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Your local family doctors, cardiologists, and anesthesiologists are certified, licensed medical professionals. What you won’t find – in Virginia – are certified medical cannabis providers. WMRA’s Sara Prince reports in the first installment of an ongoing series.
I’m at the Virginia Cannabis Conference in Richmond to learn how medical providers get certified to recommend — not prescribe — medical cannabis. Short answer? They don’t. Providers don’t prescribe cannabis, and cannabis is not classified as a medication. They simply recommend it and issue a certification (you might think of it as a medical marijuana card). Dawn Adams, one of the keynote speakers at the conference, is a nurse practitioner and a former state delegate. She says providers have minimal requirements beyond being a licensed professional, but Adams emphasizes the importance of practitioner knowledge.
RVA Telecare
Dawn Adams is a nurse practitioner and a former state delegate, representing parts of the bay counties east of Richmond from 2018 to 2024.
DAWN ADAMS: Having just random people issue certifications without any knowledge goes against our standards of practice.
In 2023, the General Assembly removed the requirement for healthcare providers to register (or enroll) with the state’s Board of Pharmacy in order to issue medical cannabis certifications. Virginia NORML is a non-profit affiliated with the National Organization for the Reform of Marijuana Laws. JM Pedini is on the Board and explains that oversight shifted in 2023 to the Cannabis Control Authority – an agency led by five citizen board members appointed by the governor and approved by the Assembly to oversee broad aspects of cannabis use in Virginia.
JM PEDINI: There is a platform out there called BioTrack THC to provide patient data to the dispensaries. This is what people are talking about when they’re talking about practitioners having to enroll to issue written certifications.
With a certification in hand, the responsibility of finding and using cannabis falls on the patient. Their best option is one of Virginia’s 23 dispensaries. But what if patients don’t trust their providers? One attendee at the conference shared a story about a friend who sought medical cannabis after his heart attack.
ATTENDEE: He is a daily consumer. And I told him that cardiovascular issues can be a contraindication to cannabis use. So I said, “does your doctor know that you consume cannabis on a regular basis?” And he said his practitioner told me that he smokes too. So, what do you do when it’s somebody who’s trying to educate someone, and they don’t listen because their practitioner does not enforce these same boundaries?
ADAMS: Most people in the medical model, historically, just do what they’re told. Because there’s just not an infrastructure set up for treating yourself as a whole person so it’s no surprise that when a medical provider has an office visit, and you’re reaching office visit, seven minutes long, that the answer would be short.
Time pressures make it difficult for providers to thoroughly discuss cannabis. There’s a lot to consider, and cannabis research is still in its infancy in Virginia. Ryan Vandrey, a professor at Johns Hopkins University in Maryland, runs the Cannabis Science Lab and has been researching cannabis for two decades. He says evaluating a patient for cannabis therapy requires a careful, step-by-step process.
Johns Hopkins University
Professor Ryan Vandrey runs the Johns Hopkins Cannabis Science Laboratory.
RYAN VANDREY: You want to establish that trying medical cannabis might be appropriate for a given patient. Then the decision becomes, well, what type of cannabis product?
That’s a particular concern for Dr. Christopher Holstege, a toxicologist at UVa’s Blue Ridge Poison Center in Charlottesville. He sees the potential benefits of cannabis, but would like to see more evidence.
CHRISTOPHER HOLSTEGE: Because we know some of these chemicals can certainly cause harm and one of the tenets of medicine is we do not want to do harm.
Providers are mostly left on their own to educate themselves on cannabis. Or, a provider can refer a patient to someone with more expertise. Still, when faced with a patient in need of answers, where do they begin?
VANDREY: The first thing is to determine what the aim of cannabis therapy is going to be. Are you looking to treat the underlying etiology of the disorder or managing symptoms? And looking at a high THC product versus a high CBD product. So for example, if the aim of the therapy is to treat short-lasting pain, then you would want to select a route of administration that has the most immediate effect as needed, and then go away in a short period of time. So you’d steer someone more towards an inhaled cannabis product. If you have a patient and they’re dealing with long-lasting, chronic pain symptoms, I’d steer people away from anything inhaled and toward the topical or an oral dose, because those give you more stable blood levels of the drug and longer lasting peak effects.
In the next installment of our series on medical cannabis in Virginia, we’ll look at issues patients face – how they are being protected, where they are getting their information, and what can be improved. For WMRA News, I’m Sara Prince.
“}]] Your local family doctors, cardiologists, and anesthesiologists are certified, licensed medical professionals. What you won’t find – in Virginia – are certified medical cannabis providers. WMRA’s Sara Prince reports in the first installment of an ongoing series. Read More
