Maryland Passes Landmark Bill Protecting Firefighters Who Use Medical Cannabis

Maryland's House of Delegates has passed legislation that could fundamentally change how the state treats first responders who rely on medical cannabis for conditions like PTSD, chronic pain, and anxiety. House Bill 797, sponsored by Delegate Adrian Boafo, passed on third reading with a decisive 100-31 vote, signaling strong bipartisan support for a measure that sits at the intersection of cannabis policy, workplace rights, and first responder health.

The bill prohibits employment discrimination against firefighters, emergency medical technicians, cardiac rescue technicians, and paramedics employed by the state or local governments who test positive for cannabis metabolites — provided they are registered medical marijuana patients using cannabis while off duty.

Why This Bill Matters

First responders face some of the highest rates of post-traumatic stress disorder, chronic pain, and mental health challenges of any profession. Firefighters routinely encounter traumatic situations — from structure fires and vehicle accidents to medical emergencies involving children and mass casualty events. The cumulative psychological toll is well documented, with studies showing that firefighters experience PTSD at rates significantly higher than the general population.

Despite Maryland legalizing medical cannabis and later recreational use, firefighters and rescue workers have remained in a precarious position. Even those holding valid medical cannabis cards have faced the threat of termination or disciplinary action if routine drug tests detected THC metabolites — regardless of whether they consumed cannabis days earlier, off duty, and in full compliance with state law.

This disconnect has forced many first responders to choose between accessing a legally prescribed treatment and keeping their jobs. HB 797 addresses that directly by creating employment protections for medical cannabis patients in fire and rescue services.

What the Bill Does — and Doesn't Do

The legislation is carefully constructed to balance worker protections with public safety. Under HB 797, firefighters and rescue personnel who are registered medical marijuana patients cannot face employment discrimination or retaliation solely for testing positive for cannabis metabolites. The key word is "off duty" — the bill explicitly permits employers to maintain policies that prohibit cannabis use while on duty and prohibit employees from performing their duties while impaired.

If a fire or rescue employee reports to work impaired by cannabis, the employer is required to report the incident to the State Emergency Medical Services Board. This safeguard ensures that the bill does not create a pathway for impaired workers to operate in safety-critical roles. The distinction between off-duty use and on-duty impairment is central to the legislation's framework.

Additionally, the bill does not mandate that employers accommodate cannabis use in the workplace, nor does it prevent agencies from implementing fitness-for-duty evaluations. It simply prevents the use of a positive drug test — by itself — from being grounds for termination or discipline when the employee is a legitimate medical patient.

The Senate Companion and Path Forward

A Senate companion version, SB 439, sponsored by Senator Carl Jackson, has already advanced through the Senate. If both chambers reconcile any differences and the bill reaches the governor's desk, it would take effect on October 1, 2026.

The bill's passage through the House with a strong majority suggests that Maryland lawmakers recognize the evolving understanding of cannabis as a medical tool, particularly for populations that carry outsized health burdens. The 100-31 vote margin indicates that resistance to protecting medical cannabis patients in the workplace is diminishing, even in the traditionally cautious arena of public safety employment.

A Growing National Trend

Maryland is not operating in isolation. Across the country, states are increasingly grappling with the tension between cannabis legalization and workplace drug testing policies. Several states have enacted laws prohibiting employers from penalizing workers for off-duty cannabis use, though most of these protections apply to recreational users rather than specifically targeting first responders.

What makes Maryland's approach notable is its focus on a specific high-risk population with documented medical needs. Rather than a broad workplace protection, HB 797 targets a group whose occupational health challenges are well understood and whose access to alternative treatments — including prescription opioids and benzodiazepines — carries its own set of risks.

The bill also arrives at a moment when the national conversation around cannabis and employment is shifting. Federal marijuana rescheduling efforts, the expansion of state medical programs, and growing evidence supporting cannabis for PTSD treatment are all contributing to a policy environment where blanket drug testing policies are increasingly difficult to justify.

What This Means for First Responders Nationwide

If signed into law, Maryland's bill could serve as a model for other states considering similar protections. Fire departments and EMS agencies across the country face the same recruitment and retention challenges, and the ability to offer medical cannabis access without employment risk could become a meaningful benefit in attracting and retaining personnel.

For first responders who have long relied on cannabis for symptom management while living in fear of losing their careers, this legislation represents more than a policy change. It represents recognition that the people who run toward emergencies deserve access to the full range of legal medical treatments available to every other Maryland resident.

Key Takeaways

• Maryland's House of Delegates passed HB 797 by a 100-31 vote, protecting firefighters and rescue workers from job discrimination for off-duty medical cannabis use.
• The bill maintains strict safeguards: employers can still prohibit on-duty use and are required to report impairment incidents to the State Emergency Medical Services Board.
• If signed into law, the measure would take effect October 1, 2026, and could serve as a national model for first responder cannabis protections.

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