Chapter One: Why Employers Need a Medical Cannabis Policy

The current landscape, and why most UK employers are unprepared for an employee bringing a legal medical cannabis prescription into the workplace. 

Patient numbers have grown sharply since medical cannabis prescribing was legalised in the UK in 2018, yet awareness among the general population has failed to match its pace. 

This dynamic means that medical cannabis patients often face difficulties in the workplace, in their properties, and with law enforcement, despite their prescriptions being entirely legal and fully regulated. This is born not of prejudice, but a lack of awareness and understanding. 

Releaf Protect, a first-of-its-kind legal support service for patients at Releaf Clinic, has fielded 114 support sessions for roughly 70 patients between January and April 2026 alone. Issues relating to the workplace and employment accounted for 29% of those calls, nine of which involved discrimination concerns, with the average employment-related call running longer than 16 minutes.

Rupa Shah, Chief Legal and Compliance Officer at Releaf, believes that the prevalence of employment issues among the patient community reflects a policy vacuum among UK employers. 

‘Without a clear policy, employers are more likely to be influenced by their understanding of recreational drug use and will improvise, resulting in inconsistent decisions, unnecessary suspensions and potential discrimination. 

‘The employment enquiries reaching Releaf Protect often begin because an existing zero-tolerance policy never contemplated lawful treatment.’  – Rupa Shah

The zero-tolerance trap

The core misunderstanding sits with HR teams rather than line managers. Medical cannabis prescriptions remain incredibly rare on the NHS, meaning most prescriptions carry an ‘unlicensed’ label. This is a regulatory quirk rather than a red flag. Many HR teams read that combination as evidence the patient obtained the drug illegally.

‘Many HR teams still equate prescribed cannabis with illicit drug use, or assume that because it is rarely available on the NHS and has an ‘unlicensed’ label, most patients have obtained it illegally.’ – Rupa Shah

This, in turn, directly influences workplace policy. A drug-testing or disciplinary policy written for recreational use, with no clause distinguishing a valid prescription, leaves a line manager with no clear or properly informed route to a proportionate response when a legitimate patient tests positive for THC. 

Patients stopped by police with a valid prescription have reported confusion even among frontline officers unfamiliar with how a prescription should be handled, while a further 2022 investigation found patients risked criminalisation through drug testing that could not distinguish lawful treatment from recent impairment. Employers inherit the same evidentiary problem with none of the police training designed to address it.

Why disclosure feels risky

The result is that patients often do not trust their own employer to handle a disclosure fairly, and go looking for outside advice before they say anything at work at all.

‘The automatic assumption is often that it is illegal, that you must be a certain type of person to take cannabis, and that you’re probably impaired and incapable of working effectively or safely. Some contact Releaf Protect before speaking to HR because they do not trust that disclosure will be handled fairly or confidentially.’ – Rupa Shah

A 2023 survey found patients at risk of workplace discrimination simply for holding a valid prescription, and union representatives have since begun engaging directly on the issue. Cannabis Health reported in September 2025 on the growing role of unions in supporting members through exactly this kind of disclosure conversation.

How can employers treat patients fairly?

The best course of action for employers is to simply update the medicines and drug-testing policy, build a confidential disclosure route, and use individual risk assessments rather than blanket rules. None of it requires new legislation.

‘Employers should update their medicines and drug-testing policies, create a confidential disclosure route and use individual risk assessments. Our work with ACAS and other stakeholders has reinforced that employers need practical guidance before a difficult case arises.’ – Rupa Shah

Through Releaf’s engagement with ACAS and other stakeholders, it knows that employers have repeatedly requested a working framework they can apply before, not after, a case lands on an HR desk, rather than a legal lecture. This handbook aims to provide just that. 

Chapter 2,