Virginia looks more and more like it has a full-blown medical marijuana program

People haven’t really been sure what to call Virginia’s foray into the world of medical cannabis.

When it first came up a few years ago, discussions focused on CBD (cannabidiol), a non-intoxicating compound found in cannabis that has been used as a treatment for everything from seizures to anxiety.

It’s been broadened since then, but lawmakers weren’t ready to call it a “medical marijuana program” this year, cutting the language from a bill in the House of Delegates while otherwise leaving the legislation intact.

Meanwhile, the state regulators tasked with overseeing the program, the Board of Pharmacy, officially call it a “low-THC oil program.”

Whatever language people land on, advocates say changes to state law that sailed through the General Assembly this year make clear that there is nothing necessarily “low-THC” about the state’s approach.

“Virginia greatly expanded its medical cannabis program to allow our producers to sell full, therapeutic-strength products in a variety of preparations,” said Jenn Michelle Pedini, executive director of Virginia NORML, the state chapter of the National Organization for the Reform Marijuana Laws.

She said the only meaningful way the state could go further is to allow the sale of marijuana flowers — the part of the plant that’s smoked. Under current law producers are only allowed to sell extractions of the active ingredients, but she said even with that limitation in place, the range of products and the strength at which they will be accessible to patients will be no different than many other states with medical marijuana programs.

“Virginia’s model is not unique,” she said.

The most significant change this year was to expand the kinds of products that producers licensed by the state will be able to sell.

When the legislation first passed last year, they were limited to oils. Under legislation passed this year, they can sell any preparation, which, according to NORML, would include “capsules, sprays, tinctures, oils, creams, gels, lozenges, patches, troches, suppositories, and lollipops.”

The legislation limits a dose to 10 milligrams of THC, the active ingredient in marijuana, but there are no limits on how many doses a patient can take at any given time. It will be up to doctors and pharmacists to decide what’s right for a given patient, said Sen. Siobhan Dunnavant, R-Henrico, a doctor who carried the legislation.

Dunnavant said even that isn’t as big a change as it might sound like because, under the earlier iteration, patients had access to as much oil as they needed, but because of a limit to 5 percent THC by volume, they potentially would have to “take a whole lot of gross-tasting oil.”

“I had always thought of it as a medical marijuana program,” Dunnavant said. “The board of pharmacy thinks of it as a low-THC program. I’m not sure what the differentiation is … but we’ve established this year that they’re going to have dosing that will be sufficient to provide relief to patients.”

Other changes to the program approved by lawmakers include legislation that will let a patient’s caregiver pick up marijuana products on their behalf. They also expanded the medical providers who can issue medical marijuana certificates to patients to include nurse practitioners and physician assistants, in addition to doctors.

Another piece of legislation will allow school nurses to administer medical cannabis products to students.

“School use is remarkable because it’s not just progressive for Virginia, it’s progressive for the nation,” Pedini said. “Virginia would be the fourth state to allow it.”

The Pharmacy Board has licensed five producer-pharmacies around the state to produce medical marijuana products. The program is expected to go live later this year.

The producers applauded the changes the General Assembly made this year, which they said will increase access to cannabis products.

“We’re thankful there was some good thoughtful progress,” said Adam Goers, the chair of the Virginia Medical Cannabis Coalition and an executive at Columbia Care, which won the state’s license to sell medical cannabis products in the Hampton Roads area.