Amy Hauser just discovered one more thing medical marijuana patients can’t do because cannabis remains illegal at the federal level: They can’t volunteer to help comfort hospital patients in their dying days.

The Richmond resident is studying to be a nurse, with a goal to work in hospice care.

“I really do enjoy spend time with people at the end of life,” Hauser said. “I have a calling for it.”

The 50-year-old has been volunteering at different Bay Area hospice care facilities as she works her way through nursing school. She often takes along her ukulele and plays songs for patients. Sometimes she talks, sometimes she listens to them talk. Other times she just holds their hands.

“We have a saying in hospice: ‘I can’t add days to your life, but I can add life to your days.’ That’s what I strive to do,’” she said. “I can’t do that right now.”

A week ago, Kaiser Permanente officials told Hauser she can’t be part of their volunteer hospice program if she tests positive for cannabis, even though it is legal in California and she has a doctor’s recommendation for medical marijuana.

Federal law still classifies cannabis as a Schedule I narcotic, a category reserved for drugs such as heroin that are said to be highly addictive and have no medical value. U.S. Attorney General Jeff Sessions has been doubling down on that stance, even though polls show a record-high number of Americans now believe marijuana should be legal, 29 states permit medical marijuana and nine states plus Washington, D.C. allow recreational use.

For cannabis consumers, the ongoing conflict with federal law can impact everything from gun ownership rights to employment opportunities. And California’s legalization law explicitly states that employers remain free to penalize workers who test positive for marijuana use, even if there’s no indication they were actually high on the job.

Hauser knew that policy existed for employment, but she didn’t think it would come into play for volunteers. She said it hasn’t been a problem at several private facilities where she donates her time.

She has a goal to one day work as a nurse for Kaiser Permanente, praising the medical group for its steadiness, benefit packages and typically progressive policies. So, in September, she signed up to go through a training program to volunteer in Kaiser hospice care facilities.

She’d nearly completed the training when a Kaiser employee told her she’d need to pass a drug test before she could start volunteering. Hauser had to break the news: She’s a medical marijuana patient.

She takes one antidepressant, and doctors have suggested in the past that she try other pharmaceuticals to help treat insomnia, anxiety and symptoms of PTSD triggered by what she described as domestic violence in a previous relationship. She opted to try cannabis instead, under guidance of her doctor. And she said it’s been very effective at improving her quality of life.

When Hauser first explained this to the Kaiser volunteer coordinator, she said she was told that it shouldn’t be a problem. But a week ago, when she was getting ready to sign her final paperwork, Hauser said she was forwarded a copy of an updated policy which reiterates that, even though marijuana is now legal in California, Kaiser has to maintain a drug-free environment because it contracts with the federal government.

“As a health care organization we always abide by all applicable laws and regulations to ensure the safe provision of care for our members and patients,” Kaiser spokeswoman Mayra Suárez said via email. The company declined to comment further about how those employment rules apply to volunteers or whether it’s made any recent changes to its marijuana testing policies.

The root of the problem is that blood and urine tests can’t actually measure whether someone is impaired by cannabis. The active chemicals in cannabis stay in the system much longer than the compounds in alcohol or harder drugs. So regular consumers like Hauser could test positive for marijuana hours, days or even weeks after any physical or mental effects of the substance have passed.

“Just because it’s in my system doesn’t mean I’m under the influence,” she said.

Hauser said she only consumes cannabis at night, to calm her anxiety and help her sleep.

“Just like I would never show up to work drunk, I would never show up to work high,” she said. “The idea that because I smoke it at night I would somehow be irresponsible during the day, it’s completely illogical.”

Scientists are studying ways to more accurately test for marijuana impairment. The state contracted with UC San Diego to research better methods for determining if drivers are high, and companies are working to develop cannabis breathalyzer tests.

In the meantime, Hauser still wants to volunteer for Kaiser. So she’s temporarily giving up cannabis so she can pass the drug test.

A week into her marijuana-free month, she said she’s already feeling the effects.

“I’m not going to get the sleep I need. My anxiety is going to be significantly worse, and I’m not going to be as present for my family,” she said.

Hauser’s two kids are also prone to anxiety. When she’s unsettled, she said, they pick up on it. So she’s worried that they’ll suffer over the coming weeks, too.

After the month is up, even if Hauser is able to volunteer with Kaiser, she knows the struggle isn’t over.

She still hopes to work for the medical group once she finishes nursing school.

“It’ll come up again and I’ll do what I have to do,” she said.

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