat cells. The half-life for THC/CBD can be at least 4+ days, and it may take up to 5 days for 80-90% of the total dose to be excreted. This means that depending on the amount of THC in your CBD product and the amount of CBD you are taking, the residual THC amounts could put you into the danger zone.
So, will I fail a drug test for CBD? Possibly.
Again, you won’t fail a drug test for CBD, but you could potentially fail a drug test for any residual THC in that CBD product. This is why it is important that you are prescribed a product that is legally manufactured in a government-approved facility, and which is therefore supplied with a certificate of analysis that shows exactly how much CBD and THC (if any) is present. Legal CBD-only products sold under Schedule 4 (S4) contain no THC.
Would it show up in a saliva swab on a roadside test? Most likely not.
That said, most employers do urine tests to test for THC, and an employee would fail a drug test if their urine tests positive for any more than a trace amount of the THC metabolite, THC-COOH, usually at 40-50 billionths of a gram per milliliter of urine (40-50 ng/mL). On top of this, a lot of old technology is still being used (gas chromatography) which is known to show false positives.
How long do trace amounts of THC take to leave my system?
There are a lot of factors that lead to this, including how much you took, method of administration (inhalation versus oral) how long you’ve been taking the product, your metabolism, and other factors like hydration levels.
You could hypothetically take a CBD-dominant medicine with very low levels of THC, or a CBD full-spectrum oil for months, at low amounts (50 mg/day), and never fail a urine screen for THC-COOH. It is not clear how much CBD oil is needed—or for how long—to end up with more than 40-50 ng/mL of THC-COOH in your urine. But certainly, if you’re taking large amounts of these full-spectrum CBD products (we are talking hundreds of milligrams daily), you could theoretically test positive for THC.
What can I do to protect myself?
This information is not meant to scare you from taking cannabis medications, but instead be well-informed so you can make an educated decision on whether it is right for you.
Firstly, see if your workplace has a drug and alcohol policy. What do they test for? How do they test for THC? What levels are deemed inappropriate? Before starting your medication, disclose to your employer what you have been prescribed. Most workplaces want to see you succeed, and if the medication will help your quality of life at home and productivity at work, they might get on board.
Secondly, if using CBD medications with trace amounts of THC, disclose this on roadside tests prior to any swab test. It is best to disclose this upfront as a medical patient, but remember – this is NOT a get out of jail free card. If you test positive for THC, you will most likely lose your license, receive a fine, or receive criminal charges for driving under the influence.
And finally, if you have to drive or perform safety sensitive tasks, regardless of when your last dose was, always ensure that you feel alert and able to do so, otherwise, wait until you feel capable to drive or find other forms of transportation.
To close, it’s imperative to find better solutions for drug testing for medicinal cannabis than the current ones, in line with other countries. Professor McGregor comments, “We should instead be focusing on developing novel methods for detecting drivers who are impaired by cannabis. The two devices used by police in MDT were never designed to measure impairment. Authorities in other jurisdictions, such as Canada, remain far more cautious in their use of such devices,”