Licit Substance Use in Physical Rehabilitation Settings

The purpose of this commentary is to consider circumstances under which it may be ethical to permit patients to use licit substances in rehabilitation contexts. While the content of this commentary may be transferable to other healthcare spaces, our focus on rehabilitation is based on some important distinctions that exist between rehabilitation and acute care spaces. Résumé Abstract L’objectif de ce commentaire est d’examiner les circonstances dans lesquelles il peut être éthique de permettre aux patients de consommer des substances licites dans des contextes de réadaptation. Bien que le contenu de ce commentaire puisse être transposé à d’autres espaces de soins de santé, l’accent mis sur la réadaptation est fondé sur certaines distinctions importantes qui existent entre la réadaptation et les espaces de soins aigus. The purpose of this commentary is to consider circumstances under which it may be ethical to permit patients to use licit substances in rehabilitation contexts. While the content of this commentary may be transferable to other healthcare spaces, our focus on rehabilitation is based on some important distinctions that exist between rehabilitation and acute care spaces. to an inpatient unit at a physical rehabilitation centre. As part of Courtney ’ s rehabilitation, her clinical team recommends a number of therapies, and she consents to all recommendations. Courtney has a good support network of friends who visit frequently and take her outside for fresh air. On one occasion, a clinician sees Courtney with her friends. The group appears to be drinking alcohol and smoking cannabis. Although both alcohol and cannabis are legal substances in this rehabilitation centre ’ s jurisdiction, the centre does not permit patients to use substances during their inpatient journey regardless of whether they are legal or consumed off-property. The clinical team approaches Courtney after being informed of the staff member’s observations, and in response to the team ’ s queries, Courtney states that alcohol and cannabis are a regular part of social activities with friends. She communicates good knowledge of the risks and knows where to seek support if ever needed. Courtney also expresses frustration upon learning of the rehabilitation centre ’ s position/prohibition of patients consuming these legal substances, especially since she will consume them post-discharge.