‘I chose to unenroll’: Why a Utah nursing student had to leave school over medical cannabis

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A Utah mother of three couldn’t find housing that would accept her family after she tried to buy medical marijuana and ended up getting charged with a crime.

An Ogden firefighter had to sit on the sidelines for months, drawing down his sick leave as he battled his employer over his right to hold a cannabis patient card. And a Morgan nursing student had to choose between her schooling or the marijuana treatments that had changed her life.

Advocates say they are too often hearing stories like these — about patients who are seeking relief for their ailments through Utah’s medical cannabis program but are discovering that legal doesn’t always mean free of consequence.

“There is that mindset in a lot of patients that just see this [program] as nonsense because it doesn’t actually offer protections the way that it was designed to,” said Desiree Hennessy, executive director of Utah Patients Coalition. “I mean, if you’re still having to cough up $5,000 because you got caught with a medical cannabis card and your product, then they see it as, ‘Well, what’s the point?’”

Utah lawmakers this legislative session are trying to tackle at least a piece of this problem, advancing a bill in response to a standoff between Ogden officials and a city firefighter.

State code already requires government agencies to treat an employee who uses medical marijuana the same way they would treat someone who legally takes prescription narcotics. Now, state Sen. Daniel Thatcher is trying to tighten up this law even further by prohibiting Utah’s public employers from punishing a worker for simply having a cannabis patient card.

Thatcher says employers have every right to discipline someone who shows up intoxicated to work but shouldn’t be allowed to discriminate against people just for pursuing a legal remedy.

Thatcher’s legislation would help close one of the loopholes that have enabled discrimination against cannabis users, Hennessy says. But more than three years into Utah’s program, she also is growing frustrated that many in power, from judges to government employers, still seem confused about state marijuana laws. And then there is the biggest and thorniest issue of all — that locally sanctioned cannabis use is still illegal on a national level, a discrepancy that will likely continue to bedevil state programs until the federal government resolves it.

These fixes might come too late for some patients.

Giovona Ralphs lowered her daily oxycodone dosage by shifting to marijuana a couple of years ago but said legal repercussions that upended her life have since left her too scared to participate in the state’s cannabis program. Instead, she is relying once again on opioids.

“How am I going to be a parent on pain medication that knocks me down?” the Ogden mom said. “What are you going to do if I end up addicted to pain medication because I was too afraid to use cannabis for my pain?”

Trouble at a traffic stop

By early 2020, Ralphs was up to six daily doses of oxycodone to dull chronic pain from an autoimmune disease and an old back fracture.

The drugs were knocking her out, making it hard just to get out of bed, and her body was growing dependent on them, she observed, noticing that it was getting more painful to skip a dose.

Ralphs’ physician wondered if medical cannabis might help her wean herself from the heavy-duty painkillers — and sure enough, after she had been trying the plant-based substance for a bit, she was able to slash her oxycodone use by a third. She felt well enough to get out of bed and go fishing, something she hadn’t managed to do in a year.

“It was helping a ton,” she said.

So in May of that year, the family packed up into their car and drove across state lines to re-up at a dispensary in Dinosaur, Colo. They had headed back into Utah when a police officer pulled them over near Vernal.

The officer ultimately discovered the cannabis, which was meant to be a six-month supply for Ralphs and her husband, also a medical marijuana patient. He didn’t believe them when they insisted it was legal, she said, and slapped both of them with drug possession charges.

After leaving the traffic stop, the family pulled over at a nearby convenience store, and Ralphs darted into the bathroom to collapse on the floor in tears.

“I didn’t want to lose my children,” she said. “You get in trouble with drugs, and you get in trouble with stuff like that, especially in the state of Utah, you’re looking at losing your kids.”

Hennessy later got involved to help the couple navigate the cases against them and said she was able to point the prosecutor to the laws that showed the couple was allowed to buy cannabis flower from out-of-state while Utah was still rolling out its program. They asked state health officials to confirm that Ralphs’ husband held a cannabis card and showed prosecutors a written statement in which Ralphs’ physician acknowledged recommending marijuana as a treatment. Ralphs shared the statement with the Tribune.

However, unbeknownst to the couple, the Colorado dispensary had tucked a complimentary joint into the couple’s sealed to-go bag, Ralphs said.

Hennessy says these types of “exit joints” are provided by some dispensaries, but Utah’s medical program doesn’t permit cannabis in this form, and Ralphs ultimately pleaded guilty to a drug paraphernalia charge.

Because of the legal problems, Ralphs was denied when she applied for low-income housing, and the family had to spend months longer living in her parents’ basement. It wasn’t until late last year that they found a place that would accept their housing voucher, she said.

She is still relying on heavy-duty painkillers to get by, she said. Cannabis is too much of a risk.

A fire department’s ultimatum

Levi Coleman has been working as an Ogden firefighter for more than a decade, an “exemplary” employee despite suffering from chronic back pain, his attorneys say.

Last year, a doctor recommended that he try cannabis, and Coleman received his state-issued medical cannabis card the following day.

Coleman knew that telling his fire department about the card could create problems but disclosed it anyway, according to court documents. And sure enough, the city gave him an ultimatum — leave the state’s medical cannabis program or don’t bother coming to work.

“He said, ‘No, I’m following the doctor’s prescription, which would mean there is no chance of being impaired. And it works for me, the prescription works for me. And I don’t want to relinquish it,’” said Jack Tidrow, president of the Professional Firefighters of Utah, which has helped represent Coleman.

Instead of giving in, Coleman sued.

His case argued the city had been violating state law that prohibits public employers from discriminating against cannabis patients and requires them to treat medical marijuana the way they would an opioid or other prescribed controlled substance.

But he had to burn through his leave for the last five months as he battled his employer, unable to do the job he loves.

The lawsuit states that other firefighters faced with the same choice have relinquished their cannabis cards rather than deal with the professional consequences.

The city of Ogden contended that they have followed state law to the letter and are treating Coleman exactly as they would someone with an opioid prescription.

“In that case, what we do is we rely on medical standards and medical recommendations,” Gary Williams, Ogden city’s attorney, told a legislative panel last month.

And in the opinion of the city’s physician, Williams said, medical cannabis would interfere with a firefighter’s job performance (although Coleman’s lawsuit argues the doctor didn’t have any factual basis for concluding that simply having a patient card rendered the firefighter unfit for duty).

Thatcher, R-West Valley City, who ran his legislation in response to the conflict, says a public employer should not be allowed to crack down on a worker just for using a particular type of medication or getting a doctor’s recommendation to do so.

Although the law already bars a government employer from punishing a worker simply for using medical cannabis, Thatcher says the Ogden situation shows legislators also need to specify that agencies can’t discriminate against people just for having patient cards.

His legislation has gained final passage in the Legislature and awaits the governor’s signature. And last week, Coleman returned to work after he and the city of Ogden settled the lawsuit.

Under the agreement, Coleman can return to work and will get back all the leave he expended while battling the city. Going forward, a union representative will help the department develop policies for medical cannabis use among its staff, according to Tidrow.

Coleman said his goal has always been “to fight for the cannabis rights of firefighters.”

“Hopefully my case will start a conversation of cannabis benefits not only in Utah, but nationwide,” he said. “I believe my case sets the precedent that Utah firefighters are not only allowed to get a medical cannabis card but should do so without fear of punishment or loss of their entire livelihood.”

Barriers at nursing school

While Thatcher’s bill focuses on government employers, Hennessy says there also needs to be progress in the private sector.

She estimates her organization hears from about seven Utahn patients each month who have been rejected from housing, are facing employment consequences or have been cited for their legal possession of medical cannabis. And she suspects there are many others she never hears from.

Teisha Emery reached out to Hennessy earlier this year after her nursing program told her she couldn’t use medical cannabis anymore.

Marijuana treatments have been transformative for Emery, who suffers from nausea, chronic pain and inflammation because of several genetic and autoimmune conditions. Before she joined the state’s medical cannabis program, she was on an array of medications to ease her symptoms — and had to take more drugs for the side effects.

“It just kind of was like a cycle where I just kept getting on more stuff just to try to feel human,” she said.

Emery has discontinued all of those other drugs since she started trying medical cannabis, she said. She has energy to work two different jobs, play with her kids and work out again.

The Morgan resident even felt well enough to enroll in a health care program, with the goal of one day becoming a flight nurse and caring for patients being airlifted to the hospital. Her medical marijuana use didn’t seem to be a problem until the end of her first year, when she had to start her clinicals, or hands-on training.

She had been open about the fact she was a cannabis patient, and when she failed her drug test, her supervisor initially indicated she could resolve the issue by sending the school a copy of her state-issued card.

Then, the dean contacted her to say she would be barred from her required clinical training until she could pass a drug test — whether or not she was a legal user.

“You will be expected to submit a weekly toxicology screen to me, at your expense, for the remainder of the semester until you are negative for all substances,” the dean wrote in an email that Emery shared with The Salt Lake Tribune. “I would advise you to contact your health care provider and find alternative medications and treatments to manage your current medical needs.”

Emery asked the Tribune not to identify her nursing program, out of concern that there might be further repercussions against her.

But when faced with this choice, the decision was clear to Emery.

“I am not willing to mess with my health in that manner. I’m not willing to go back to the person that was barely living,” she said. “And so I chose to unenroll.”

She has been looking at other nursing programs since then, but the ones she has researched have similar no-tolerance policies.

So for now, she said, her nursing dreams are on hold.