Vermont’s Cannabis Control Board is pushing for changes to its medical marijuana program, including new educational requirements and oversight structures, according to a legislative report released in November.

The recommendations come as Vermont’s medical cannabis patient registry has declined to 2,707 patients, down from about 3,001 a year earlier, according to the board’s data.

Central to the board’s recommendations is acquiring a state license for Cannify.us to provide standardized cannabis education and training for employees serving medical patients.

However, the Vermont Medical Society laid out concerns about using an app for medical guidance, noting in public comments, “the problem is that with the current lack of substantive research, along with the explosion of new forms of cannabis products, there are no definitive answers on the potential risks vs. the therapeutic benefits of regular use of specific cannabis products for patients seeking to manage specific chronic conditions.”

The report also proposes creating a non-legislative entity to evaluate and approve new qualifying medical conditions, similar to review boards in states like Connecticut and Arizona. Currently, adding qualifying conditions requires legislative action.

“The process of evaluating and approving new qualifying conditions decisions should be governed and maintained by the oversight body,” the Green Mountain Patients Alliance noted in its feedback on the recommendations.

The proposed 11-person panel would be housed within the CCB and include addiction medicine specialists, researchers, and patient representatives, operating with support from the Department of Health and University of Vermont medical educators. It would review research, hold public hearings, and provide guidance on medical cannabis products and dosing.

The change would parallel Vermont’s previous “Cannabis for Symptom Relief Oversight Committee” and “Marijuana Review Board,” which historically reviewed patient application denials and studied data relevant to cannabis for symptom relief.

The new pitches for the medical program come amid broader evolution in Vermont’s cannabis market. The state launched adult-use sales in October 2022 and recently created a medical-use endorsement allowing retailers to serve registered patients. The state has collected approximately $15.21 million in marijuana tax revenue through October 2024, derived from a 14% excise tax plus 6% sales tax, with portions allocated to substance misuse prevention and after-school programs.

Active licenses across all cannabis business categories total 583, including 387 cultivation licenses, 94 retail licenses, 88 manufacturing licenses, 2 testing lab licenses, and 9 wholesaler licenses. The board reports that 61% of licenses are standard priority status, while 22% fall under Economic Empowerment priority and 17% under Social Equity priority.

The report shows indoor growing space increased to 399,500 square feet in 2024 from 370,000 in 2023, while outdoor cultivation ticked down to 526,000 square feet from 564,000. The board conducted 60 inspections and 9 investigations over the year.

Medical stakeholders are divided on some proposals. The Vermont Medical Society opposed the Cannify.us recommendation and suggested reinstating requirements for patients to have pre-existing relationships with healthcare providers before joining the registry. The group cited concerns about “medical card mills” potentially expanding the black market.