For the last two decades, Donna Hudnell has struggled with chronic back pain. As she got older, it only got worse.

“I had trouble sitting, walking, sleeping,” said Hudnell, who’s 60. “I can’t do any of that.”

Her doctor recommended medical marijuana, and for a time, it was a salve. Sleeping came easier. Then her employer, Thomas Jefferson University, required her to take a drug test after a medical leave.

Hudnell was in the process of renewing her medical marijuana card, which had been expired for two months, when she took the test in the fall of 2019. As she explained to the nurse administering the test, she had a doctor’s appointment scheduled for the following week to get the necessary annual recertification to use medicinal marijuana.

That didn’t matter — Hudnell got fired from her IT job five days later, the same day she got her recertification. Jefferson told her she had violated its drug and alcohol policy.

Hudnell’s situation is an example of the risks medicinal marijuana patients face, despite its legal status in 33 states, including Pennsylvania. In 2020, there were more than 297,000 registered medical marijuana patients in Pennsylvania, the equivalent of one in 31 adults. In Philadelphia and statewide, lawmakers have sought to pass stronger employment protections for medicinal marijuana patients. But these protections are still being tested, even when they’ve been written into law.

The Chester resident has filed a lawsuit in federal court against her former employer, alleging that Jefferson violated Pennsylvania’s Medical Marijuana Act. The act, signed by Gov. Tom Wolf in 2016, states that employers cannot discriminate or retaliate against medical marijuana patients.

» READ MORE: How being a medical marijuana patient affects your employment rights in Pennsylvania

Jefferson spokesperson John Brand said the institution does not comment on pending litigation.

Jefferson sought to dismiss the case by arguing that the Medical Marijuana Act does not allow workers to sue their employers, an argument rejected by U.S. District Court Judge Gerald J. Pappert last September. Pappert’s decision paves the way for similar lawsuits.

The state Department of Health said it does not enforce the employment protections outlined in the Medical Marijuana Act.

“If someone has a concern in regard to their rights in regard to medical marijuana usage, they should take legal action,” said spokesperson Maggi Barton.

Jefferson, home to the Lambert Center for the Study of Medicinal Cannabis & Hemp, calls itself “the first major health sciences university in the United States to provide a comprehensive academic resource for the medicinal application and business of cannabis and hemp.” It’s also one of eight medical schools in Pennsylvania to participate in the country’s first state-authorized medical marijuana research program.

Told of Jefferson’s medical marijuana research, Hudnell laughed.

“How ironic,” she said, “and yet you have no leniency with your medical marijuana policy.”

» READ MORE: First medical marijuana research launches in Pa.; patients to be paid for participating in Jefferson U. studies

It was the fall of 2019, a year after she first started taking medical marijuana, when Jefferson asked Hudnell to take a drug test to return to work. Hudnell, who had worked in IT for Jefferson for five years, was returning from medical leave after undergoing spinal surgery in hopes of alleviating her back pain.

By then, Hudnell had paid the annual $50 fee to the state to renew her medical marijuana card but didn’t realize she also needed to get recertified by her doctor to complete the renewal of her card. When she tried to explain this to the nurse during her drug test, Hudnell said she felt like the nurse “treated her like a criminal.”

Her doctor, Bracken Babula, practices at Jefferson. After Hudnell’s drug test, he wrote a note explaining why she would test positive for marijuana, even though her card was expired.

“She would have been eligible to purchase a month’s supply of medical marijuana at a dispensary up until her card expired on 8/21/2019,” he wrote. “Due to her chronic use of medical marijuana and the length of time THC remains in the urine, I would expect her urine drug screen to remain positive throughout the 2 months of time between her expired card and her recertification.”

Her employer denied Hudnell’s appeal “because you did not have an active card/certification for medical marijuana use,” according to an October 2019 letter from a Jefferson human resources staffer.

The firing devastated Hudnell.

“I’m a single woman,” she said. “I live alone. I got a house, I got a mortgage to pay, I got a car note.”

Many states, including Pennsylvania and Delaware, require medical marijuana patients to renew their cards every year. In New Jersey, it’s every two years.

» READ MORE: Many Philly employers won’t be able to test new hires for marijuana under a new bill

Annual renewals don’t make sense for patients with chronic conditions, like Hudnell, said Dustin McDonald, interim policy director of Americans for Safe Access, which advocates for medical marijuana access.

“It’s a little outrageous,” he said, adding that patients have to pay for doctor’s visits each time they get recertified.

Genester Wilson-King, a Florida-based obstetrician and gynecologist and the vice president of the Society of Cannabis Clinicians, said she makes it a point to tell her medical marijuana patients that they need to be on top of renewing their card as well as understand their employer’s policies. But “life can get in the way,” she said, “and things can get pushed back.”

“You would think there’d be some level of understanding about that,” she said, noting that “cannabis is still widely considered as a drug of abuse.”

As more states legalize medical marijuana, employers are making the call to stop testing for marijuana, said John Dooney, a human resources knowledge advisor at the Society for Human Resource Management.

“Rather than being concerned about a suit being filed, they won’t test for it or they won’t use that as a way to restrict [individuals] from being employed,” he said.

» READ MORE: Pennsylvania’s 2022 races show how marijuana legalization has gone from fringe to front-runner

And lawmakers are introducing bills to protect medical marijuana patients.

Philadelphia City Council approved a bill this month to make it illegal for employers to test new hires for marijuana, though a wide range of employers are exempt from the bill, including those that employ law enforcement officers, truck drivers, and certain kinds of health-care workers.

Pa. State Rep. Chris Rabb (D., Philadelphia) introduced a slate of medical marijuana protection bills this month, including one that would shield medical marijuana patients who fail a work-related drug test. Rabb called Hudnell’s situation “absurd and entirely disheartening.”

Hudnell has since found a new job doing IT for Qurate, the parent company of QVC. But she has since stopped using medical marijuana, even if it did help her sleep and relax.

“It’s not worth the trouble of me not working, not being able to make a living,” she said.