Is there a safe and effective way to decriminalize or even legalize marijuana in the Caribbean for medical or recreational use? The question came up Friday morning during a session on medical tourism at the Caribbean Tourism Organization’s State of the Industry Conference in St. Thomas.

The innocuously titled “Diversifying the Tourism Product – Taking Advantage of Opportunities in Medical, Health and Wellness Tourism” has been a running punch line during the three-day conference since it was disclosed part of the otherwise sober discussion would touch on the controversial drug.

Joseph Woodman, founder and CEO of Patients With Out Borders, brought up the topic during his talk on the benefits of medical tourism, but steered clear of much elaboration. Less than 24-hours earlier U.S. Virgin Islands Senator Terrence Nelson had introduced a bill that would legalize possession of small amounts of cannabis. The bill quickly passed through the Homeland Security and Public Safety Committee, but will certainly face an uphill battle before the full Senate and any eventual decision by the territory’s governor.

Prompted by the subject matter, Dr. C. James Hospedales, executive director of the Caribbean Public Health Agency, appeared by taped video with a scientific take on the drug, warning Caribbean countries to “Proceed with an abundance of caution, given the significant adverse effects of cannabis smoking on health and social and occupational functioning, and especially so among youth.”

Hospedales said weighing any medical, societal, or economic benefits or detriments was a political policy decision, but warned mixed data on the drug’s effectiveness left him skeptical.

Sen. Nelson was in attendance at the session and pointed out afterward that there are many ways to consume marijuana that do not involved the harmful lung effects of smoking it. Hospedales had also emphasized this point, but said the most effective methods of treatment involved synthesized products from the same cannabis family.

One of the big questions, however, remains. If marijuana is a treatment for long-term problems (post cancer complications, glaucoma, HIV/AIDS-related pain and anorexia, etc.) then how could its use in medical tourism make sense.

Certainly tourists would not be advised to attempt to take their medication home with them unless their home country’s law allowed it. At that point the emphasis changes to recreational marijuana tourism such as that found in Colorado and Washington State.

The issue is one that will surely be contested for years to come.

Earlier Friday, the CTO Secretary General Hugh Riley announced the southern Caribbean island of Curacao will host the 2015 meeting.

Riley noted the conference was in a former British territory, St. Kitts, in 2012, in the French island of Martinique in 2013, in the United States Virgin Islands this year, and set for a Dutch island in 2015.

Surely coincidentally, the Dutch have traditionally been lenient on their marijuana policy, having largely decriminalized possession. Dr. Hospedales pointed out this is an area the Dutch government has been reconsidering and even pulling back from in some ways.