USVI did not have a medical cannabis program before 2019, although voters did approve a non-binding referendum supporting medical cannabis in 2014. In early 2019, the Governor of the U.S. Virgin Islands signed the Virgin Islands Medicinal Cannabis Care Act to allow qualifying patients to possess and obtain cannabis for medical purposes. The program includes chronic pain and home cultivation (up to 12 plants with an ID card) and allows registered patients to possess up to four ounces at a time with a certification from a healthcare practitioner. The program offers strong civil rights protections for patients.