Business Article Critique II

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Reactions to Employer Policies Regarding Prescription Drugs and Medical Marijuana: The Role of Safety Sensitivity

Donald M. Truxillo • David M. Cadiz •

Talya N. Bauer • Berrin Erdogan

Published online: 30 September 2012

� Springer Science+Business Media New York 2012

Abstract

Purpose Given the prevalence of drugs in the lives of

many workers, employers often face difficult decisions

about how to reconcile their drug use policies with

employees’ health needs. This is compounded by laws in

17 U.S. states and the District of Columbia that now

legalize medical marijuana and that are in direct conflict

with federal drug-free workplace laws. The purpose of the

present studies was to examine employee attitudes toward

workplace policies regarding prescription drugs and med-

ical marijuana.

Design/Methodology/Approach We conducted two

experimental studies (students with work experience and

nurses) to examine employee attitudes about policies

ranging from a drug-free workplace to accommodation of

prescription drugs and medical marijuana.

Findings The perceived safety sensitivity of jobs mod-

erated the perceived fairness of workplace drug policies.

Employees who perceived their jobs as low in safety sen-

sitivity reported more favorable reactions to policies

allowing prescription drugs than policies allowing medical

marijuana. In contrast, employees in high safety-sensitive

jobs did not differentiate between the two drugs, reacting

equally negatively to policies accommodating either drug.

Nurses rated organizations with drug-free policies as most

attractive.

Originality/Value These are the first studies to examine

employee attitudes toward workplace policies regarding

medical marijuana and prescription drugs, integrating

perceived safety sensitivity as a key moderator to better

understand these attitudes.

Keywords Safety sensitivity � Medical marijuana � Workplace drug policies � Organizational justice

Nearly half of all Americans use at least one prescription

drug at any given time (Centers for Disease Control and

Prevention 2004), and the medical and non-medical use of

prescription pain drugs in the United States is increasing at

a significant rate (e.g., Gilson et al. 2004). The potential

implications for the use of pain prescriptions by workers

are significant, especially for safety-sensitive jobs (i.e.,

jobs where impaired performance can result in danger to

oneself, one’s coworkers, or the public Murphy and

Thornton 1992). While prescription pain medication may

allow a worker to continue to work, the medication may

affect the worker’s safety and productivity. 1

However, no

research has examined employee perceptions of the use of

legal prescription drugs at work, an issue which is exam-

ined in the present studies.

Similarly, marijuana is the most commonly used illegal

drug in the U.S. (National Institute on Drug Abuse 2010).

D. M. Truxillo (&) Department of Psychology, Portland State University,

P.O. Box 751, Portland, OR 97207, USA

e-mail: [email protected]

D. M. Cadiz

Oregon Nurses Foundation, Tualatin, OR, USA

T. N. Bauer � B. Erdogan School of Business Administration, Portland State University,

Portland, OR, USA

1 However, it has been shown that users of certain drugs (e.g.,

opioids) may develop a tolerance that causes them little impairment

(Zacny 1996).

123

J Bus Psychol (2013) 28:145–158

DOI 10.1007/s10869-012-9276-3

In fact, 6.4 % of U.S. employees admit to using marijuana

in the past month (Larson et al. 2007). Marijuana use has

become a complicated issue for employers since the pas-

sage of medical marijuana laws in 17 U.S. states and the

District of Columbia (e.g., Welchand and Leinwand 2010).

Medical marijuana laws currently apply to *83 million Americans (a little more than 25 % of the U.S. population),

and medical marijuana legislation is pending in additional

11 states (http://medicalmarijuana.procon.org). With the

recent economic downturn, states such as California and

Massachusetts have considered the legalization and taxa-

tion of marijuana to address budget deficits (McKinley

2009). While most Americans are still against the general

legalization of marijuana, majorities in the U.S. now favor

its legalization for medicinal use (Risling 2010). However,

employee perceptions of medical marijuana at work have

remained unstudied, a gap we aim to fill in the present

studies.

State laws do not require accommodating on-the-job use

of medical marijuana (Haygood et al. 2010). Similarly, the

Americans with Disabilities Act does not require accom-

modation even of all prescription drugs, and there are

recent court cases where firing of employees who used

prescription drugs at work was held to be legal (Bates v.

Dura Automotive Systems 2010). Laws do not provide

guidelines regarding how and whether organizations should

accommodate prescription drugs or medical marijuana, and

organizations have some autonomy in deciding their poli-

cies. Further, there are no studies to help organizations

craft these policies. Although there is an extensive litera-

ture on how potential and current employees feel about

employer policies regarding illicit drugs (e.g., Crant and

Bateman 1993; Cropanzano and Konovsky 1995; Murphy

et al. 1990) and employer drug treatment programs (e.g.,

Paronto et al. 2002), to date no published research has

examined how workers feel about employer policies

accommodating the use of prescription pain medications

and medical marijuana—drugs which may be legal and are

relatively common. This is a significant gap in the

employment literature given that employee reactions to

legal and illegal drug use in the workplace may vary

significantly.

In the current paper, we examine reactions to employer

policies regarding medical marijuana and prescription drugs

in two experimental studies. Grounded in organizational jus-

tice theory, we assessed the perceived fairness of employer

policies regarding medical marijuana and prescription pain

medication (Studies 1 and 2) and the attractiveness of orga-

nizations that use these policies (Study 2). Further, we

examined perceived job safety sensitivity as a moderator of

employee reactions to different types of drug-use policies. Our

experimental studies used a sample of students with work

experience (Study 1) and a sample of nurses (Study 2).

We aim to make three contributions to the literature. First,

these studies are the first to examine employee attitudes

toward policies about the use of legal drugs in the workplace

such as prescription drugs and medical marijuana. Second,

we consider the role of perceived job safety sensitivity in

understanding employee reactions to these policies, as

research has shown that safety sensitivity (e.g., Murphy et al.

1990; Tepper 1994) affects reactions to drug testing policies.

Third, understanding employee perceptions regarding these

policies may provide guidance to employers in creating drug

use policies that are acceptable to employees.

Research on Employee Reactions to Workplace Drug

Issues

Organizational justice theory conceptualizes fairness in

terms of procedures (procedural justice) leading to a

decision, fairness of the outcomes (distributive justice), and

fairness of the interpersonal treatment that occurs during

the implementation of the procedures (interactional justice;

Colquitt et al. 2001; Greenberg 1990; Leventhal 1980; Lind

and Tyler 1988). Of these dimensions, procedural and

distributive justices are particularly salient in the design

phases of organizational processes. For example, organi-

zational justice theory has been used to explain reactions to

selection systems (e.g., Gilliland 1993), performance

evaluations (e.g., Colquitt 2001; Greenberg 1986), orga-

nizational events (e.g., Ambrose et al. 2007), and organi-

zational policies (Greenberg 1994).

Research on reactions to employer drug testing policies

(e.g., Cropanzano and Konovsky 1995) and treatment

programs (e.g., Paronto et al. 2002) has also used a justice

framework. Employer drug testing policies are perceived as

more fair when testing is done for cause (e.g., Arthur and

Doverspike 1997), when it is done on new job applicants

(e.g., Bennett et al. 1994), when fair procedures are used

(e.g., opportunity for appeals; e.g., Cropanzano and

Konovsky 1995), when it is used for safety-sensitive jobs

(e.g., Tepper 1994), and when it is less punitive (i.e., a

positive test leads to rehabilitation rather than termination;

Cropanzano and Konovsky 1995). Reactions to employer

drug treatment policies are also driven by whether the

treatment is voluntary or monitored and by respondents’

past drug use (e.g., Paronto et al. 2002).

However, no research has examined how employees

react to the use of potentially legal drugs like medical

marijuana and prescription drugs. Such research is needed

because employee reactions to drug-free workplace poli-

cies (regarding illegal drugs) may differ from reactions to

policies allowing the use of drugs that are legal but with

potential safety and performance implications. Moreover,

this topic provides a new context for the application of

146 J Bus Psychol (2013) 28:145–158

123

organizational justice theory, because the use of both these

drugs (prescription drugs and medical marijuana) may be

legal, but the stigma associated with marijuana may cause

it to be perceived more negatively. In short, we believed

that those who perceive themselves to be in safety-sensitive

jobs would perceive policies allowing either drug as unfair

for their jobs, whereas those in non-safety-sensitive jobs

would see prescription drugs as more acceptable than

marijuana due to the historical stigma associated with

marijuana and marijuana use.

As in previous research on workplace drug policies (e.g.,

Cropanzano and Konovsky 1995; Konovsky and Cro-

panzano 1991; Paronto et al. 2002), we used organizational

justice theory as the key reaction to employer policies

regarding prescription drugs and medical marijuana. Also,

as in past research, we focused on the fairness of the drug

policy to those affected by it, that is, the employees or

applicants to whom it pertains. Workplace drug policies are

at the intersection of legal, ethical, and moral perspectives

which may drive an individual’s evaluations of justice or

fairness. Thus, organizational justice theory appropriately

captures the key elements involved in reactions to issues

such as workplace drug policy and safety sensitivity. In

Study 1 (currently or previously employed students) and

Study 2 (nurses), participants were assigned to experi-

mental conditions (e.g., an employer who allows medical

marijuana).

Study 1: Student Sample

Hypotheses

According to the ethicality rule of organizational justice

(Leventhal 1980), procedures should be compatible with

fundamental moral and ethical values. An employment policy

allowing medical marijuana will be perceived as less fair than

one allowing prescription drugs, because marijuana for non-

medical uses is illegal in the U.S., and because of the social

stigma associated with marijuana in the U.S. for generations.

Indeed, much of the clinical substance abuse literature has

used the stigma concept to understand reactions to users of

illegal drugs. For example, stigma has been used to explain

nurses’ reactions to substance abusers (e.g., Skinner et al.

2007). Further, because many employer safety programs

include a substance abuse prevention component, they suggest

to employees that there is a link between illicit drug use and

safety. Because of the ethicality rule of justice, the illegality of

marijuana under most circumstances, and the resulting stigma

associated with its use (Hathaway 2004) even when it is used

for medical reasons, we predict that policies accommodating

legal use of marijuana would be perceived as less fair than the

use of prescription drugs.

Hypothesis 1 Employer policies which sanction the use

of medical marijuana will be perceived as less fair than

those which sanction the use of prescription drugs.

Job safety sensitivity, the perceived danger that

impaired performance on the job can have on oneself,

one’s coworkers, or the public (e.g., Murphy et al. 1991;

Tepper 1994), is a primary determinant of how people

perceive employer drug testing (e.g., Cropanzano and

Konovsky 1995; Murphy et al. 1991; Tepper 1994). For

example, Tepper (1994) found that job safety sensitivity

was related to the perceived fairness of drug testing, and

Paronto et al. (2002) found that people who believed their

jobs to be more safety-sensitive perceived drug treatment

to be more fair. Perceived safety sensitivity as a moderator

of reactions to drug policies makes sense from an organi-

zational justice perspective, as sobriety is particularly job

related for safety-sensitive jobs. Gilliland (1993) cites job

relatedness as a key facet of the procedural fairness of

selection systems. Murphy et al. (1991) found that the

danger associated with the job (i.e., job safety sensitivity)

was related to the acceptability of drug testing. Tepper

(1994) also found that perceived safety sensitivity can

serve as a form of justification for the use of organizational

drug testing (cf. Bies and Shapiro 1988).

Thus, we considered the perceived safety sensitivity of the

job when examining reactions to organizational drug policies

regarding prescription drugs and medical marijuana. Based

on previous research, we posited that perceived safety sen-

sitivity would moderate the perceived fairness of different

employer policies (one allowing prescription drugs versus

one allowing medical marijuana). Specifically, employees in

low safety-sensitive jobs, where impairment could lead to

less serious consequences, will react more negatively to the

use of medical marijuana at work than to the use of pre-

scription pain medication because of the stigma associated

with marijuana use (Hathaway 2004). In contrast, employees

in safety-sensitive jobs should perceive policies allowing the

use of any drug that might impair performance as equally less

fair, because abstaining from such drugs would be a job-

related requirement in safety-sensitive jobs and impairment

from any drug would be unacceptable. In short, employees in

safety-sensitive jobs will perceive policies allowing medical

marijuana or prescription drugs to be unfair. In contrast,

those in non-safety-sensitive jobs will focus less on the

negative outcomes and more on the stigma associated with

marijuana, even when used for medical reasons. Therefore,

we expected that perceived safety sensitivity would moder-

ate reactions to policies allowing prescription pain drugs

versus medical marijuana.

Hypothesis 2 Perceived safety sensitivity will moderate

the fairness of employer drug policies. Employees in low

safety-sensitive jobs will perceive policies allowing

J Bus Psychol (2013) 28:145–158 147

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medical marijuana to be less fair than policies allowing

prescription drugs, whereas employees in high safety-

sensitive jobs will perceive policies allowing the use of

either drug as less fair.

Study 1: Method

Participants

Participants were 78 non-traditional (mean age 26.33,

SD = 6.09) undergraduate students enrolled in five psy-

chology and business courses from an urban state univer-

sity in the Western U.S. based on enrollments in these

classes, the response rate was *60 %. Eighty-one percent of the sample was currently working, and 25 % worked

full-time. All respondents indicated that they had at least

some work experience. Respondents had worked in a wide

range of jobs. Using EEOC job classifications, the most

common jobs held were Service Worker (22 %), Office/

Clerical (18 %), Sales (12 %), and Professional (10 %).

The sample was 72 % female. With regard to ethnicity, the

sample was 77 % Caucasian, 6.4 % Hispanic, 5.1 % Asian/

Pacific Islander, 3.8 % Native American, 2.6 % Black,

1.3 % Filipino, and 2.6 % classified themselves as ‘‘other.’’

Their average education was 14.9 years.

Design and Procedure

Participants were randomly assigned to one of two condi-

tions (via collation of the two surveys), specifically, an

employment scenario with an employer that allowed pre-

scription pain medication or one that allowed medical

marijuana. Participants were first asked to provide infor-

mation about their current job, or their most recent job if

they were currently unemployed. Next, participants were

asked to read a scenario about a coworker using either

medical marijuana or prescription pain medication. Then,

keeping in mind their current or most recent job, partici-

pants were asked to indicate their thoughts about an

employer who would allow this type of drug use in the

workplace. Specifically, the instructions were: ‘‘For each

statement indicate the response that best represents your

opinion about this scenario for your current or most recent

job.’’ The next section of the survey assessed participants’

personal drug use history, and was followed by demo-

graphic questions. The survey concluded with a manipu-

lation check question regarding which drug was used in the

scenario; 90 % of respondents answered correctly, and

dropping those who did not had any effect on the results of

the hypothesis tests.

Participants received extra credit for their participation.

Due to the sensitive nature of the questions, extra steps

were taken to maintain the confidentiality of the

participants. For example, the class instructor left the room

before data collection began, and participants were asked

to return their survey responses to the research assistants in

unmarked, sealed envelopes.

Measures

Unless otherwise noted, variables were measured on a

5-point scale ranging between 1 = strongly disagree and

5 = strongly agree.

Perceived Safety Sensitivity

We used three items based on Tepper’s (1994) one-item

measure. Participants were asked how integral safety was

to their job, how impaired performance would impact

themselves and others, and whether or not following safety

procedures could create a dangerous work environment. A

sample item from this scale is, ‘‘Impaired performance in

my job could create a danger or a safety hazard for me, my

co-workers, or the public.’’ Responses to the measure were

made on a 5-point Likert-type scale (1 = strongly disagree

to 5 = strongly agree). Cronbach’s alpha for the scale was

.89.

Perceived Fairness

Fairness perceptions regarding the employer policy were

measured with a three-item scale based on Cropanzano and

Konovsky’s (1995) and Konovsky and Cropanzano’s

(1991) fairness measure. The items were adapted to assess

how a participant would feel about an employer that

allowed the use of a particular type of drug (i.e., pre-

scription pain medication, medical marijuana) at work. In

keeping with past research (e.g., Cropanzano and Konov-

sky 1995), we used items geared toward both procedural

and distributive justice. Such an approach is also consistent

with recent findings regarding overall justice and the utility

of overall justice for predicting a range of outcomes

(Ambrose and Schminke 2009). A sample item is

‘‘Allowing an employee to use [type of drug] in a situation

like this is fair.’’ (a = .95).

Control Variables

We used past drug use history as a control variable because

drug use has been found to be important in understanding

reactions to employer drug policies (e.g., Murphy et al. 1990;

Paronto et al. 2002). Past marijuana use was measured with

one item based on that used by Paronto et al. (2002).

Responses to the questions were on a 5-point scale ranging

from ‘‘I have never used’’ to ‘‘I have used it in the past

7 days.’’ For this study, drug history was operationalized as a

148 J Bus Psychol (2013) 28:145–158

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dichotomous variable (0 = no prior use of marijuana,

1 = past use of marijuana), because past research has found

differences between those who have never used marijuana

compared with those who have used it at some time (Truxillo

et al. 2001). We also used sex as a control in our analyses

because men and women tend to differ in their reactions to

drug testing (e.g., Truxillo et al. 2001) and because of the

higher level of drug use and on-the-job impairment reported

among male employees (Frone 2006, 2008).

Study 1: Results

Means, standard deviations, and intercorrelations among

the study variables are presented in Table 1. At the cor-

relational level, perceived fairness was negatively but not

significantly related to the drug policy (r = -.16, ns) and

to safety sensitivity (r = -.22, ns). There was a positive

relationship between sex and fairness of the drug policies,

(r = .34, p \ .01), with women rating both policies more fair than men did, perhaps indicating a greater caring ori-

entation (Jaffee and Hyde 2000) to accommodate a cow-

orker who has pain.

Hypothesis Tests

We used hierarchical regression to test the hypotheses. We

created a dummy variable for the independent variable

(i.e., whether the policy allowed prescription drugs or

medical marijuana). To reduce any potential multicolline-

arity we centered safety sensitivity by standardizing it

(Aiken and West 1991). We conducted a hierarchical

regression analysis with perceived fairness as the depen-

dent variable. We entered the control variables (sex and

drug use history) in Step 1 (e.g., Paronto et al. 2002); the

main effects of safety sensitivity and drug policy in Step 2;

and the interaction term for the safety sensitivity 9 drug-

type interaction in Step 3. The results of this regression

equation are shown in Table 2.

The final regression equation was significant (R2 = .24,

F (5, 70) = 4.46, p \ .01). Hypothesis 1, the main effect of drug type on perceived fairness, was not supported, (b = -.14, ns). However, the change in R2 with the addition of

the interaction term was significant (DR2 = .07, DF (1, 70) = 6.28, p \ .01), indicating that there was an inter- action between safety sensitivity and drug policy (b = .40, p \ .05). To examine its nature, we plotted the interaction at one standard deviation above and below the mean

(Fig. 1). People in low safety-sensitive jobs perceived a

policy allowing prescription pain medication as fairer than

one allowing medical marijuana. In contrast, those in high

safety-sensitive jobs perceived the two policies as equally

less fair. Thus, Hypothesis 2 was supported.

Study 1: Discussion

In Study 1, we examined whether the type of drug allowed by

an employer affected the perceived fairness of the policy, and

whether perceived safety sensitivity of the respondent’s job

moderated this effect. We found an interaction between

safety sensitivity and drug policy. Specifically, participants

who were in low safety-sensitive jobs perceived a policy

allowing prescription drugs as more fair than one allowing

medical marijuana, which is in alignment with the ethicality

justice rule (Leventhal 1980) and the public’s stigma toward

the use of marijuana (Hathaway 2004) because of its asso-

ciation with illegal drug use. In contrast, those in safety-

sensitive jobs perceived the two policies as equally (and

relatively less) fair, perhaps because any impairment could

be dangerous in a safety-sensitive job, in alignment with the

job relatedness (e.g., Gilliland 1993) and justification (e.g.,

Bies and Shapiro 1988) approaches to organizational justice.

Study 2: Nurse Sample

One strength of Study 1 is that it used respondents from a

naturally occurring range of jobs with correspondingly

Table 1 Descriptive statistics, reliabilities, and intercorrelations among Study 1 variables

Mean SD 1 2 3 4 5

1. Sex 0.72 0.45 –

2. Drug history 0.69 0.47 -0.11 –

3. Safety sensitivity 3.72 1.20 -0.15 0.03 (0.89)

4. Drug policy 0.50 0.50 -0.06 -0.17 -0.15 –

5. Perceived fairness 3.68 1.13 0.34** 0.10 -0.22 -0.16 (0.95)

Notes: N = 76–78. Values on the diagonal in parentheses represent the Cronbach’s alpha reliability estimate for these variables. Sex is coded 0 for males and 1 for females. Drug history is coded 0 = no use, 1 = previous use. Drug policy is coded 0 = prescription pain medication,

1 = medical marijuana

* p \ .05 ** p \ .01

J Bus Psychol (2013) 28:145–158 149

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differing degrees of safety sensitivity. But because drug

policies are most relevant to safety-sensitive jobs (National

Institute on Drug Abuse 1989), we chose to study a sample

of nurses in Study 2, a critical, safety-sensitive job. This is

especially important given the shortage of nurses (Buer-

haus et al. 2000) and the access members of this profession

have to prescription drugs. Nurses’ perceptions of medical

marijuana were also of particular interest to the nurses

association partnering with us in Study 2, which operates in

a state that has allowed medical marijuana use for several

years. Because this nursing sample was older and had

greater age variance, we hoped to increase the generaliz-

ability of our findings to the broader population.

In Study 2, we further refined the types of policies

examined in three ways. First, we examined reactions to a

drug-free workplace policy, as this is perhaps the most

common employer policy, especially for safety sensitive

jobs. Second, instead of looking at a policy that only

allowed medical marijuana, we examined reactions to a

policy allowing prescription drugs and medical marijuana

together, because both of these drugs are frequently used

for pain management, and most employers allowing med-

ical marijuana would also allow prescription drugs. In

addition, although past research has examined the fairness

of employer drug policies, it has also examined the orga-

nizational attractiveness of employers with these policies

(e.g., Paronto et al. 2002). Organizational attractiveness has

been shown to relate to the fairness of employer drug

policies in past studies (Paronto et al. 2002). Moreover,

organizational attractiveness is an outcome of great

importance to employers, particularly those who might be

considering the implementation of new drug policies

among safety sensitive workers.

Hypotheses

From a procedural justice perspective, nurses may be more

aware than the general public of the potential effects of drugs

on performance. Therefore, the use of drugs has a particular

job-relatedness and relevance to the nursing profession

(Trinkoff et al. 2000), because allowing someone to be

impaired while at work would not be perceived as procedur-

ally fair as it would put both coworkers and patients at risk. In

addition, from a distributive justice perspective (Folger and

Konovsky 1989), if a coworker is allowed to use drugs,

impairment could lead to decreased performance, thereby

placing greater pressure on unimpaired coworkers, resulting

in feelings of inequity with regard to the distribution of work.

Table 2 Hierarchical regression results testing the moderating effects of safety sensitivity on the relation between type of drug sanctioned in the organizational drug policy and fairness perceptions, Study 1

Variables Step 1 Step 2 Step 3

B SE B b B SE B b B SE B b

Sex 0.82 .31 .33** 0.73 .27 .30** 0.87 .27 .36**

Drug history 0.40 .26 .17 0.35 .26 .15 0.33 .25 .14

Drug policy -0.30 .24 -.14 -0.31 .23 -.14

Safety sensitivity (SS) -.22 .12 -.20 -0.54 .17 -.50**

Drug policy 9 SS 0.59 .23 .40*

DR2 0.12* 0.05 0.07*

DF 5.12* 2.18 6.28*

Overall F 5.12** 3.73** 4.46**

R2 for final equation 0.24*

Notes: N = 75. Sex is coded 0 = males and 1 = females. Drug history is coded 0 = no use and 1 = previous use. Drug policy is coded 0 = prescription pain medication and 1 = medical marijuana

SS safety sensitivity

* p \ .05 ** p \ .01

1.00

1.50

2.00

2.50

3.00

3.50

4.00

4.50

5.00

Pain Prescription Medical Marijuana

P er

ce iv

ed F

ai rn

es s

Type of Drug Policy X Safety Sensitivity Interaction

Low Safety Sensitivity (-1 SD below the mean)

High Safety Sensitivity (+1 SD above the mean)

Fig. 1 Type of drug policy (medical marijuana vs. prescription drug) by safety sensitivity interaction on perceived fairness, Study 1

150 J Bus Psychol (2013) 28:145–158

123

Besides examining policies allowing prescription drugs

and medical marijuana, in Study 2 we also examined

reactions to a drug-free policy. We thus expanded our

original Hypothesis 1. Specifically, we hypothesized that a

drug-free policy would be perceived as more fair than a

policy allowing prescription drugs, or one allowing pre-

scription drugs and medical marijuana, particularly in a

safety-sensitive job such as nursing. Specifically, because

nursing is a safety-sensitive job, a policy that does not

allow any drug use should be perceived as most fair

because it would be most job-related (Paronto et al. 2002),

and any drug use perceived as a violation of the job-

relatedness (Gilliland 1993) and justification (Bies and

Shapiro 1988) justice rules.

Hypothesis 3a Among nurses, a drug-free workplace

policy will be perceived as more fair than one allowing

either prescription drugs or one allowing drugs and medical

marijuana.

Hypothesis 3b Among nurses, an employer with a drug-

free workplace policy will be perceived as more attractive

than one allowing either prescription drugs or one allowing

drugs and medical marijuana.

Although nursing is considered as a safety-sensitive job,

there are still varying levels of safety sensitivity across

nursing jobs. For example, critical care nurses are in more

safety-sensitive jobs than nurse administrators or execu-

tives who are far removed from direct patient care. Further,

different nurses within the same job type may perceive

their jobs as differentially safety sensitive. Thus, while all

nurses should prefer a drug-free policy, we expected that

nurses who perceived themselves to be in higher safety-

sensitive positions would perceive any drug use in the

workplace, either prescription drugs or medical marijuana,

as being less fair because any impairment on the job would

have greater negative consequences. In contrast, we

expected that nurses who perceived themselves to be in

lower safety-sensitive positions to align with respondents

in other low safety-sensitive jobs who perceived policies

regarding medical marijuana as less fair than policies

allowing prescription pain medications.

Hypothesis 4a Perceived safety sensitivity will moderate

the relationship between employer drug policy and fairness

perceptions. Nurses who perceive their jobs to be more

safety-sensitive will perceive policies allowing prescription

drugs and those allowing prescription drugs/medical mar-

ijuana as equally and relatively less fair compared to drug-

free policies. Nurses who perceive their jobs as lower in

safety-sensitivity will perceive a policy allowing prescrip-

tion drugs as more fair than one allowing prescription

drugs/medical marijuana, while the drug-free policy will be

perceived as most fair.

Hypothesis 4b Perceived safety sensitivity will moderate

the relationship between employer drug policy and orga-

nizational attractiveness. Nurses who perceive their jobs to

be more safety-sensitive will perceive organizations

allowing prescription drugs and those allowing prescription

drugs/medical marijuana as equally and relatively less

attractive than organizations with drug-free policies. Nur-

ses who perceive their jobs as lower in safety-sensitivity

will perceive organizations allowing prescription drugs as

more attractive than ones allowing prescription drugs/

medical marijuana, while the drug-free policy will be

perceived as the most attractive.

Study 2: Method

Participants

Surveys were distributed to 172 nurses at a multi-day,

annual, state-wide nursing conference put on by a nurses

association in a Western U.S. state. This state has had a

medical marijuana law in place for several years, and Study

2 was supported by the state nurses association which was

concerned about attitudes towards medical marijuana

among its members. We received 129 responses, resulting

in a response rate of 75 %. The mean age of the partici-

pants was 52.2 years (SD = 9.68), and 92 % were female,

which generally reflects the demographics of nurses in this

state. The average years of work experience was

26.2 years. The ethnic makeup of the sample was 93 %

Caucasian, 2.4 % Hispanic, 2.4 % African American, and

the remainder of ethnicities combined was less than 3 % of

the sample. Ninety-five percent of the sample was currently

working, and 51 % were working full-time (36 or more

hours worked per week). Eighty-five percent of the sample

indicated that they worked in a hospital setting, and 72 %

indicated that their specialty was one that was associated

with the day-to-day dispensing of drugs. The majority

(52 %) classified themselves as ‘‘Critical Care, NICU’’ and

‘‘General Medical, Medical Surgical, General Surgical’’,

categories that would be safety sensitive. Eighty-six per-

cent of the participants indicated that they held the position

of staff nurse, and the remaining participants were in

higher-level or unspecified positions.

Design and Procedure

In Study 2, we examined three drug policy scenarios: drug-

free workplace policy, prescription pain medication

allowed, and prescription pain medication/medical mari-

juana allowed. As in Study 1, participants were first asked

about their work experience. Then they were presented

with one of the three workplace drug policies and were

asked to rate the perceived fairness of the policy as well as

J Bus Psychol (2013) 28:145–158 151

123

the attractiveness of an organization that has this policy.

Similar to Study 1, random assignment to conditions was

via collation of the 3 surveys. Further, in Study 2, the

nurses were specifically asked to evaluate the policy within

the context of ‘‘a job like yours.’’ We did this so that when

considering the fairness of the policy, participants’ would

be considering their own job and the safety sensitivity they

associated with it. The final section of the survey assessed

personal drug history and demographics.

Note that in Study 1, it was important to examine reactions

to medical marijuana and prescription pain medication sep-

arately to see if there were differences in perceptions of

policies allowing medical marijuana versus prescription pain

medication, and in fact there were. In Study 2, however, we

used a combined medical marijuana and prescription pain

medication condition because in discussions with experts on

employer drug policies we could not envision an employer

policy that would allow medical marijuana, but not allow

prescription pain medication, as both types of drugs are used

in pain management, but the prescription pain drugs are legal

by prescription under U.S. federal law. Therefore, in Study 2,

we compared three levels of employer drug use policy: Drug-

free workplace policy, a policy that allows prescribed pain

medication, and a policy that allows both prescribed pain

medication and medical marijuana. To eliminate confusion

as to what is meant by ‘‘drug free,’’ we provided this defi-

nition: ‘‘Some employers have a drug-free policy at work,

such that employees are not allowed to use either prescrip-

tion pain medication(s) or medical marijuana for certain

jobs. Although the details of these programs differ from each

other, give your general opinion about this sort of policy,

thinking specifically about a job like yours.’’ (emphasis in

original).

Measures

The perceived fairness (a = .96) items were parallel to those in Study 1. As described in Study 1, this scale utilized

both procedural and distributive justice items combined

into a single scale of overall justice, as would be suggested

by Ambrose and Schminke (2009). The drug use history

item was the same as that used in Study 1.

Perceived Safety Sensitivity

We adjusted the wording of the three-item measure used in

Study 1 to make the items more relevant to nursing. We

also added three items with regard to appropriate staffing

and patient handling which resulted in a total of six items

to assess safety sensitivity. A sample item was, ‘‘Impaired

performance in my job could create a danger or a safety

hazard for me, my co-workers, patients, or the public.’’

(a = .94).

Organizational Attractiveness

We assessed organizational attractiveness of employers using

these drug policies with four items (e.g., Paronto et al. 2002;

Truxillo et al. 2001). A sample item is, ‘‘All other things being

equal, I would prefer to work for an organization that had this

policy for a job like mine.’’ (a = .95). There was a high correlation between perceived fairness

and organizational attractiveness (r = .87, p \ .01), a finding that is similar to previous research on reactions to

workplace drug policies (Paronto et al. 2002). However,

because this correlation suggests that these two variables

may be redundant, we conducted a CFA examining whe-

ther a 2-factor model fits the data significantly better than a

one-factor model. There was a significant difference in

Chi-squared between the 1-factor and 2-factor models (Dv2

(1) = 48.70, p \ .01, N = 127) indicating that the two- factor model fit the data significantly better than the one-

factor model. Thus, we treated organizational justice and

organizational attractiveness as two separate variables.

Study 2: Results

Means, standard deviations, and intercorrelations among

the Study 2 variables are presented in Table 3. We created

two dummy variables for the three-level policy variable,

using the drug-free workplace policy as the comparison or

base category. The two dummy variables were labeled

‘‘prescription’’ and ‘‘prescription and medical marijuana.’’

To create the prescription dummy variable, we recoded this

condition as one and the other two conditions as zero. We

then created the prescription and medical marijuana

dummy variable by recoding this condition as one and

recoding the other conditions as zero. As seen in Table 3,

there is a significant negative correlation between the

prescription medication and medical marijuana dummy

variable and perceived fairness (r = -.24 p \ .01). This relationship indicates that the most inclusive drug policy,

which condoned the use of prescription pain medication

and medical marijuana, is perceived as less fair than the

other two policies combined. Similarly, there was a nega-

tive correlation between the prescription medication and

medical marijuana variable and organizational attractive-

ness (r = -.22, p \ .05), suggesting that organizations allowing prescription drugs and medical marijuana were

perceived as less attractive than organizations with the

other two policies.

We used hierarchical regression to test Hypotheses 3a

and 4a, the effects of employer drug policy and safety

sensitivity on perceived fairness. Once again, we stan-

dardized safety sensitivity to center it (Aiken and West

1991). With perceived fairness as the dependent variable,

we entered sex and drug use history as the control variables

152 J Bus Psychol (2013) 28:145–158

123

in Step 1; the main effects of safety sensitivity and the two

dummy coded drug policy variables in Step 2; and the

interaction terms for the safety sensitivity by drug policy in

Step 3. The results of this regression are shown in Table 4.

The overall equation was significant (R 2

= .26, F (7,

105) = 5.17, p \ .01). Hypothesis 3a, the main effect of drug type on perceived fairness, was supported in that the

drug-free workplace policy was perceived to be more fair

than a policy allowing prescription drugs and a policy

allowing prescription drugs and medical marijuana

(bs = -.36 and -.51, p \ .01). However, these main effects were qualified by a significant interaction between

safety sensitivity and drug policy (DR2 = .05, DF (2, 105) = 3.59, p \ .05). This interaction is shown graphi- cally in Fig. 2. Examination of the betas for the interaction

term for each dummy variable indicates that while the two

groups were ordered similarly for the drug-free workplace

and prescription drug/medical marijuana conditions

(b = .05, ns), the two groups were ordered differently for the drug-free workplace and prescription drug conditions

(b = -.25, p \ .05). As shown in Fig. 2, nurses in high safety-sensitive jobs perceived the prescription drug policy

to be about as fair as the prescription drug/medical mari-

juana policy, whereas those in low-safety-sensitive jobs

Table 3 Descriptive statistics, reliabilities, and intercorrelations among Study 2 variables

Mean SD 1 2 3 4 5 6 7

1. Sex 0.92 0.27 –

2. Drug history 0.58 0.49 -.08 –

3. Safety sensitivity 3.86 0.69 -.07 -.08 (.86)

4. Prescription 0.38 0.49 -.07 .08 .02 –

5. Prescription and MM 0.29 0.46 .06 -.04 .08 -.50** –

6. Perceived fairness 2.79 1.30 -.03 .11 .01 -.14 -.24** (.95)

7. Org attractiveness 2.72 1.21 -.02 .14 .05 -.09 -.22* .87** (.95)

Notes: N = 115–129. Values on the diagonal in parentheses represent the Cronbach’s alpha reliability estimate for these variables. Sex is coded 0 = males and 1 = females. Drug history is coded 0 = no use and 1 = previous use. Prescription = dummy variable for drug policy allowing

prescription pain medication. Prescription and MM = dummy variable for drug policy allowing prescription pain medication and medical

marijuana. Org Attractiveness organizational attractiveness

* p \ .05 ** p \ .01

Table 4 Hierarchical regression results testing the moderating effects of safety sensitivity on the relation between type of drug sanctioned in the organizational drug policy and fairness perceptions, Study 2

Variables Step 1 Step 2 Step 3

B SE B b B SE B b B SE B b

Sex -0.16 0.44 -.03 -0.13 0.40 -.03 0.13 0.41 .03

Drug history 0.27 0.25 .10 0.28 0.23 .11 0.30 0.23 .11

Prescription -0.99 0.27 -.37** -0.97 -0.36 -.36**

Prescription and MM -1.43 0.29 -.49** -1.49 0.29 -.51**

Safety sensitivity 0.08 0.12 .06 0.24 0.21 .18

Prescription 9 SS -0.62 0.31 -.25*

Prescription and MM 9 SS 0.12 0.28 .05

DR2 .01 .19** .05*

DF 0.70 8.67** 3.59*

Overall F 0.70 5.54** 5.17**

R2 for final equation .26**

Notes: N = 112. Sex is coded 0 = males and 1 = females. Drug history is coded 0 = no use and 1 = previous use. Prescription = dummy variable for drug policy allowing prescription pain medication. Pain prescription and MM = dummy variable for drug policy allowing pre-

scription pain medication and medical marijuana

SS safety sensitivity

* p \ .05 ** p \ .01

J Bus Psychol (2013) 28:145–158 153

123

perceived the prescription drug policy as fairer than the

prescription drug/medical marijuana policy. Therefore,

Hypothesis 4a was supported.

To test Hypotheses 3b and 4b, the effects of drug policy

and safety sensitivity on organizational attractiveness, we

created a regression equation in a similar way with orga-

nizational attractiveness as the dependent variable. The

results of this regression are shown in Table 5. The overall

regression equation was significant (R2 = .19, F (7,

105) = 3.48, p \ .01). Hypothesis 3b, the main effect of drug type on organizational attractiveness, was supported

in that an organization with a drug-free policy was per-

ceived to be more attractive than a policy allowing pre-

scription drugs and medical marijuana (b = -.43, p \ .01) and a policy allowing only prescription pain drugs (b = -.29, p \ .01). The final step in the regression analysis did not result in a significant change in R

2 (DR2 = .04, DF (2,

105) = 2.58, ns), suggesting that the interaction was not

significant; thus we did not find support for the moderating

effect of safety sensitivity on organizational attractiveness

(Hypothesis 4b).

Study 2: Discussion

The results in the nurse sample in Study 2 are similar to

those of the students in Study 1. Specifically, nurses who

regard their jobs as low in safety-sensitivity reacted more

negatively to policies allowing medical marijuana than to

those allowing prescription drugs. In contrast, nurses who

perceived themselves to be in highly safety-sensitive jobs

reacted to policies allowing either prescription drugs or

medical marijuana equally negatively. These results are not

surprising because since the federal drug-free workplace

was initiated by Executive Order 12564 in 1986 followed

by the Drug-Free Workplace Act of 1988 (National Insti-

tute on Drug Abuse 1989), a drug free workplace was

established as the norm for safety-sensitive jobs.

The results for organizational attractiveness were a bit

different. Perceptions of organizational attractiveness were

higher for drug-free policies than for policies allowing drug

use, and perceived safety sensitivity did not moderate these

effects. Thus, safety sensitivity of the job did not affect

nurses’ perceptions of organizational attractiveness.

Rather, whether they perceived their jobs as safety sensi-

tive or not, nurses were more attracted to organizations

with drug-free workplace policies than to organizations

allowing either type of drug, perhaps because of their focus

Fig. 2 Type of drug policy (drug free vs. medical marijuana vs. prescription drug and medical marijuana) by safety sensitivity

interaction on perceived fairness, Study 2 (Nurses)

Table 5 Hierarchical regression results testing the moderating effects of safety sensitivity on the relation between type of drug sanctioned in the organizational drug policy and organizational attractiveness, Study 2

Variables Step 1 Step 2 Step 3

B SE B b B SE B b B SE B b

Sex -0.07 0.41 -.02 -0.20 0.39 -.01 0.19 0.40 .04

Drug history 0.28 0.24 .11 0.30 0.22 .12 0.31 0.22 .13

Prescription -0.75 0.26 -.30** -0.73 0.26 -.29**

Prescription and MM -1.11 0.28 -.41** -1.16 0.28 -.43**

Safety sensitivity 0.14 0.12 .11 0.24 0.21 .19

Prescription 9 SS -0.49 0.30 -.21

Prescription and MM 9 SS 0.13 0.28 .06

DR2 .01 .14** .04

DF 0.76 5.65** 2.58

Overall F 0.76 3.73** 3.48**

R2 for final equation .19**

Notes: N = 112. Sex is coded 0 = males and 1 = females. Drug history is coded 0 = no use and 1 = previous use. Prescription = dummy variable for drug policy allowing prescription pain medication. Prescription and MM = dummy variable for drug policy allowing prescription

pain medication and medical marijuana

SS safety sensitivity

* p \ .05 ** p \ .01

154 J Bus Psychol (2013) 28:145–158

123

on fitness to practice which is in their code of ethics and

training.

General Discussion

Organizations in many U.S. states need guidance regarding

whether and how to incorporate state medical marijuana

laws into their drug use policies. Understanding employee

reactions to workplace drug policies is critical for organi-

zations designing policies that comply with legal regula-

tions but that are acceptable to employees. To date, past

research has focused on employee reactions to organiza-

tional policies regarding illegal drugs (Cropanzano and

Konovsky 1995; Paronto et al. 2002; Tepper 1994). While

informative, these studies do not directly speak to the issue

of how employees would respond to organizational policies

about prescription and legal drugs. The present studies are

the first to focus on prescription pain medication or medical

marijuana, potentially legal drugs which may cause job

impairment. Using organizational justice as our theoretical

framework, we also examined perceived job safety sensi-

tivity (e.g., Tepper 1994) as a moderator of reactions to

these policies.

With regard to perceived fairness, the findings across

our two samples were consistent. Specifically, those in less

safety-sensitive jobs reacted more positively to policies

that allowed prescription drugs than to those that allowed

medical marijuana. However, those in the most safety-

sensitive jobs, that is, those whose jobs would be most

affected by drug use, reacted equally negatively to a policy

allowing prescription drugs and one allowing medical

marijuana. With regard to organizational attractiveness,

however, we found no moderating effects for safety sen-

sitivity: nurses were more attracted to organizations that

had a drug-free policy than to those that allowed pre-

scription drugs or medical marijuana.

Implications for Research

The literature on reactions to employer policies about illicit

drugs has largely focused on the fairness of employer

policies (e.g., Konovsky and Cropanzano 1991; Paronto

et al. 2002). Specifically, the greater the perceived safety

sensitivity of the job involved, the more likely respondents

are to rate employer drug policies as fair (Murphy et al.

1991). Paronto et al. (2002) specifically linked the impor-

tance of job safety sensitivity with the job-relatedness of

employer drug policies. In other words, the greater the

relevance of drug testing and treatment to the job, the more

likely respondents will be to accept employer drug policies,

even policies with more punitive outcomes (Cropanzano

and Konovsky 1995). This aligns with the job-relatedness

(e.g., Gilliland 1993) and justification (e.g., Bies and

Shapiro 1988) justice rules.

The present studies expands this application of organi-

zational justice theory in four important ways. First, while

past studies in the I-O/OB literature have focused on the

perceived fairness of workplace policies regarding illicit

drugs, the present studies examine reactions to policies

about drugs that are potentially legal, specifically, medical

marijuana and prescription pain medication. Second, these

studies further demonstrate the key role of perceived safety

sensitivity in explaining the perceived fairness of employer

policies regarding the use of these types of drugs. Third, we

use the organizational justice concepts of justification (e.g.,

Bies and Shapiro 1988) and ethicality (e.g., Leventhal

1980) to explain fairness reactions to workplace policies

about these drugs, confirming the usefulness of the orga-

nizational justice approach for explaining and predicting

reactions to workplace drug policies. Finally, these studies

show the multiple sources of justice judgments: Those in

safety-sensitive jobs perceived policies allowing these two

drugs similarly, perhaps because the effects of any drugs

were job-related, while those in non-safety-sensitive jobs

may have focused on the relative stigma associated with

each drug.

Implications for Practice

Many U.S. states have passed laws allowing medical

marijuana, and the use of prescription drugs is on the rise.

As such, employer policies will need to respond to the

increased use of these drugs. Employers are provided sig-

nificant autonomy regarding whether medical marijuana

use on the job should be accommodated (Haygood et al.

2010). Although medical marijuana laws vary by state,

employers may want to consider accommodating users of

medical marijuana in the same way that they would

accommodate workers who legally use prescription drugs,

for example, as long as the drug use does not interfere with

the performance of essential job duties and the employee is

not in a safety sensitive job. Accommodation might also

include reassigning employees or allowing them only to do

certain job tasks.

The present study can aid in the development of more

informed employer and government policies regarding the

use of prescription drugs and medical marijuana. First,

these results suggest that for people who perceive them-

selves to be in safety-sensitive jobs, an organization with a

drug-free policy was perceived to be fairer than one with

policies allowing any sort of drug use. Further, among

nurses, the organization with the drug-free policy was

considered to be most attractive. This finding is particularly

relevant since the nurse workforce is facing dramatic

shortages, and attracting and retaining nurses is pertinent to

J Bus Psychol (2013) 28:145–158 155

123

meet increasing demands on the health care system

(Buerhaus et al. 2006).

Most important, health care organizations must also

weigh how the potential for employee impairment could

negatively affect quality care. At the same time, organi-

zations should try to accommodate employees who need

legal medication to manage pain; perhaps they can be

accommodated by putting them into less safety-sensitive

jobs, if available. Such complex factors need to be taken

into account when developing drug policies in safety-

sensitive jobs.

Moreover, policies allowing prescription drugs and

those allowing medical marijuana seem equally inappro-

priate to employees in safety-sensitive jobs. However,

these results present a bit of a paradox regarding non

safety-sensitive jobs: Employees in these jobs reacted more

positively to allowing prescription medications than to

allowing medical marijuana, perhaps because of the stigma

associated with marijuana use in general. Thus, what is key

is to determine whether a job in question is safety-sensi-

tive, and whether the use of pain medications and pre-

scription drugs would actually lead to impairment which

would affect performance.

As our results suggest that stigma may be attached to

policies accommodating medical marijuana use, at least

among those who do not hold safety sensitive jobs, orga-

nizations considering incorporating medical marijuana into

their existing prescription drug policies may want to con-

sider potential negative reactions of their employees. It

may be useful to provide explanations for why medical

marijuana will be accommodated, as research has shown

that explanations for organizational policies can have a

substantial effect on employee attitudes (Shaw et al. 2003),

although this issue needs additional research. Further,

employees should be informed about differences among

jobs regarding which ones would allow for the accommo-

dation of medical marijuana and prescription drugs.

Potential Limitations

These studies are not without their potential limitations.

Study 1 employed a sample of college students. However,

the sample was older than most student samples with a

mean age of 26, and respondents were either employed or

had work experience. Study 1 participants had also worked

across a wide range of jobs. Moreover, the results for this

sample paralleled those found in our older sample of

employed nurses. Second, our studies gathered information

at only one point in time. However, we used an experi-

mental design with participants randomly assigned to

conditions which allowed us to be more confident in our

findings. Moreover, we controlled for variables such as

drug use history and sex which past research has shown to

be important for explaining drug attitudes. Third, we used

the term ‘‘drug-free policy’’ in the nurse sample, providing

them with a definition of it. However, the use of a between

subjects design may have complicated this issue because

respondents were not privy to the information in the other

conditions. Future research should tease apart this issue by

operationalizing the term ‘‘drug-free policy’’ for respon-

dents. Finally, in Study 1, participants were not necessarily

considering the policy in the context of their own job, but

more generally for jobs in their organization. However, this

issue was addressed in Study 2, because the nurses were

specifically asked to evaluate the policy within the context

of their own jobs and the safety sensitivity they associated

with it. Future research should confirm that the safety

sensitivity of the respondent’s job has effects on reactions

to drug policies developed for all employees in the

organization.

Future Research

As the first studies on perceptions of legal drug use at work,

these studies suggest several avenues for future research.

First, some research (e.g., Cropanzano and Konovsky

1995) has examined how the consequences (e.g., rehabili-

tation, termination) of a drug test coming back as positive

for drug use affect reactions to drug testing policies. Future

research should examine a more detailed policy which

would include the consequences of drug use, such as

moving a worker using legal drugs into another, less safety-

sensitive job. Second, research should examine reactions to

coworkers using drugs legally at work. In particular, the

stigma associated with drugs such as marijuana (cf.,

Hathaway 2004) may affect perceptions of coworkers using

them. Further, future research should directly examine the

relative stigma associated with medical marijuana (for

example, because of its perceived availability to people

without a medical condition) versus prescription drugs. We

also suggest that future research examine the conditions

under which a particular drug is used. For example, drug

use by coworkers may be more accepted where there is an

explanation for such use (cf., Shaw et al. 2003) or when the

coworker is known and has performed their job well in the

past. Relatedly, it may be possible to provide explanations

for why an employer might allow the use of medical

marijuana to reduce concerns among employees in low

safety-sensitive jobs. These issues should be examined in

the context of other safety-sensitive jobs (e.g., truck driv-

ers). We also recommend that researchers measure the role

of ethicality and justifications in reactions to employer drug

policies, especially policies regarding the use of legal

drugs. Although we examined perceived safety sensitivity,

which is consistent with past studies on reactions to

employer drug policies, future research may also examine

156 J Bus Psychol (2013) 28:145–158

123

the role of safety sensitivity determined by objective means

(e.g., via O*NET) and how it might affect workers’ per-

ceptions of drug use. Finally, an issue not addressed in the

I/O literature is the complex interrelationship of the

legality, stigma, and safety issues associated with a range

substances such as alcohol (a legal drug), prescription

drugs used legally, illegal use of prescription drugs, med-

ical marijuana, and illegal drugs (e.g., cocaine, heroin). For

instance, even legal drugs used off-site and many hours

prior to work may be of interest to employers because of

potential effects on work performance (e.g., alcohol use the

night before work and hangover), and future studies should

examine this as well (cf., Frone and Trinidad 2012).

Conclusion

This paper presents the first studies to examine reactions to

employer policies regarding prescription drugs and medical

marijuana. We found that those who perceived themselves

to be in low safety sensitive jobs perceived policies

allowing prescription drugs were perceived as more fair

than those allowing medical marijuana. However, those in

safety sensitive jobs perceived policies allowing either

drug equally negatively, and perceived a drug-free policy

to be best. We also found that nurses were more attracted to

organizations with drug-free policies than to organizations

allowing prescription drugs or medical marijuana. As such,

these findings provide guidance for the development of

workplace drug policies.

Acknowledgments We thank Sue Davidson and Chris O’Neil of the Oregon Nurses Association for their help with this project. We thank

Elizabeth McCune for her helpful comments. Earlier versions of the

two studies in the paper were presented at the 2008 SIOP Conference

in San Francisco.

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