The Code of Virginia authorizes the Board to issue up to five pharmaceutical processor permits authorizing the facilities to cultivate cannabis, produce and dispense cannabis products. As of the date of this report, there are four current active permits. All pharmaceutical processors are currently cultivating cannabis and submitting medical cannabis products to the Board for approval. As of July 1, 2021, the Code of Virginia changed to allow the dispensing of botanical cannabis products. The Board of Pharmacy approved regulations regarding the cultivation and dispensing of botanical products on July 6, 2021 and those regulations became effective on September 1, 2021. The pharmaceutical processors continue to have cannabis oil products such as nasal spray, chewables, suppositories, topical· gel, oral oils and vaped oil, wax concentrate, and bubble hash concentrate inhalations available for dispensing while adding whole flower, pre-rolled joints and ground flower products for dispensing. Tetrahydrocannabinol (THC) is the psychoactive component of cannabis. Tetrahydrocannabinol-A (THC-A) can be converted into THC through decarboxylation. Of the products currently dispensed, the vaped inhalation products from oils, wax concentrates, and bubble hash concentrates have the highest THC/THC-A combined concentrations, ranging from 34.8% to 82%. Botanical cannabis products have the next highest THC/THC-A combined concentration, ranging from 7.57% to 28.99%.

Conditional approval issued to PharmaCann for a fifth pharmaceutical processor permit located in Health Service Area I was rescinded in June 2020. Deadline for a subsequent Request for Application (RF A) to competitively award a permit in this health service area was December 4, 2020. The Board received 26 applications during the RFA period. PharmaCann appealed the Board's decision and on January 14, 2021, the Henrico County Circuit Court ordered the Board to cease reviewing applications until further order by the Court. As a result, the Board must wait for the Court's resolution of PharmaCann's appeal, which remains ongoing at this time.

The Board may also award up to five cannabis dispensing facility permits per health service area. The Governor approved the board's proposed emergency regulations in January 2021, with those regulations becoming effective on February 8, 2021. Currently, there are three permitted cannabis dispensing facilities in the Commonwealth. Patients may obtain cannabis products from these three facilities, in addition to the four pharmaceutical processors.

The Board currently receives 1,000 to 1,200 applications per week from individuals seeking registration. As of November 14, 2021, there are 35,832 registered patients, 220 registered parents/legal guardians, 151 registered agents, and 950 registered practitioners. Registrations for 688 medical cannabis products have also been issued to date.

On November 15, 2021 and due to continuing issues with U.S. Postal Mail delivery across Virginia, the Board of Pharmacy ceased routinely issuing physical medical cannabis registration cards. Once an applicant is approved, he or she will receive an email and may take this email, in either electronic or printed form, to a medical cannabis dispensary to obtain medical cannabis products. This change does not obviate the patient from obtaining and renewing registration with the Board or from providing photo identification and a valid, non-expired, written certification to the dispensary. The Board has also continued to actively pursue implementation of a new licensing software system to improve efficiencies in the registration process.