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Karen O'Keefe has extensive work experience in marijuana policy reform and advocacy. From 2003 to 2018, they worked at the Marijuana Policy Project, where they held various roles. Karen started as a Legislative Analyst and was responsible for lobbying campaigns and ballot initiative efforts in multiple states. Karen then became the Assistant Director and later the Director of State Policies, overseeing the state legislative and grassroots advocacy department. During their time at the organization, they played a significant role in drafting and enacting marijuana policy reforms, including the first two legalization laws passed through state legislatures. In 2018, Karen joined the City of West Hollywood as a Rent Stabilization Commissioner, serving in that role until 2021.

Karen O'Keefe completed their Bachelor's degree in Public Policy and International Studies at Michigan State University from 1996 to 2000. Karen then went on to pursue a Doctor of Law degree (JD) at Loyola University New Orleans College of Law from 2000 to 2003.