Regulation Matters 2018 - Issue 2

Cannabis: What You Need to Know

The College has already received calls from dietitians asking how the legalization of recreational cannabis will impact their practice. The same laws and regulations and the same professional practice obligations and responsibilities apply to recreational cannabis as to any other substance that can impair practice or otherwise impact safe, client-centred care. Dietitians must always be fit to practice and must always be able to provide ethical, competent and safe client services within their own scope of practice.

1. If I use recreational cannabis, why should the College get involved? This is my private life.

The College has a legal mandate for public protection and would get involved if a dietitian was found to be practicing dietetics while impaired under the provisions of the Regulated Health Professions Act, 1991, or if a dietitian was charged with or found guilty of a criminal offence related to cannabis, such as driving while impaired by cannabis or any other substance.
Provision 8 of the College's Professional Misconduct Regulation states that it is misconduct to, "practice the profession while the member’s ability to do so is impaired by any substance”. Using cannabis can impair a dietitian’s ability to practice safely and competently, which puts clients at risk. It is mandatory for employers and colleagues to report any dietitian who has been practicing dietetics while impaired by cannabis or any other substance.

2. Is it within my scope of practice to advise clients with respect to cannabis?

The College has received questions from members about whether they can provide advice to clients in relation to cannabis consumption. Nothing has changed in the regulatory landscape for dietetic practice regarding giving advice to clients with respect to cannabis. Legalization of recreational use of cannabis has not changed the scope of practice of the profession. There may be legitimate advice within the scope of practice of dietetics that deals with the use of cannabis by clients (i.e. impact of cannabis consumption on appetite). Members must use their own judgement to determine what, if any, advice regarding cannabis consumption properly falls within the scope of practice of dietetics.  Keep in mind that just because cannabis can be incorporated into food, does not mean that it falls within the scope of dietetic practice.  

3. Should I be collecting information about the use of cannabis from clients?

The Personal Health Information Protection Act, 2004 has established rules for the collection, use and disclosure of personal health information.  Dietitians should only inquire about the use of cannabis when there is a legitimate reason to do so. If asking questions about cannabis is necessary for providing care, dietitians should clearly explain why they need to collect this information.

4. What do I need to be aware of when obtaining informed consent for treatment from a client who has been using cannabis?

Under the Health Care Consent Act, 1996, clients are assumed to be capable to consent to treatment. This means that, a person is presumed to have the ability to understand the treatment information, the options and the consequences of a decision or a lack of a decision relating to their treatment.

If clients are unable to understand and appreciate information relevant to the decision being made about their care, whether due to the use of cannabis or any other substance, then they are unable to provide informed consent. It is important to note that the mere presence of cannabis in the body does not make someone incapable of giving consent.

5. How can I determine if someone, another dietitian or health provider, is working while impaired? 

Some of the signs* to look for are:
  • personality changes or erratic behaviour (e.g. increased interpersonal conflicts or overreaction);
  • appearance of impairment (e.g. odor of cannabis, alcohol or other substances, glassy or red eyes, unsteady gait, slurring, poor coordination);
  • working in an unsafe manner;
  • consistent lateness or absenteeism; and
  • reduced productivity or quality of work

 *from Canadian Human Rights Commission,  2017, p. 5:Impaired at Work – A guide to accommodating substance dependence

If you have any further questions about the legalization of cannabis, refer to the Government of Canada’s resource or contact the College’s Practice Advisory Service:
416-598-1725 / 1-800-668- 4990 ext. 397