Mississippi Legalizes Medical Cannabis (Again)
“Mississippi employers should review their workplace drug and alcohol testing policies to confirm they reflect the Mississippi Medical Cannabis Act.”
Mississippi legalized medical cannabis in February 2022. But employers who remember voting on this in 2020 are not misremembering — the state has legalized medical cannabis twice, and the two versions are not the same.
The difference matters, because the law now in force gives Mississippi employers more latitude than most state medical cannabis statutes do.
How Mississippi Got Here
Mississippi voters approved a medical cannabis program in November 2020 through Initiative 65, a ballot measure that carried roughly 69 percent of the vote. That initiative included generally favorable guidance for employers.
In spring 2021, the Mississippi Supreme Court found that the state’s signature requirements for ballot measures could not be satisfied as written. The ruling invalidated Initiative 65 — and, in the process, the state’s entire ballot initiative mechanism. The medical cannabis program ended before it began.
Legislators spent the balance of 2021 working on a replacement. In late January 2022 the legislature passed Senate Bill 2095, and the governor signed it on February 2, 2022, re-legalizing medical cannabis under a new framework.
What SB 2095 Does
SB 2095, known as the Mississippi Medical Cannabis Act, permits the use of medical cannabis for a defined list of qualifying medical conditions and took effect immediately on signing. The program is now operational, with licensed dispensaries serving registered patients across the state.
For employers, the significant feature of the Act is not what it grants patients. It is what it declines to grant them.
What Mississippi Employers Need to Know
Unlike many state medical cannabis laws, the Mississippi Act contains no express employment protections for registered cardholders. That single fact shapes everything below.
Under the Act, Mississippi employers:
- Are not required to permit or accommodate medical cannabis use in the workplace.
- Are not required to reimburse costs associated with medical cannabis use.
- Are not required to modify a job or working conditions for an employee who uses medical cannabis.
- Are not prohibited from refusing to hire, or from taking adverse employment action against, an individual because of medical cannabis use — regardless of whether that individual is impaired.
- May continue to establish and enforce written drug testing policies.
- May discipline employees for using medical cannabis in the workplace or for working while under the influence.
An employer may also employ a registered medical cannabis user without exposure to state penalties for doing so.
The Workers’ Compensation Presumption
The provision Mississippi employers most often overlook is not in the Cannabis Act at all. It sits in the workers’ compensation statute.
A positive test at the time of injury — for a drug illegally used, a valid prescription medication taken contrary to the prescriber’s instructions or label warnings, medical cannabis used in accordance with the Mississippi Medical Cannabis Act, or a blood alcohol concentration of .08% or higher — creates a presumption that the proximate cause of the injury was that use.
Two consequences follow.
First, medical cannabis is named alongside illegal drugs and misused prescriptions. Lawful, card-holding use under the Act still triggers the presumption. Compliance with the Cannabis Act does not insulate an employee from the workers’ compensation consequence.
Second, the same statute addresses refusal. If an employee declines testing immediately after an alleged work-related injury, illegal drug use is presumed.
Both presumptions depend on having a test — administered promptly, documented properly, and defensible afterward. A presumption you cannot support with a clean chain of custody is not worth much when the claim is contested.
DOT-Regulated Employers
The Act is not intended to interfere with federal employment or contracting requirements, including Department of Transportation regulations.
For safety-sensitive employees covered by DOT rules, marijuana remains prohibited under federal law regardless of state legalization or patient registry status. No state medical cannabis provision changes that analysis.
What to Do Now
Mississippi employers should review their workplace drug and alcohol testing policies against the Act as enacted.
Reviewed your policy in 2020, after the ballot initiative passed? That is a good start — but do it again. The Act differs from the initiative voters approved, and a policy built around Initiative 65 is built around a law that no longer exists.
The policy should state clearly what the company’s position on cannabis is, when testing occurs, what fitness for duty means, and what follows a violation. In a state that grants cardholders no employment protections, the limiting factor on an employer’s authority is usually the employer’s own written policy.
Questions about drug testing compliance in Mississippi or any other state? Schedule a compliance review or call (800) 269-0502.
This information is provided for educational purposes only and is not legal advice. Reader retains full responsibility for the use of the information contained herein.
