Updated on June 28, 2021.
Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer
In Virginia, lawmakers have been busy addressing different aspects of cannabis legalization in the state. In February 2021, the Virginia General Assembly reviewed a number of measures to take legalization of medical cannabis forward. Virginia will be the first Southern state in America to fully legalize cannabis.
Patients, consumers, and cannabis advocacy groups are celebrating the progress. However, in a new announcement made in February, possession of cannabis products for non-medical cardholders will not be legal until January 1, 2024. That is just over three years that consumers will have to wait for adult-use cannabis.
The recreational cannabis marketplace will not open until 2024 in Virginia. The reason for the delay is to refine the state constitution regarding penalties. The legal framework is being drafted for review by the Virginia General Assembly. This review will determine penalties for underage use and for offenses including consuming cannabis in a public place.
The motion to legalize adult-use has been finalized. But Virginia lawmakers will decide a number of different regulatory issues, including fines and penalties before adult-use sales begin in 2024. As of July 1, 2020, cannabis has been decriminalized in Virginia. Possession of up to 1 ounce of marijuana is a $25 fine with no criminal charges.
How Many Medical Cannabis Dispensaries Are Open Right Now in Virginia?
At the time of writing, there are only four dispensaries open in Virginia for medical cannabis patients. There is one producer of extraction-based medical cannabis products in each one of the five Health Service Areas (HASs) in the state. These companies are responsible for the cultivation, processing, and dispensing of medical marijuana products.
In the state of Virginia, the businesses licensed to produce products are called ‘pharmaceutical processors.’ They are vertically integrated for quality control. That means every product they sell to patients must be produced exclusively by the licensed operator. Each licensed operator designated within the Health Service Area (HSA) has permission to open up to five dispensaries.
The Marijuana Business Factbook projects that medical cannabis sales in Virginia will reach between $9 million and $11 million in 2021. Sales of cannabis in Virginia are projected to reach more than $50 million by 2024 when adult-use sales of cannabis start.
How Much Medical Cannabis Can a Patient Buy in Virginia?
The legislation may change. However, for the time being, patients with a medical card in Virginia are limited to a 90-day supply of cannabis. That sounds like a lot, but the actual amount that constitutes a 90-day supply varies by patient. And it is determined by the pharmacist dispensing the products to the patient.
Patients who have severe chronic pain, for instance, may receive a larger amount of cannabis. Or patients who require more than one strain (daytime and nighttime use) may also be permitted to purchase more cannabis for symptom management.
Virginia lawmakers would like the maximum purchase amounts to be determined on a case-by-case basis. Rather than create a uniform maximum purchase amount for patients. It sounds restrictive, but in fact, it is a very accommodating approach. It will help patients who need more cannabis (hospice or compassionate care) to get the quantity of cannabis products they need.
What Are the Qualifying Health Conditions a Patient Must Meet to Get a VA Medical Card?
Currently, Virginia only recognizes two mental health disorders as a qualifying health condition for medical cannabis. Patients with Post-Traumatic Stress Disorder (PTSD) qualify with a diagnosis from a mental health provider. And so do patients with clinical anxiety. Depression is not currently on the list of qualifying health conditions in Virginia.
Some of the other qualifying health conditions accepted by the Virginia medical cannabis program include:
Amyotrophic Lateral Sclerosis (ALS)
Inflammatory Bowel Disease (IBD)
Caregivers and guardians of adults with disabilities or minors must apply to become a Registered Agent in Virginia. Minors under the age of eighteen (18) years cannot purchase cannabis from a pharmacy. However, the registered agent may purchase on behalf of the minor. Each Registered Agent (designate caregiver) may not be registered to assist more than two patients.
What Kind of Medical Cannabis Products Are Available Now in Virginia?
When SB 1557 passed in 2019, it authorized licensed physician assistants, nurse practitioners, and physicians to issue written patient certifications to use cannabidiol oil (CBD) and THC-A oil. In the legislature, licensed medical professionals can prescribe any formulation to a patient to be dispensed by a licensed pharmacy.
Currently, patients with a medical card may be prescribed:
Oils, creams, or gels
Vape Inhalation products
As of February 2021, medical cannabis products in Virginia are still limited to extraction-based preparations. However, botanical cannabis (flower) will become available in 2024, when adult-use legislation is finalized.