In 2017, the federal government announced the intention to amend legislation that will change the definitions regarding legal uses of cannabis products, including marijuana. The upcoming changes are expected to take effect this summer. We have received a number of questions at the College and would like to share the following guidance with you:

The use of any drug or substance, whether prescription, over-the-counter, or recreational[1], has the same implications and considerations in Massage Therapy service delivery.

Please refer to the two frequently asked questions that we have received on this topic below.

1. What should Massage Therapists (MTs) do in cases where a client seeks Massage Therapy treatment while exhibiting signs of having used, or where they disclose the recent use of, a prescribed drug or recreational substance?

The CMTO Standards of Practice provide important guidance to support you with the delivery of safe and effective care. The Standards encourage you to interview the client to discuss treatment goals, record health history, obtain informed consent, perform assessments and re-assessments to determine whether Massage Therapy is a safe and suitable option.

The Health Care Consent Act, 1996, establishes that informed consent can only be obtained if the client has the mental capacity to provide consent. Some drugs and substances, including alcohol, prescription and recreational drugs as well as herbal remedies, may impact the client’s ability to provide proper consent. Here are some of the ways that clients demonstrate the ability to consent:

• Can the client understand the possible risks and benefits associated with treatment or not having the treatment?
• Is the client able to respond appropriately to questions you have asked?

In cases where client’s ability to consent is unclear, it must be assumed that informed consent cannot be obtained at this time, and that treatment must not proceed.

Other factors to consider include whether the side effects of the alcohol, prescribed drugs or recreational substances alter the client’s mental or physical ability to, accurately perceive pain and pressure levels, tolerate and recover from treatment. In cases where this is possible, MTs should adjust their treatment and assessment applications to reduce potential risks.

2. If an MT currently has a medical prescription to personally use cannabis products to manage a health condition, can the MT continue to use the products as necessary once medical cannabis becomes a ‘recreational drug / substance’?

According to Part VIII of the Massage Therapy Act, 1991, it’s considered an act of professional misconduct for registrants to practice in the profession while their ability to do so is impaired. This legislative guideline would apply to all circumstances where an MT is either required to take a prescribed drug, or whether they choose to use or ingest recreational substances.

Before using any substance, you are encouraged to consider any side effects to determine whether those side effects have the potential to compromise your ability to provide safe and effective care. If the substance affects communication, professional judgment or decision-making skills, then you should refrain from practicing Massage Therapy while taking the drug or substance or while feeling its effects. For more information about potential side effects of alcohol, prescription drugs or recreational substances, please discuss the matter with your primary care provider(s).

If you have further questions regarding the upcoming legislative changes and their impact on the Massage Therapy profession, please email our Practice Specialist at practicespecialist@cmto.com.

[1] Recreational substances include: alcohol and illegal and legal substances not prescribed to address a medical issue.  These can be ingested, injected, absorbed, or inhaled.