Qualifying for the Program:

  • Qualifying patients will apply to the Office of Cannabis Regulation for a registration card that allows them to use and safely access medical cannabis. To qualify, patients must have a qualifying debilitating medical condition and a written certification issued by a healthcare practitioner with whom they have a bona fide relationship.
  • Certifications can be signed by an MD, DO, naturopath, homeopath, chiropractor, physician’s assistant, or nurse practitioner who has a certificate for completing a medical cannabis course.

Qualifying Conditions:

  • The qualifying conditions are: cancer, glaucoma, HIV/AIDS, hepatitis C, amyotrophic lateral sclerosis, Crohn’s disease, ulcerative colitis, agitation of Alzheimer's disease, PTSD, traumatic brain injury, hospice care, Parkinson’s disease, Huntington’s disease, arthritis, diabetes, chronic pain, neuropathic pain, or the treatment of these conditions or conditions that cause cachexia or wasting; severe nausea, seizures, or severe and persistent muscle spasms.
  • The Office of Cannabis Regulation (OCR) may approve additional conditions or their treatments.

Possession Limits:

  • Registered patients who are residents of the Virgin Islands may possess up to four ounces of cannabis and an amount of cannabis products allowed by regulation. Patients whose ID cards specify they can cultivate cannabis may grow 12 plants in a secure location and possess the cannabis harvested from those plants.
  • Nonresident patients may possess up to three ounces of cannabis, plus an amount of cannabis products allowed by regulation.


  • Patients may designate a caregiver to assist them with the medical use of cannabis. Caregivers are also issued ID cards from the OCR.
  • A patient may have more than one caregiver if the patient — or the person responsible for making medical decisions on their behalf — submits documentation showing that additional help is needed due to the patient’s age or medical condition.
  • Caregivers may pick up a patient’s cannabis from a dispensary on their behalf.
  • Either a patient or their caregiver — not both — may cultivate plants for a patient. Patients will notify the OCR of whether they or the caregiver will be designated to cultivate.
  • Caregivers must be 21 or older.
  • Caregivers may only assist up to five patients, unless the patient is admitted to a residential care or medical facility where the caregiver works.

Medical Cannabis Businesses:

  • The Office of Cannabis Regulation, within the Department of Licensing, is charged with licensing cultivation facilities, cannabis testing facilities, cannabis product manufacturing facilities, and dispensaries. It appears, but is not entirely clear, that every qualified applicant will be licensed.

Medical Cannabis Businesses, Specific Requirements:

  • Medical cannabis businesses cannot be located within 500 feet of pre-existing schools.
  • At least 50% of an applicant’s principal officers, its board of directors, and its shareholders must be Virgin Island residents for the past 24 months or longer.

Regulatory Oversight:

  • A nine-member advisory board would have substantial authority. It would meet at least four times, lasts three years, and may be extended.
  • It would include one or two representatives from the health department, department of agriculture, department of licensing and consumer affairs, a farmer appointed by the agriculture commissioner, a healthcare practitioner who is knowledgeable about medical cannabis, and a disability rights advocate.

The advisory board will issue regulations, including:

  • Ensuring patients’ ability to get high-quality medicine in a timely fashion
  • Developing rules for hemp cultivation
  • Developing rules for non-resident medical cannabis tourism
  • Establishing a testing lab on each major district, initially operated by private entities with annual contracts via an RFP (the Virgin Islands could operate its own later)
  • Developing education and certification requirements for medical cannabis staffers
  • Establishing a list of approved medical cannabis establishment vendors
  • Establishing rules for members-only on-site consumption locations (for patients who are 21 or older) and on-site consumption at dispensaries
  • Developing rules about sensitive locations (such as schools and churches) and addressing street-level and media-based marketing around them
  • Developing security, recordkeeping, health and safety, transportation, employment, training, labeling, and oversight requirements
  • Promulgating requirements for safe, accurate, and appropriately childproofed packaging and labeling

Limitations and Prohibitions:

  • A dispensary may not dispense more than three ounces of dried cannabis per patient, per 14-day period. The sales will be logged on a confidential website to ensure compliance.
  • Patients may not drive, operate a boat, train, or aircraft, or undertake any task that would be negligent or professional malpractice while under the influence of cannabis.
  • Cardholders who sell medical cannabis to non-cardholders face felony penalties.
  • Cardholders who violate the law can have their ID cards revoked or suspended and, where applicable, face criminal penalties. Cards must be suspended permanently if they sell cannabis.
  • Cannabis could not be smoked in any public place or place that is open to the public, and no establishment would be required to allow a guest to smoke cannabis on the property.
  • Landlords would not be required to allow cannabis cultivation on their properties.

Legal Protections:

  • The bill protects patients, caregivers, medical cannabis businesses and their agents, attorneys, and medical practitioners from arrest, prosecution, or penalties for actions allowed by the bill.
  • Until 25 days after applications are available, a healthcare practitioner’s certification serves as a registry identification card.
  • Once a patient submits their application and healthcare practitioner’s certification, a copy of those materials serve as a temporary ID card until the OCR acts on the patient’s application.
  • Registered patients are protected from discrimination in housing, school enrollment, child custody and visitation, and eligibility for medical care, including organ transplants. In addition, employers are to treat off-site, off-hours medical cannabis use as they would pharmaceutical medication, unless federal law, regulations, or contracts require otherwise. Employers may continue to prohibit employees from working under the influence of cannabis or using cannabis at work or during work hours, and may presume a patient to be impaired if, during the work day, they have a THC concentration of 150 nanograms/ml or higher in their blood or urine.

Visiting Patients:

  • Medical cannabis patients who are registered in other territories, states, or countries can use and obtain medical cannabis in the Virgin Islands. They would need to submit their documentation to the OCR and to have a medical condition that qualifies under the Virgin Islands law.
  • Also, patients who are not registered for medical cannabis in their home jurisdiction can use medical cannabis under the recommendation of a Virgin Islands medical cannabis physician and apply for and receive a non-resident ID card. These are typically limited to no more than 30 days but that can be extended for good cause.

Affirmative Defense:

  • Individuals with qualifying medical conditions may raise a defense in court for their medical use of marijuana – and, if proven, be acquitted — if a healthcare practitioner treating the patient has stated he or she believes the patient may find relief from medical cannabis.
  • The defense applies if the patient possessed no more than eight ounces of cannabis in a secure location that only that individual could access, no more than three ounces elsewhere, and no more than 16 plants.

Fees, Taxes, and Regulatory Costs:

  • The program must be funded entirely by the fees and taxes it generates within two years. An initial loan of $500,000 must be repaid within the two years.
  • A 10% excise fee is levied on transfers to dispensaries and manufacturing facilities.
  • A 5% excise fee is levied on sales to patients.
  • The tax revenue will be used to repay the initial loan and to: address addictive behavior, drug education, and rehabilitation programs (12.5%); defray licensing costs (12.5%); help fund the Department of Agriculture’s Agriculture Depot Program (10%); help fund sports development, training, and travel through the Department of Sports, Parks and Recreation (10%); support government-owned buildings in the territory via the Department of Public Works for Infrastructure Maintenance and Improvement (10%); promote medical tourism (5%); fund medical cannabis education and training for law enforcement (5%); fund an apprenticeship program run by the Department of Labor with the Department of Education (5%); and help fund performing arts programs via the Department of Planning and Natural Resources for the Council of the Arts (5%).
  • Medical cannabis business application fees range from no more than $500 (for a tier 1 license to grow no more than 100 plants, if the applicant is a farmer) to no more than $5,000 (for cannabis product manufacturers and dispensaries). Half of the application fees are refundable.
  • The OCR will set a licensing and renewal fee, which may not exceed the application fee. All fees may be adjusted annually for inflation.
  • Virgin Islands resident patients will pay an annual registry fee of no more than $50.
  • Fees for visiting patients will be set by the OCR and the maximum fees range from $50 for five days to $100 for 30 days.


  • Draft rules would be due within 120 days of the effective date. They would be final no more than 60 days later.
  • The OCR must grant registrations to qualified medical cannabis business applicants within 90 days of the applications’ submission.