The Code of Virginia authorizes the Board to issue up to five pharmaceutical processor permits. These permits authorize the holder to establish facilities to cultivate cannabis, produce and dispense cannabis products to patients issued a written certification by a physician, nurse practitioner, or physician assistant for the use of such products for treatment or to alleviate the symptoms of any diagnosed condition or disease determined by the practitioner to benefit from such use. As of the date of this report, there are four current active pharmaceutical processor permits. On September 26, 2023, the Board of Pharmacy voted to rescind the 2020 Request for Application (RFA) to award the fifth pharmaceutical processor permit. Because statutory and regulatory oversight of the medical cannabis program will transition from the Board of Pharmacy to the Virginia Cannabis Control Authority (VCCA) as of January 1, 2024, it is anticipated that the VCCA will develop a new RFA for awarding the fifth permit.

The Code also authorizes the Board to award up to five cannabis dispensing facility permits per Health Service Area. A cannabis dispensing facility must be partly owned by the pharmaceutical processor located in the Health Service Area. Currently, there are 18 permitted cannabis dispensing facilities in the Commonwealth. Patients may obtain medical cannabis products from these 18 facilities, in addition to the four pharmaceutical processors.

All pharmaceutical processors are currently cultivating cannabis and submitting applications to the Board to register various formulations of medical cannabis products. Since the inception of the program, the Board has registered 3,629 medical cannabis products. During the past year, pharmaceutical processors continued to have the following available for dispensing: cannabis oil products such as nasal spray, chewables, suppositories, and topical gel; oral oils; inhaled (vaped) products to include oil, wax concentrate, and bubble hash concentrate; whole flower, pre-rolled joints; and ground flower products. 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 0.25% - 90.80%. Tablet/capsules are available with a THC/THC-A range of 0.26% - 74.20%. Botanical cannabis products have the next highest THC/THC-A combined concentration, ranging from 7.57% - 36.74%.(*1)

As of July 1, 2022, medical cannabis patients and parents/legal guardians are no longer required to register with the Board of Pharmacy prior to obtaining medical cannabis products but may voluntarily request a registration card pursuant to an enactment clause of Chapter 391 of the 2022 Acts of Assembly. Since July 1, 2022, the Board has seen an 88% reduction in patient registration applications. As of July 1, 2023, practitioners are no longer required to register with the Board of Pharmacy and registered agents are not required to register with the Board if a practitioner has added their name to the patient’s written certification for the use of medical cannabis. (See Chs. 760 and 780 of the 2023 Acts of Assembly.) Currently, there are 1,051 registered practitioners.

The Board implemented a new licensing software system to improve efficiencies in both the patient and medical cannabis product registration process in September 2023. The system allows the practitioner to issue an electronic written certification in lieu of the paper format provided by the Board and provide the patient with a digital card that validates the possession of the written certification. The system also streamlines the registration process for patients should they voluntarily choose to obtain registration.
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(*1) Tetrahydrocannabinol (THC) is the psychoactive component of cannabis. Tetrahydrocannabinol-A can be converted into THC through decarboxylation