Can having smoked marijuana get me in trouble at my green card medical exam?

The short answer is yes.

Although negative consequences of light marijuana use (as opposed to habitual) are not very likely, they are certainly possible.

For one, the doctor performing the medical exam asks about medical history, including use of illegal drugs. Although random drug screening is not a required part of the examination, the doctor can decide to institute this testing, making reference to the specific individual’s “history, behavior and physical appearance.”

Some factors that doctors are told to look for when deciding on a drug test are:

  • History of any substance abuse or dependence with a specific substance listed in Schedules I through V of Section 202 of the Controlled Substances Act [marijuana is covered under in these sections of the Controlled Substances Act].
  • Applicant-provided information that appears to contradict information provided by family members or from other records, such as police, military, school, and employment.
  • Unexplained gaps of time in the applicant’s past schooling or employment.
  • Evidence of unreliable or false information given during the interview or examination.
  • Any demeanor, presentation, or findings that the examining physician associates with substance abuse or dependence, such as motor ability and interpersonal skills; deepened skin coloring, needle scarring, or skin ulcers along the veins in the arms or legs; or a hard, bumpy, or shrunken liver.
  • Evidence or appearance of intoxication with any substance during the examination.
  • Disturbed behavior that might be associated with a substance-related disorder.
  • Follow-up of an initial positive drug screen or a history of a positive drug-screening test.

If a doctor decides to engage in random drug screening, they can requests tests with as little as 24 to 48 hours of notice. It is also worth noting that, while drug testing is not an automatic requirement, marijuana use can show up in a routine urine test, which in turn could trigger any of the more rigorous testing mentioned above.

If a doctor determines that an applicant has a substance abuse problem, this can be a bar on their adjustment of status.