The recent legalization of recreational marijuana sales in both Colorado and Washington raises concern for the possible legal introduction of marijuana and its psychoactive metabolites, primarily DELTA~9-tetrahydrocannabinol (DELTA~9-THC), into the US blood donor supply. Previous studies concerning the prevalence of illegal substances in the US blood supply are sparse, but one small study published before the legalization of recreational marijuana found that 20% (15 of 75 donors) of paid, source plasma donations in the United States tested positive for marijuana.1 At present, the Universal Donor Health Questionnaire (UDHQ) does not query volunteer donors about the use of marijuana and there is no federal requirement for testing of blood donors for any illicit drugs, including marijuana. Although only two states currently have legalized recreational marijuana, blood products are routinely shipped across state lines and blood donors may choose to donate while visiting another state. As a result, the blood supply in all 50 states is theoretically impacted by the legalization of recreational marijuana in Colorado and Washington.
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