Last verified: May 2026
The Original Timeline — July 2019
When Gov. Justice signed SB 386 on April 19, 2017, the law contemplated patient access by July 2019. The two-year window was intended to allow the West Virginia Department of Health and Human Resources (DHHR), through what would become the Bureau for Public Health Office of Medical Cannabis (OMC), to:
- Promulgate program regulations
- Build patient and physician registration infrastructure
- Issue grower, processor, and dispensary permits
- Allow time for cultivation, harvest, processing, and laboratory testing
- Begin patient sales
The two-year window proved entirely inadequate.
Cause #1: Banking Refusal (2018)
In 2018, then–State Treasurer John Perdue announced that no bank would accept the state’s cannabis-program funds because of federal Schedule I status. Then–U.S. Attorney for the Southern District of West Virginia Mike Stuart publicly threatened prosecution of any bank or business handling cannabis money. Without a bank willing to hold the state’s permit fees, tax remittances, or operating accounts, the program could not progress.
The Legislature responded with HB 2538 (2019), the Cannabis Banking Act, which allowed credit unions to bid for the state’s account and provided limited protections for state employees handling cannabis funds. The Act passed in time to allow program implementation to resume in late 2019, but the year-plus delay was already locked in.
Cause #2: Product-Form and Vertical-Integration Fights (2019–2020)
SB 386 originally banned "dry leaf or plant form" — meaning even vaporizable flower was illegal. The Medical Cannabis Advisory Board recommended whole-plant access in 2018, but the recommendation required statutory amendment.
- SB 1037 (2019) — expanded the dispensary cap from 30 to 100 and authorized vertical integration (single MSO holding grower + processor + dispensary licenses simultaneously). This is the change that produced the current Trulieve / Verano / Holistic / Curaleaf / Cannabist market structure.
- SB 339 (2020) — added "dry leaf or plant form" for vaporization. This is the change that allowed dispensaries to sell vaporizable flower, now ~65% of WV sales.
Both bills passed but consumed legislative time and added regulatory complexity that the OMC needed to absorb before issuing permits.
Cause #3: Slow Rulemaking (2019–2021)
The Office of Medical Cannabis was not formally established within the Bureau for Public Health until February 3, 2021, when patient registration finally opened. The OMC’s formal establishment was delayed by:
- The COVID-19 pandemic, which began in March 2020 and drew DHHR resources to public-health emergency response
- Personnel transitions within DHHR / Bureau for Public Health
- The complexity of integrating cannabis program oversight with the Bureau’s existing public-health portfolio
Once the OMC was operational, it had to promulgate regulations, build patient and physician portals, train inspectors, and establish testing protocols — all under public-comment rulemaking timelines.
Cause #4: Permit Issuance (October 2020 to January 2021)
- Grower permits: issued October 2, 2020 to 10 entities (Armory Pharmaceutical, Blue Ridge Botanicals, Buckhannon Grow, Columbia Care WV, Harvest Care Medical, Holistic WV Farms I, Mountaineer Holding, Mountaineer Integrated Care, Tariff Labs, Verano WV).
- Processor permits: issued late 2020 to 10 entities (overlap significantly with grower licensees plus V3 WV GP).
- Dispensary permits: 100 dispensary permits announced January 29, 2021. Many permittees needed additional months for buildouts, local zoning approvals, security installation, and METRC integration.
Cultivation cycles then took an additional 4–6 months for first harvest, plus processing and testing time. The first sale finally occurred November 12, 2021 at Trulieve Morgantown, with a Weston, WV location opening November 15.
By Comparison — Other State Timelines
- Pennsylvania (Act 16 signed April 17, 2016) — first sales February 2018, ~22 months.
- Ohio (HB 523 signed September 8, 2016) — first sales January 2019, ~28 months.
- Maryland (HB 881 signed May 2014) — first sales December 2017, ~43 months.
- West Virginia (SB 386 signed April 19, 2017) — first sales November 12, 2021, ~55 months.
WV’s 55-month gap is the longest among neighboring states and among the longest in U.S. medical-cannabis history.
The Cost of the Delay
Patients who qualified for relief in 2017 waited four years before legal access existed. During that period, many turned to:
- Out-of-state cards (which WV does not honor — functionally meaningless in WV)
- Cross-border purchases (legally exposed under § 60A-4-401(c) and federal trafficking statutes)
- Illicit-market product (without testing, dosing precision, or pesticide regulation)
- Hemp-derived CBD and delta-8 products (gray market under WVDA hemp-program oversight)
- Continued opioid use
The four-year delay arguably contributed to the state’s peak-year opioid mortality (2017–2020), although causation is contested. See opioid-crisis overview.
For in-depth cannabis education, dosing guides, safety information, and research summaries, visit our partner site TryCannabis.org
Related on this site: WV 30-Day Supply Limit, How to Get a West Virginia Medical Ca..., WV: No Edibles.