Can a North Carolina Nurse Use THC or Marijuana?
Recreational marijuana use has not been approved by the North Carolina General Assembly. As it currently stands, marijuana remains a Schedule I controlled substance under both North Carolina law and federal law. This means that even though marijuana and THC products are legal in some other states, they are still illegal to use, possess, or distribute in North Carolina.
Despite this, many adults—including healthcare professionals—may occasionally use marijuana or THC-based products, especially in neighboring states where recreational use has been legalized. For nurses in North Carolina, however, this choice carries very real professional risks. Before deciding to use THC or marijuana, it’s important to understand how the North Carolina Board of Nursing (NCBON) views this issue and how even a single positive drug test can affect your nursing license.
The North Carolina Board of Nursing’s Position on Marijuana Use
The NCBON takes impairment and drug use very seriously. Under Board rules, any use of controlled substances—whether legal or illegal—can raise questions about a nurse’s ability to practice safely.
Even if a nurse uses marijuana off-duty or in another state where it is legal, testing positive for THC can still lead to Board discipline in North Carolina. THC metabolites can remain in your system for days or weeks after use, meaning a positive test does not necessarily prove you were impaired on duty—but that distinction often matters little once a report is made to the Board.
Showing Up to Work Under the Influence
Working while under the influence of marijuana or any controlled substance is one of the fastest ways to lose your nursing license. If you come to work impaired—or even appear impaired—coworkers, supervisors, or administrators are obligated to report the behavior. Hospitals and healthcare employers have a duty to protect patient safety, and your employer’s interests will always come before yours.
If you appear impaired, your facility will likely require a “for-cause” drug test. A “for-cause” drug test is different from a random or pre-employment screen—it’s performed because there is a specific reason to believe you may be impaired. Examples include slurred speech, erratic behavior, or smelling like marijuana.
What Happens After a “For-Cause” Drug Test?
Once a “for-cause” drug test is ordered, you have two options: take it or refuse it.
However, it’s important to know that refusing a “for-cause” drug test is generally treated the same as testing positive. A positive (or refused) test result will almost always be reported to the Board of Nursing, and you could face suspension, probation, or other disciplinary actions.
If you find yourself in this situation, it is critical to contact a nursing license defense lawyer immediately. Early legal help can sometimes prevent escalation or limit disciplinary consequences.
Failing a Pre-Employment Drug Screen
A pre-employment drug screen is different. These are typically performed before you start a new job, often while you’re not actively working or even licensed with that employer yet.
Many nurses take breaks between positions or work as travel nurses. During that downtime, some may use marijuana or THC-based products recreationally. However, if you fail a pre-employment drug screen, your prospective employer may still file a report with the Board—especially if they are concerned about liability or compliance with federal healthcare regulations.
While a failed pre-employment test may not carry the same weight as a “for-cause” test (since there’s no allegation of impairment at work), the Board can still open an investigation into your fitness to practice or potential substance use issues.
If you receive notice that a complaint has been filed against you, do not face the Board alone. Having an experienced North Carolina nursing license defense attorney guide you through the process can make a significant difference in the outcome. At Brooks Peterson PLLC, we regularly represent nurses before the NCBON in cases involving positive drug tests, substance use allegations, and license reinstatement matters.
Key Takeaways for North Carolina Nurses
Marijuana is still illegal in North Carolina—even if purchased legally elsewhere.
THC can remain in your system long after use, which may cause you to fail a drug test even if you are not impaired.
“For-cause” drug tests (after alleged impairment at work) are treated much more seriously than pre-employment tests.
Refusing a “for-cause” test is usually treated the same as testing positive.
A positive test can lead to Board discipline, including probation, suspension, or mandatory participation in an alternative-to-discipline program.
Contact a nursing license defense lawyer immediately if you are reported to the Board or fail a drug test.
Need Help Protecting Your Nursing License?
If you are a nurse in North Carolina who has failed a drug test, been reported to the Board, or are facing disciplinary action related to THC or marijuana use, Brooks Peterson PLLC can help. The firm focuses exclusively on professional license defense and understands how the NCBON handles substance-related complaints.
We can help you navigate the process, respond to the Board, and protect your ability to continue practicing. Contact Brooks Peterson PLLC today to schedule a confidential consultation about your case.
This is not legal advice. If you do need legal representation call the office at: 919-616-3317