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November 2018: Client Under the Influence of Cannabis

Q: What should I do if a client shows up for an occupational therapy appointment and they are under the influence of cannabis?

A: If a client is under the influence of cannabis, similar to if they were under the influence of alcohol or any other substance that impairs judgement, the OT needs to determine if they can proceed with their services. The first step is to assess the client’s capacity to provide informed consent. An OT needs to use their professional judgement in determining if a client has the capacity to consent and if the OT can proceed with providing services.

If the OT is unable to provide services, they can discuss how the appointment will be rescheduled. The OT can also have a brief discussion outlining to the client that they may not be able to provide services if the client continually arrives for their appointments under the influence.

It is also important to address any safety risks to the client or others. If the client drove to the appointment under the influence of cannabis and is visibly impaired, the OT should take steps to address the safety concern. This could involve calling emergency services, notifying other professionals, or contacting the client’s emergency contacts. OTs should follow established organizational policies and processes. If no such procedures exist, OTs are encouraged to proactively develop a policy for their practice setting. OTs should document their discussions and actions in the clinical record.

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