After a final vote in the House on Friday, the legislation would move to the Senate, where sponsors of the House bill say it also has strong support.
"This allows another option for residents of Virginia, and it does provide some assistance for pain management and may give people an alternative to . . . opioids," said Del. Benjamin L. Cline (R-Rockbridge), the chief sponsor of the House bill.
Similar bills have failed for years in the state legislature, although a more narrow statute passed in 2015 allows Virginians to use cannabis oils to treat "intractable epilepsy." But that law does not provide any way for the drug to be produced in the state or for patients to secure a doctor's permission to obtain it.
The District of Columbia and 28 states, including Maryland, have legalized most or all types of marijuana products for medical purposes. Nine states and the District have also legalized the drug for recreational use.
Sixteen other states, in addition to Virginia, allow limited use of marijuana products for a narrow range of diseases, according to the National Conference of State Legislatures.
The increased legalization of medical marijuana — including in Guam and Puerto Rico — reflects a shift in public opinion on marijuana: In 1969, 84 percent of Americans thought the drug should be illegal, the Pew Research Center said. By 2017, only 37 percent agreed.
Del. Eileen Filler-Corn (D-Fairfax), chief co-patron of the Virginia bill on the Democratic side, said she's been working on the proposal for four years, ever since she was approached by a family in her district about the difficulty of controlling their daughter's seizures. The family was so frustrated with the slow pace of change that they temporarily moved to Colorado to have legal access to cannabis.
Another child whose family was seeking access to marijuana oil had a seizure in the hearing room during a hearing on one of the bills, Filler-Corn said.
"It is a huge, huge deal, especially for people with epilepsy, multiple sclerosis, Crohn's disease or cancer," Filler-Corn said. "Things happen very slowly in the legislature, and this was an educational process. It took time and education and a tremendous amount of energy and passion on the part of the families."
Launching a medical marijuana industry can be both time-consuming and lucrative. It took Maryland four years to license growers, producers and retail sellers before opening its first medical marijuana dispensaries late last year.
If the more expansive bill passes, Virginia would seek requests for proposals for five growing and distribution facilities this spring or summer. Patients and physicians would be required to register with the state Board of Medicine to have access to the oils, which could be recommended for those suffering from specific, serious conditions.
Del. Mark H. Levine (D-Alexandria) tried to pass a medical marijuana bill aimed at cancer patients last year, but the legislation died in subcommittee.
Bills by state Sens. Adam P. Ebbin (D-Alexandria) and Barbara A. Favola (D-Arlington) that would have decriminalized marijuana possession and reduced penalties for its distribution failed in committee this year.
Lawmakers said they believe the medical marijuana bill has gained enough support to pass because of lobbying efforts by families and individuals, the growing number of peer-reviewed scientific studies supporting medical marijuana, and the increased number of states that have made it legal.