Cannabis and Massage Therapy: What you need to know

Cannabis use is now legal in Canada, not only for medicinal purposes but also for recreational use.  Many people turn to Cannabis for pain management or symptom relief from conditions such as M.S., Parkinson’s, epilepsy, anxiety, depression and chronic pain.  Massage therapists work with clients with many of these conditions, assisting in restoring function, movement and helping them return to a pain-free life. 

What Happens Now

Cannabis use is now as legal as drinking, smoking, taking Tylenol, or prescription medications.  Do not be too quick to judge, but at the same time don’t ignore or downplay Cannabis use in your practice.  The legalization of Cannabis does not alter your rights and responsibilities as a massage therapist.  The impact of the consumption of drugs and alcohol by yourself or your clients remain the same.  The main point to remember is that the use of Cannabis will be treated much like the use of alcohol or other drugs in your workplace. 

Cannabis Use by a Massage Therapist

Employers have the responsibility to ensure the health and safety of their employees and thus have a duty to prevent the risk of their employees being impaired at work.  Employers may control Cannabis use by employees not only at work or during employee breaks but also for fixed periods of time prior to starting work.  The law in Canada allows employers to require its employees to be unimpaired at work.  Employers are legally entitled to test for drug impairment of their employees using reasonable methods.

How Cannabis Use Can Impact Your Practice

So, what does this mean for you in your practice?

  1. You cannot be impaired at work;
  2. You cannot recommend Cannabis use to your clients. When it comes to prescribing medication, you must advise your clients to consult with their doctor or pharmacist.
  3. If a therapist believes their clients are under the influence of any drug (including Cannabis) or alcohol making it unsafe for them to participate in massage therapy, you should reschedule the appointment. 
  4. You should be aware that under Alberta’s Traffic Safety Act you are also obligated to inform the police if you believe a client will be driving impaired. (This applies to impairment from either Cannabis or alcohol or any other substance).
  5. Cannabis can have different effects on each individual and can impact on how a person moves or functions.  Some of these effects can impact a person’s cardiovascular function, their perception of pain, and their memory or attention. These are all contraindications to massage therapy treatment.

What to do as a Massage Therapist When Your Client is Using Cannabis

  1. If your client appears impaired, you should follow your clinic’s policies and procedures for dealing with any impaired individual.  This may require you to cancel your treatment or rebook it to a different time.
  2. A client impaired by Cannabis may not be able to provide informed consent to treatment.
  3. If your client uses Cannabis but is not impaired at the time of treatment it is important to take a thorough history and understand why your client is using Cannabis.  The reasons for their use of Cannabis can offer information, assisting you to provide an appropriate treatment and use evidence-based resources to assist you to manage their condition.
  4. You may not advise your client to use Cannabis. You may give your clients guidance towards reputable sources of information and refer them to their doctor or pharmacist.
  5. Your client may have many reactions to Cannabis and this may require you to modify how you deliver treatment.  As there are many different types, strengths and dosages of Cannabis, it is best to be cautious if you know your client recently used Cannabis or if they are a regular user.  Cannabis is often used for its pain relief properties and so it follows that your client may have a blunted response to pain.  As a result, some modalities which require intact sensations such as hot stones or deep tissue massage may be contraindicated.  Also, Cannabis use can have an effect on memory or cognition which may impact how your clients retain educational tips or advice.  Finally, the use of Cannabis affects cardiovascular and respiratory function, increasing heart rate and blood pressure.  Long term use may lead to opposite effects of decreased heart rate and blood pressure, as well as respiratory issues associated with smoking.

The Use of CBD Oils and Lotions

Cannabidiol oil or CBD is a Cannabinoid oil extracted from Cannabis plants.  Oil derived from Cannabis, including CBD oil, is a controlled substance and can only be purchased with a medical marijuana prescription or from a licensed Cannabis retailer.  Unlike THC, CBD does not produce a high or intoxication.  Notwithstanding that, you cannot legally purchase Cannabis-based oils in Alberta except from a licensed retailer or with a medical marijuana prescription.

Some internet retailers are claiming their products containing CBD are allowed in Canada because they don’t get you high.  The unauthorized movement of any form of Cannabis across Canada’s borders or through the internet remains a serious criminal offence.  Health Canada is concerned about claims made by retailers touting health benefits which are not yet proven.  Health Canada is especially concerned about advertisements relating to the use of CBD oil which may be false, misleading or deceptive, and those which advertise Cannabis in relation to therapeutic claims. 

So where does that leave us?

  • Do not use oil or lubricants that contain any amounts of CBD or THC
  • Do not sell any products that contain any amounts of CBD, THC or Cannabis.  The sale of such products is limited to licensed Cannabis retailers.
  • Do not recommend any products that contain CBD or THC, as prescribing or recommending controlled substances is not within the scope of practice of massage therapy.

Some Important Points Everyone Should Know About Cannabis

  • There are limits on the amount a person can possess. Trafficking is still a serious criminal offence.
  • It is not legal for minors (under 18 in Alberta, older in some provinces).  It is illegal to provide it to minors
  • The locations one can use Cannabis are very limited – generally even more limited than where one can smoke cigarettes or drink alcohol.  Each municipality will have their own regulations on where Cannabis can be smoked.  Many landlords and condominium associations will also have rules on smoking of Cannabis.
  • Edibles are not yet legal to sell.
  • DON’T take Cannabis across international borders. In Canada, it is a crime punishable with up to 14 years in prison!   If convicted, you could lose your right to travel outside of Canada.   Canada is only the second country in the world to legalize recreational Cannabis.   Recreational Cannabis use is still illegal virtually everywhere else in the world.   While recreational use of Cannabis is legal in ten states in America IT IS NOT LEGAL in most US states and it is illegal to cross the US -Canada border with it EVEN into a state that has legalized it.  Border Services are federal jurisdiction and the US federal government has not legalized Cannabis. Even medically prescribed use does not entitle you to cross an international border with Cannabis.
  • Impaired driving from Cannabis is as dangerous and treated as seriously by police and the courts as impaired driving from alcohol.  Cannabis can’t even be within the reach of anyone in a vehicle.
  • Minors can’t enter Cannabis stores – not even with an adult.
  • Even though Cannabis is legal, Health Canada still advises that its use poses risks to health.  Smoking Cannabis is not recommended just as smoking cigarettes is not recommended. Cannabis contains hundreds of substances and the impact on a person’s health is not yet fully understood. 

If you have further questions about how Cannabis affects you or your Massage Therapy business, please contact your CRMTA member representative.