Medical cannabis bill heads to Virginia governor’s desk; what happens next

STAUNTON – It was only two months ago that Staunton's Nikki Narduzzi met Delegate Ben Cline at our local Starbucks to ask him to patron a Let Doctors Decide medical cannabis bill that would make public policy history.

As patient coalition director of Cannabis Commonwealth, she continued to advocate in the hopes that 2018 would be the year medical marijuana became legal for patients. After years of tireless advocacy and telling people to hang in there, we are so close, she can now tell people help is here and guide patients with next steps.

“Today’s passage of the HB 1251 is a monumental win for patients across Virginia,” said Narduzzi. “Cannabis Commonwealth is ready to transition from educating our legislators to educating patients and healthcare providers about what this means for them. We are excited to help patients achieve their goals of pain management, reducing prescription opioid use and a better quality life via cannabis therapies right here in their home state.”

More: Medical marijuana bill passes Virginia Senate 40-0

Virginia NORML issued a release on Wednesday to announce that Cline’s bill to expand Virginia’s medical cannabis laws made its final passage in the House of Delegates and is heading to Governor Ralph Northam’s desk for signature.

“Medical cannabis oil has been proven to effectively and safely help patients manage pain,” said Cline. “With Virginia fighting a growing opioid crisis, this is smart legislation to reduce dependence on addictive narcotics. By expanding the ability to recommend medical cannabis oil, we are giving doctors the freedom to make a decision based on the most up to date research and data, just as they do for any other medication they prescribe. I am pleased to see this bill pass the general assembly, and I look forward to the governor signing it into law.”

Read: Pain over politics: How this Staunton Republican became an advocate for medical marijuana

What happens next

In 2017, Virginia approved a regulatory program for the in-state production of medical cannabis oil by five providers, one per Health Service Area, which will grow, extract, dispense and deliver the medical cannabis oils. These licensed providers​, called “pharmaceutical processors” in the code, are vertically-integrated, meaning everything from growth through dispensation is done on one site by one provider.

Once operational, patients will register with the program and then be able to fill their recommendation at one of five licensed facilities in Virginia. Doctors will be required to obtain Continuing Medical Education credits in medical cannabis in order to recommend medical cannabis to their patients. The annual registration fee for patients and physicians will be $50.

More: Decisions on marijuana medical extracts will be made where they should, by doctors

While the new laws will technically not make these medical marijuana compounds legal, they will provide an affirmative defense for possession by patients and caregivers with written certification and for production by licensed processors. An affirmative defense defeats or mitigates the legal consequences of the defendant’s otherwise unlawful conduct.

Physicians will ​recommend​ the oils, not prescribe them as they do with traditional pharmaceuticals. “Prescribe” is reserved for FDA-regulated products, and legally means to write a prescription on a DEA-numbered prescription pad.

Virginia’s regulations mandate that the medical cannabis oils must contain at least 15% cannabidiol (CBD) or at least 15% tetrahydrocannabinolic acid (THCA-A) and may contain no more than 5% tetrahydrocannabinol (THC).

“Virginia can now benefit from the same reduction in opioid fatalities observed by states that have implemented medical cannabis laws,” said Virginia NORML’s executive director, Jenn Michelle Pedini. "25% fewer opioid overdose deaths occur after states adopt medical marijuana laws, and after just a few short years the percentage escalates to 30-35%. Three Virginians die every day from opiate overdose, so this legislation will help immensely in mitigating the opiate crisis in the Commonwealth.”

HB 1251 and the companion bill in the Senate, SB 726 patroned by Senator Siobhan Dunnavant, were introduced at the direction of the Virginia Joint Commission on Healthcare.

“HB 1251 is the culmination of several years of work with my constituents and a year long study by the Joint Commission on Health Care, on which I serve,” said Delegate Kaye Kory. "I am proud to be a chief co-patron along with Delegate Ben Cline. This bill will allow more Virginians to avail themselves of the healing properties of medical cannabis oils which can ease the symptoms of painful and debilitating diseases and conditions.”

For Virginians suffering from conditions like cancer, Crohn’s and PTSD, their long wait to have legal access to the healing attributes of medical cannabis oil will soon be over.

“The passage of HB 1251 is an important next step to improving the lives of so many Virginians and sets an important precedent for laws like this across the country,” said chief co-patron Delegate Eileen Filler-Corn. "Those who suffer from intractable epilepsy have already seen the benefits of cannabidiol oil and how it can improve their quality of life. These bills will allow more Virginians to benefit from cannabidiol oil as well.”

Soon Virginia doctors will be the ones determining whether or not medical cannabis oil will help their patients find comfort and heal by recommending medical cannabis oil for the treatment of any diagnosed condition or disease.

Governor recommends emergency clause

“As a former President of the Virginia Board of Medicine, I can tell you it is long past time for us to allow physicians, not legislators, to make medical decisions in treating their patients,” said co-patron Delegate Steve Heretick. "This is a big step in the right direction. I am particularly thankful for the emergency clause recommended by the governor, which will allow this law to go into effect as soon as he signs the bill.”

Virginia’s novel approach to medical cannabis will serve as a model to states that have adopted limited-access policies.

“Virginia will set historic public policy today, by becoming the first state legislature to expand a hyper-restrictive medical cannabis program from a single qualifying condition to any diagnosed condition. I have championed expansion of Virginia’s medical cannabis laws since I took office,” said co-patron Delegate Mark Levine.

Expanding affirmative defense and access to all Virginians has been a primary focus of Virginia NORML and Cannabis Commonwealth since 2015.

To learn more, visit vanorml.org/faqs.

How Virginia turned around on medical cannabis

It began with parents of children with epilepsy, who met with legislators to discuss using cannabis as medicine.

In 2015, a bill that would allow an affirmative defense for epileptic patients to possess cannabis oil with a two-year sunset clause passed, explains Narduzzi.

Families then asked legislators to provide protection for industries to produce the cannabis in Virginia. The families returned the following year to make sure the bill would continue, and former Gov. Terry McAuliffe signed it into law in 2017.

During this time, Virginia NORML was beginning to advocate an expansion to the conditions list. Legislators wanted them to provide the efficacy of each condition, a near impossible task, says Narduzzi, who was advocating with Pedini.

The Joint Commission on Health Care came back with numerous recommendations, including:

Do nothing. Add only the top conditions. Create a medical advisory panel to provide the efficacy of each condition. or Let doctors decide.

The patron of the bill in 2017 was Rep. Sen. Jill Vogel. Vogel's bill was an expansion to the conditions list with 12 conditions. She was willing to amend it down to two conditions – a daunting task – to get it passed, but it died in the House Criminal Law Subcommittee. Rep. Sen. Ben Cline was one of the yes votes on the subcommittee.

During this time, Rep. Sen. Siobhan Dunnavant, a physician who supported Vogel's bill, sat on the Joint Commission on Health Care and was able to explain to the commission why doctors should decide and not legislators.

In 2018, Cline would patron the House bill that, for the first time, would pass the House Criminal Law Subcommittee and move on to the Senate floor.

More: Medical marijuana bill passes Va House subcommittee

Dunnavant told Vogel she'd continue the fight and would become the chief patron of the Senate bill that passed unanimously on Feb. 5 allowing doctors to recommend medical cannabis oil for any condition or disease.

A huge surprise for advocates, said Narduzzi, was Rep. Sen. Dick Black, who changed his no vote to a yes. When it was over, Dunnavant walked up to Black and gave him a hug.

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Reporter Monique Calello can be reached at (540) 430-0620 or mcalello@newsleader.com. Follow her on Twitter @moniquecalello.