No. Under current DOT guidance, a state medical marijuana card does not allow a Medical Review Officer (MRO) to verify a laboratory-confirmed marijuana positive DOT drug test as negative. Under 49 CFR 40.137(a), the MRO verifies a confirmed positive marijuana result unless the employee presents a legitimate medical explanation. Under 49 CFR 40.141(b), a prescription explanation depends on "a legally valid prescription consistent with the Controlled Substances Act."
A Drug Enforcement Administration final rule published April 28, 2026 (91 FR 22714) placed FDA-approved drug products containing marijuana, and marijuana covered by a state medical marijuana license, in Schedule III of the Controlled Substances Act. Other marijuana remains in Schedule I. In Part 40 guidance last updated May 15, 2026, the DOT Office of Drug and Alcohol Policy and Compliance (ODAPC) stated that state-dispensed marijuana is still not an FDA-approved drug and cannot be prescribed. ODAPC also stated that state medical marijuana cards, physician recommendations or certifications, and dispensary records or receipts do not satisfy Part 40 requirements for a legitimate medical explanation. The same ODAPC guidance states that marijuana use is not compatible with safety-sensitive functions.
Section 40.151(f) states that use of hemp or another non-prescription marijuana-related product "is not a legitimate medical explanation." Marijuana metabolites remain on the DOT test panel under 49 CFR 40.82.
This answer applies to DOT-regulated tests under 49 CFR Part 40. Under 49 CFR 40.13(a), DOT tests "must be completely separate from non-DOT tests in all respects," and this answer does not address non-DOT tests.
Related topics are covered in Can a Prescription Explain a Positive DOT Drug Test? and What Drugs Are Included in a DOT Drug Test?.
Employers and employees can use the MyDrugTesting.com directory to search for MROs and other drug testing providers by location and service.
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