Can you Lose Your Job for Having a Maryland Medical Cannabis Card?

Cannabis has been legal for adults 21+ in Maryland since July 2023, and the state’s medical program has more than 100,000 registered patients. But legal under state law doesn’t mean protected at work. Here’s what Maryland employment law says about cannabis and your job in 2026.

This article is general information, not legal advice. Employment situations vary, so talk with an employment attorney about your specific case.

The Short Answer

Yes, in most cases you can still lose your job over cannabis in Maryland, even with a medical card. Maryland generally allows employers to:

• Keep drug-free workplace policies
• Test job applicants and employees for cannabis
• Take action based on a positive test

There are a few exceptions, covered below. Simply having a medical card, however, isn’t a reason to fire someone; what matters is the employer’s drug policy and testing.

Medical Cardholders vs. Recreational Users

Maryland’s 2023 Cannabis Reform Act legalized adult-use cannabis but didn’t add employment protections for off-duty recreational use. Maryland’s medical cannabis law protects registered patients from state criminal penalties, but it doesn’t contain a broad rule requiring private employers to accommodate medical cannabis use.

In practice, that means both recreational users and most medical patients can face consequences for a positive drug test if their employer’s policy prohibits cannabis.

The 2026 Exception: Fire and Rescue Workers

In April 2026, Gov. Wes Moore signed a law (SB 439 / HB 797) that took effect October 1, 2026. It bars employers from disciplining, firing or discriminating against fire and rescue public safety employees (such as firefighters, EMTs and paramedics) solely for testing positive for cannabis, if they’re registered medical cannabis patients and their use was off-duty.

Employers can still test these workers and still act on on-duty impairment. It’s the first statewide employment protection of its kind in Maryland, and some see it as a template for future bills.

Local Rules for Public Employees

Some Maryland local governments have gone further for their own workforces. Baltimore County, Frederick County and the City of Annapolis have ended cannabis drug screening for most public employees. If you work for a city or county, check your employer’s current policy.

Where Federal Law Still Applies

Cannabis remains illegal under federal law for most purposes, so federally regulated jobs follow federal rules no matter what Maryland allows. That includes federal employees, many federal contractors, and safety-sensitive transportation jobs covered by U.S. Department of Transportation drug testing, such as commercial drivers and pilots.

Drug Testing Rules in Maryland

Maryland allows employers to drug test applicants and employees for legitimate business purposes. When they do, the state sets procedural requirements, including using a certified laboratory and giving employees certain rights, such as confirmation testing and a copy of the results.

Practical Tips

• Read your employer’s drug policy before assuming legal cannabis is allowed off-duty.
• Never use cannabis on the job or work while impaired. No law protects on-duty impairment.
• If you’re a medical patient, you can ask HR about the policy, but understand that most private employers aren’t required to accommodate cannabis use.
• Talk to an employment attorney if you’ve been disciplined or fired over a positive test.

Learn More

• Maryland cannabis laws
• Maryland medical marijuana card
• Bloom Germantown menu

Sources

• Maryland General Assembly, SB 439 / HB 797 (2026)
• NORML, “Maryland: Governor Signs Bill Into Law Providing Employment Protections for Firefighters’ Off-Duty Use of Medical Cannabis,” April 28, 2026