Medical Cannabis in Puerto Rico: An Industry Under Pressure and a Regulatory System Facing New Questions

The Puerto Rico Department of Health’s direct involvement in matters concerning the Medical Cannabis Division, ongoing investigations, an ethics complaint against a former inspector, and a tragedy linked to commercial disputes have once again brought attention to the operations of an industry shaped by public health, economic activity, and institutional responsibilities.

Puerto Rico’s medical cannabis industry has evolved into a sector involving thousands of patients, healthcare professionals, licensed establishments, and numerous economic stakeholders. Its growth has also brought greater responsibilities in terms of oversight, compliance, and transparency.

Over the past few weeks, several developments have brought renewed public attention to the program’s operations. Although there is no evidence that all these events are directly connected, their timing raises an important discussion about the ability of institutions to oversee an increasingly complex industry.

The most recent development took place on October 27, when Health Secretary Víctor Ramos Otero issued a directive stating that matters related to the Medical Cannabis Division, with the exception of administrative matters, would be handled directly by the Secretary’s Office.

The decision comes in response to multiple ongoing investigations, both internal and involving other agencies. Although the Secretary did not specify how many investigations are underway or provide details about their nature, he explained that communications concerning these matters would be handled through his office. According to his statements, the intention is to protect investigative processes and prevent Division personnel from having to address matters that may be under investigation.

According to the Secretary, the directive does not represent a change in the office’s leadership or a modification to the processes for issuing licenses and permits. Ramos Otero stated that he continues to have confidence in Marjorie Tolentino Rivera, executive director of the Medical Cannabis Regulatory Board, as well as in the rest of the team. Administrative operations, he assured, will continue to function in much the same way.

This distinction is important: there has been no announcement regarding the elimination of the regulatory structure or the suspension of industry operations. Rather, the change concerns how the Division’s matters and communications will be handled at a time when multiple investigations remain ongoing and their details have not been disclosed.

This development also comes at a time when the program’s oversight was already under review. Months earlier, the Senate Health Commission had launched an investigation into the operations of the Medical Cannabis Program, its oversight procedures, and compliance with the regulatory framework. As part of that process, inspections were conducted at two laboratories and one dispensary, where irregularities were identified, resulting in dismissals and fines. The possibility of conducting additional inspections had also been raised.

These developments show that questions surrounding the program’s oversight did not begin with the Secretary’s directive. An institutional review of how the sector is administered and supervised was already underway.

Adding to this landscape is the complaint filed by the Office of Government Ethics against Adair Emilio Pérez Torres, who served as an inspector for the Medical Cannabis Regulatory Board from March 2021 to September 2025.

The complaint alleges that, in January 2026, Pérez Torres appeared before the same agency where he had previously worked, representing a company seeking certification as a continuing education provider. It also alleges that he provided consulting services to a regulated entity.

The controversy centers on restrictions established under Puerto Rico’s Government Ethics Act, which apply to former public officials during the two years following the end of their government service, particularly when conducting business before the agency where they were previously employed. The Office of Government Ethics is seeking sanctions over the alleged violations. However, it is important to clarify that these are allegations contained in a formal complaint, not a final determination of liability. The matter must proceed through the appropriate legal process.

Regardless of the outcome, the case highlights the importance of establishing clear boundaries between the knowledge acquired through public service and the professional activities individuals pursue afterward in the private sector.

The discussion took on a far more painful human dimension following the murders of Félix Plaud de Choudens and attorney Luis Quiñones González, as well as the subsequent death of William Noel Rivera Sánchez, who was identified as the individual responsible for both killings.

Information surrounding the case revealed that Rivera Sánchez had filed two civil lawsuits involving investments he claimed to have made in projects to establish medical cannabis dispensaries. In one case, he sought damages related to a $100,000 investment; in another, he alleged that he had invested $161,000 in a commercial project.

The court documents describe claims involving alleged breaches of agreements and damages. However, the allegations contained in these lawsuits do not, by themselves, constitute judicial findings of fraud or liability. Nor do they establish a causal relationship between the commercial disputes and the violent events, although authorities investigated a possible motive and Rivera Sánchez himself made statements about those disputes in videos circulated on social media.

This episode should not be used to generalize about an entire industry or assign collective responsibility to those who participate in it. It does, however, serve as a reminder that, as in any sector involving investments and commercial agreements, contractual clarity, due diligence, and effective dispute-resolution mechanisms are essential.

Available figures help illustrate the responsibility that comes with overseeing this program. As of August 2026, Puerto Rico had 110,736 active patients, 59 certifying physicians, and 4,505 occupational licenses. Behind these figures are patients who depend on access to treatment, professionals involved in their certification, employees and businesses operating within a regulatory framework, and a public structure responsible for establishing and enforcing the rules.

For this reason, the discussion should not be limited to who will handle the Division’s communications or the controversies making headlines. The more fundamental question is how to strengthen a system that must ensure consistent oversight, transparent processes, regulatory compliance, and patient protection.

Ongoing investigations must be allowed to follow their due process. Allegations must be evaluated based on evidence, and institutional decisions must be communicated clearly, within the limits imposed by each proceeding.

Puerto Rico’s medical cannabis industry has reached a level of development that requires institutions capable of meeting their responsibilities with rigor and consistency. Its future depends not only on economic activity or the expansion of services, but also on the trust it can establish among patients, professionals, and the public.

Because a regulated industry is sustained not simply by the rules written on paper, but by the ability to enforce them and demonstrate that they work.