The State of Medical Marijuana in Virginia

2020 Grade: F

2015 2016 2017 2018-2019 2020

2019-2020 Improvements and Recommendations

As of May 2020, Virginia maintains a registry of 5,209 patients, and a new suite of cannabis policy improvements designed to expand patient access and improve system function. Prior to pivoting to COVID emergency response measures, Old Dominion state lawmakers approved decriminalizing legislation reducing penalties for possession of up to one ounce of cannabis to a fine of $25 and no criminal record. The law also seals past cannabis possession criminal records from employers and school administrators, and removes the list of qualifying conditions for patient eligibility in favor of a physician determination.

In 2020, Virginia also passed legislation requiring the Joint Legislative Audit and Review Commission to issue a report outlining a regulatory structure to oversee a comprehensive medical and adult-use cannabis program. The report is expected to be issued before the next legislative session. Another report expected this year from the Virginia Secretary of Health and Human Resources will provide recommendations for medical cannabis system improvements, including the use of cannabis flower as a treatment option. Beyond these reforms the Virginia legislature approved a measure that permits reciprocity for out-of-state patients, and increased the number of authorized medical cannabis retail storefronts from five to 30.

While these reforms are important Virginia still has significant work to do before its medical cannabis program is functional for state patients. As the state looks to 2021 ASA recommends that lawmakers focus efforts on authorizing legal retail sale of medical cannabis flower, and authorize registered patients to cultivate cannabis at home to reduce cost and travel burdens on patients. ASA also encourages state lawmakers to remove vertical integration requirements for medical cannabis businesses. While vertical integration can allow larger cannabis businesses to maximize efficiency and cost effectiveness, it can also lead to supply problems and increased costs for patients if vertically integrated businesses become the primary or only business arrangement authorized by states or territories.


February of 2015 marked the signing of HB 1445 and SB 1235, legislation extending some legal protections to epilepsy patients using CBD or THCA extracts. This law protects epilepsy patients using those specific medicines from prosecution but not arrest, and the legislation did not authorize the creation of a medical commercial cannabis system that would license cultivators, manufacturers, distributors or legal retail facilities. However, the law only extended access to a single patient population, neglecting a large number of Virginia residents who could benefit from medical cannabis treatment, to include those suffering from chronic pain.

In 2017, Virginia enacted SB 1027, which for the first time authorizes the state Board of Pharmacy-licensed “pharmaceutical processors” to produce low-THC cannabis oils for patients suffering from intractable epilepsy. This extremely narrow law formally introduced the concept of a legal in-state cultivation, manufacturing, testing and retail of authorized CBD and THCA products for registered Virginia patients. The Virginia Board of Pharmacy adopted regulations establishing health and safety oversight in August 2017.

Old Dominion state lawmakers made significant improvements to the state’s medical program in 2018 and 2019. In March of 2018, lawmakers removed the state’s qualifying condition list to allow THCA and CBD products for any condition that a physician deemed appropriate. In the fall of 2018, Virginia authorized CBD processors to begin operating in the state, and the Board of Pharmacies approved the first five licensed pharmaceutical processors in January of 2019.

In March 2019, Virginia enacted SB 1557, which allowed for production, use and sale of full therapeutic (15 percent CBD or THCA, 5 percent THC) strength creams and lozenges for registered patients. The law also allows for the use of CBD/THCA in schools for registered patients, permits registered agents to procure CBD or THCA products for patients and authorizes licensing of five medical cannabis retail facilities. 2019 also saw Virginia expand the scope of eligible medical professionals who may certify patient eligibility to include licensed physician assistants and nurse practitioners. The year concluded with Virginia’s Attorney General calling for a special session to discuss cannabis decriminalization, social equity, CBD and hemp regulation, and pathways to establishing a comprehensive commercial cannabis policy regime.

Patient Feedback

Surveyed patients again report disappointment by the lack of dried flower and the caps on THCA and CBD.