When can I get medical marijuana in Virginia?
Monique Calello
STAUNTON – When PharmaCann came to Staunton for a Q&A session with the community, it stated the medical cannabis dispensary plans to be operational by the end of the year.
This doesn't mean registered medical cannabis patients are going to get their medicine.
To put it simply, it means they need to pass inspection or they won't be able to sell medical marijuana in Virginia.
PharmaCann has to complete construction and request inspection before the end of 2019, explains Diane Powers, director of communications at the Virginia Dept. of Health Professions. Once they meet all requirements, they get a conditional permit to move forward.
Given Virginia's vertical integration medical cannabis program, which means everything done in one place—growing and cultivating the plants, processing and formulating products, advising and dispensing medication to patients—PharmaCann chose to build from the ground up and customize their facility to meet the business model approved by the state.
According to Mike Richards, PharmaCann's community and development outreach manager, medication won't be ready for patients until 2020.
"We have to plant the plants," Richards said. "They have to grow."
It typically takes three to four months to grow marijuana.
Once grown, the pharmaceutical processing aspect of the dispensary has to process the cannabis and formulate the products they will sell to patients. PharmaCann's product portfolio for 2020 are topicals, tinctures and capsules.
These products must be approved by the Virginia Board of Pharmacy.
This also takes time.
Support health journalism with a subscription to The News Leader.
"We’re still working through the kinks," says Richards. "Respectful of the BOP and the legislation."
In Virginia, everything that the medical marijuana dispensaries do must go through the Virginia Board of Pharmacy approval process.
What does that look like?
According to the Virginia Board of Pharmacy, after the plant is cultivated and a batch of the oil product is produced, an independent laboratory must conduct the required tests.
PharmaCann needs to register each brand name and associate it with a laboratory test that includes a terpenes profile and list of all active ingredients, says Powers.
Active ingredients include:
- Tetrahydrocannabinol (THC)
- Tetrahydrocannabinol acid (THC-a)
- Cannabidiols (CBD)
- Cannabidiolic acid (CBDa)
There is no deadline for when the products must be registered with the board.
"We’re excited and very anxious to provide the medication to the patients," says Richards.
Every state has different nuances, explains Richards. What he does is help educate the community, physicians and hospitals in the area with Q&A sessions, workshops and presentations. A big part of his job, he says, is physician outreach.
"The physician at the end of the day is making the determination," says Richards.
He's also presented at hospitals and helped hospital administrators work through the process. Given hospital medical marijuana policies in Virginia look like they are written in pencil, Richards will meet with administrators to answer questions that may have already surfaced in other states further down the road implementing medical cannabis programs.
More:Medical marijuana policies at 5 Virginia hospitals
One issue that surfaced is reminding doctors that they are not actually writing a prescription for cannabis. All they're doing is certifying a patient, explains Richards.
"Certification is very different," he says.
Another issue that physicians and hospitals deal with is insuring themselves and legal considerations. In order to receive money from Medicaid and Medicare, medical professionals must be DEA compliant. Since medical marijuana is classified as a Schedule I drug by the DEA, doctors and hospitals are concerned they won't be in compliance.
More:Roadblocks limit Virginia patient access to marijuana
Certifying medical marijuana isn't done on a prescription pad.
But the federal and state law inconsistency is still there. On the federal level, marijuana—medicinal or recreational—is illegal.
Virginia provides an affirmative defense for possession. This doesn't mean medical marijuana is "legal" in the state.
It means a registered patient will have a medical marijuana certificate from the Virginia Board of Pharmacy that provides an "affirmative defense" that defeats or mitigates legal consequences.
If a hospital doesn't allow medical marijuana at their facility and doesn't allow their affiliated physicians to recommend it to patients, they are following federal law instead of state law which gives patients an affirmative defense if they are registered to use medical cannabis.
Patients must take the first step
Patients are often looking for other treatment options when they consider medical marijuana. They may have exhausted traditional medicine that hasn't helped them.
More:Pain over politics: How this Staunton Republican became an advocate for medical marijuana
"This is something they choose to do," says Richards. "A lot of the times, physicians don't want to deal with it. The more patients that take these steps, that's where we've seen pushes of doctors wanting to get educated."
This means don't expect your doctor to register to certify medical marijuana, unless you, the patient, begin the conversation.
Patients in the state have expressed frustration in the low number of medical professionals registered to certify medical marijuana. Some are specific to their specialty so unless you are a patient in hospice care, you can't see that doctor. Other practitioners who specialize in medical cannabis may charge a fee to certify medical marijuana. Some reports indicate fees can be as high as $250, which makes getting a certification too expensive for some people.
More:Why this Valley doctor registered to certify marijuana
Richards wants to help move these conversations along in Virginia so patients don't encounter this to get their medicine. He says he wants to show medical professionals and facilities how professional and scientific their medicine is, and that all of it is regulated. That means it is safe. Given vaping-related lung illnesses, regulations are essential for patient safety.
More:Vaping and lung illness: Scott Ballin says health officials send wrong message
More:1,000 THC vaping cartridges seized in Waynesboro drug bust
More:Vapes spiked with illegal drugs show dark side of CBD craze
But I need my medicine now
Recently, Washington D.C. made an announcement that they are providing access to their medical cannabis program for out-of-state patients. Virginia was excluded from the list.
According to D.C. Health division of medical marijuana and integrative therapy in their health regulation and licensing administration:
"Virginia is not included because Virginia does not have a medical marijuana program. When Virginia has fully implemented their program (including the opening of dispensaries), D.C. Health will make a determination if we offer reciprocity."
This means you have to wait until the five dispensaries opening in the state are ready to provide medical cannabis to patients.
You can't go to D.C. to get your medicine.
"It's unfortunate that registered Virginia patients are currently denied reciprocal access to the District's medical cannabis program," says Jenn Michelle Pedini, executive director of Virginia NORML.
"Virginians visiting our nation's capital will be forced to leave their medicine at home or risk the legal consequence of transporting across state lines," says Pedini.
Who's first?
According to Pedini, all of the cannabis dispensaries have their conditional permits and construction is underway at the five facilities.
"The goal is to get safely regulated products to consumers as soon as possible," says Pedini.
In July, a letter was sent to patients who registered with the Virginia Board of Pharmacy which stated that medical marijuana products are not yet available to purchase in Virginia.
The letter stated that it may take 3-6 months for products to be available once growing begins. Estimated availability date for purchase in Virginia is mid-2020.
The letter went on to clarify that CBD products sold in stores are likely produced from industrial hemp and are not regulated by the BOP.
"The products [medical cannabis] will be tested for potency and contaminants and dispensed by a pharmacist, following recommendation for use from a physician, nurse practitioner, or physician assistant. Patients possessing CBD or THC-A oil containing up to 5% THC and otherwise satisfying the legal definitions may assert an affirmative defense when carrying the written certificate and board registration," the letter stated.