Virginia’s medical marijuana program clouded by confusion

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Virginia’s first five medical marijuana facilities are set to open by the end of the year, but only 600 people have registered for the program so far. Advocates are reporting confusion about how the program works.

Madison Davis is one of those early signups. Davis was five years old when she was diagnosed with a rare type of brain cancer called ependymoma. Her parents turned to cannabis as a way to help prevent Madison from having seizures.

Madison’s mother, Melanie Davis, believes it does much more than that. She says cannabis is what allows her daughter to keep up a busy schedule of ballet, swimming and school.

“You won't convince us that that's not the reason why she is still herself today,” Davis said in an interview in May.

Right now, the Davis’ are forced to buy Madison’s cannabis oils out of state. But soon they’ll be able to get it at a so-called processor that’s set to open in Portsmouth, not far from their home in Hampton. That facility -- and four others in Richmond, Bristol, Staunton and Massass -- will grow, process and sell medical cannabis products to approved patients.

The facilities are set to make their first sales in early spring, a few months after planting and processing their first marijuana crop. But it hasn’t always been smooth sailing, and Melanie Davis is getting impatient.

“It would be nice if it was [open] in time to benefit Madison, you know?” Davis said.

Madison Davis works on math problems with her tutor at her home in Hampton. She's been taking marijuana products for over two years to help manage treatments from a rare form of brain cancer. (Photo: Ben Paviour/WCVE)

How It Works

Medical marijuana still isn’t legal in Virginia. Instead, patients register with the Virginia Board of Pharmacy for what’s known as an affirmative defense -- a kind of doctor’s note certifying to police that a patient can carry products sold at the processors.

Current law allows approved doctors to register patients for any condition they see fit.

Once patients have the registration, they can visit a processor. Those facilities won’t sell the cannabis plant itself. Instead, they’ll have oils, pills and creams. Some of them will contain THC -- the compound in cannabis that makes you high, and that is used in combination with CBD to treat medical conditions. An onsite pharmacist will prescribe the drugs.

Registration Woes

Melanie Davis said Madison’s doctor had some technical problems with an emailed form sent by the state, and they’re not the only ones who’ve had trouble navigating the new program.

Jenn Michelle Pedini heads the marijuana advocacy group Virginia NORML. In a recent interview, she estimated that she gets eight to 10 calls a day from people trying to figure out how to register. Some struggle to make sense of Board of Pharmacy’s website, which Pedini says speaks in the dense language of policymakers rather than everyday people.

“There's definitely a lack of educational resources available to healthcare providers and to patients,” Pedini said.

Pedini said Virginia NORML is trying to fill in the gaps, providing patients with instructions on how to navigate the state’s bureaucratic registration process on their website.

Doctors should also be given more guidance, according to Travis Shaw, a Richmond-area plastic surgeon who has informally advised physicians on the new program. Shaw said most doctors aren’t taught much of anything about cannabis in medical school.

“If physicians are going to be recommending this, they need to have some guidelines in place,” Shaw said.

A spokesperson for the Board of Pharmacy said the board had no plans to introduce more specific rules beyond the language in the law or to change its website.

Hemp vs. Marijuana

The state’s reliance on technical terms like “THC-A oil” can also be a barrier. Many people now recognize cannabidiol, or CBD, a compound found in both legal hemp and illegal marijuana. The hemp version is now available at gas stations and grocers across the state. The marijuana version will be sold by processors alongside products containing THC.

Processors worry that those corner store CBD gummies confuse potential customers, and possibly endanger their health.

Aaron Lopez, a consultant and lobbyist for the Manassas-based processor Dalitso, said his company and the four other firms would like to see hemp CBD products face the same testing they’re required to do for marijuana-based medicines.

“We're afraid that a patient might go out and say, ‘Well, why do I need to wait for the processors to be up and ready when I can go to a local pharmacy or a local mom and pop shop and pull it off the shelf and start taking it?’” Lopez said.

“The problem is that that bottle or that product is unregulated,” he said. “We don't know exactly what's in it. We don’t know if it’s subpotent, and we don’t know if it’s being tested for heavy metals.”

The Food and Drug Administration is in the process of drafting regulations on hemp CBD.

Five processors will open across Virginia by the end of the year. They'll begin selling product in spring, after harvesting and processing their first crops. (Graphic: Virginia NORML)

Supply Crunch

While signups have been slow so far, advocates like Jenn Michelle Pedini think Virginia will eventually need more facilities to avoid supply shortages that have occurred in other states.

One case study is Arizona, which has about $1.4 million fewer people than Virginia and a medical marijuana program that its statehouse approved in 2010. Authorities there have granted licenses to 130 dispensaries and 193,000 people as of March, according to a recent report in the Arizona Republic.

“Now, the million dollar question is when will we get more?” Pedini said of the processors. “And that's really up to Virginians and who they elect to represent them in the General Assembly.”

The GOP-controlled legislature has signaled they want to take a wait-and-see approach. It’s one favored by Lopez and the other processors, who want to recoup their substantial investments.

But some of the 46 companies that weren’t chosen the first time say the process lacked transparency and they want a crack at what is likely to be a big market. They’re pressing lawmakers to allow more facilities, pointing out that patients could face long drives if the five processors are the only options.

They may find a more receptive audience in Democrats, who have traditionally been more friendly to loosening marijuana regulations, and who are just a few seats shy of controlling the chamber.

Even those who are frustrated with some parts the program concede that change has come quickly from the state’s first tentative foray into marijuana treatments for epilepsy in 2015.

“There has been remarkable change in really a very short period of time,” said Melanie Davis. She’s found a little silver lining in her daughter’s illness.

“I would never say lucky to be sick, but she's lucky that we're at a time right now where there is a huge push for cancer research, for pediatric cancer research and for cannabis reform,” Davis said. “I think all of those things are helping her every day right now.”

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