New Medical Marijuana Law Goes Into Effect, Expanding Access To Cancer Patients And Texans With PTSD
Lawmakers also increased the allowable level of THC, the psychoactive ingredient in cannabis. But not by much.
New medical marijuana rules in Texas went into effect on Sept. 1, 2021.
Thousands more Texans can now be prescribed medical cannabis oil with low levels of THC, the ingredient that gets people high.
House Bill 1535, which went into effect Wednesday, expands the state’s compassionate use program to people with any type of cancer and those dealing with post-traumatic stress disorder.
The law also doubled the THC limit allowable under the program from 0.5% to 1%. THC, or tetrahydrocannabinol, is the ingredient in marijuana that can produce a psychological effect.
It’s another expansion of the state’s medical cannabis law created in 2015. Still, the state’s program remains one of the most restrictive in the country.
Though an overwhelming majority of Texans believe marijuana should be legal in some form, the final call when it comes to determining who can access it lies with the state’s elected leaders.
And while HB 1535 increases THC levels and expands the number of people who qualify for the program, lawmakers once again chose to move the program forward only by baby steps.
The bill Fort Worth state Rep. Stephanie Klick submitted back in March called for cannabis oil to be made available only to some sufferers of PTSD, specifically veterans. But many who testified on the bill at the Texas Capitol, including veterans, said eligibility should be extended to anyone dealing with the condition.
That was the same logic behind the move to include all forms of cancer.
“It’s arguable that any form of cancer could be terminal, right? So it felt like a very arbitrary descriptor,” said Jax Finkel, the executive director of Texas NORML, a national organization seeking to legalize marijuana.
She said people dealing with the side effects of radiation and chemotherapy shouldn’t have to worry about whether their fight against cancer is dire enough to warrant medical relief from cannabis oil.
Though the increase in the amount of THC is minor, Finkel said, it will allow cannabis oil producers to better serve their patients.
When the bill was introduced, many hoped the THC limit would increase even more, to a maximum of 5%.
That would have increased the limit tenfold. Still, some of the Texans who testified that they already self-medicate with illegal marijuana said it was too low.
Legislators in the House agreed to the 5% THC limit, but the Senate cut it back to only 1%.
The House version also included additional medical conditions. One of the most talked about was anything that causes acute or chronic pain for which a physician would otherwise prescribe opioids.
Several Texans testified about their battles with opioids over the years and extolled the benefits that medical marijuana had brought to their lives. But the Senate ultimately removed that provision.
“Texans support a robust and inclusive medical cannabis program that allows doctors and patients to decide their treatment and formulations,” Finkel said. “But then when we look at the Legislature, they’re only there every two years. So any patients that aren’t included, have to languish for two years.”
Despite the fact that about 85% of Texans believe marijuana should be legal, both medically and recreationally, lawmakers have chosen to move slowly. And the program will grow only as much as the Legislature allows it to grow.
“I think there are some easy things they can do next session to put power in the hands of doctors and patients,” Finkel said. “That’s allowing the Department of State Health Services to allow petitions, add new conditions, evaluate them and add them on a regular basis. To allow them to deal with dosing, because those are the medical professionals.”
It’s not that radical of an idea to allow DSHS to evaluate and add medical conditions to the state’s medical marijuana registry. In fact, it’s something that was included in the version of the bill the House passed.
But the Senate ultimately decided to remove that provision, too.
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‘A big step’: New law will allow Texans with PTSD to enroll in state medical marijuana program
Bill expands Compassionate Use Program, but falls short of advocates’ hopes
After receiving a medical retirement from the military stemming from her time in Afghanistan, Viridiana Edwards found herself taking 23 prescription pills a day.
“A lot of those pills were actually to treat side effects from other pills, it wasn’t even to treat my disabilities,” she said.
Edwards is just one of many Texas veterans who could benefit from a more robust medical cannabis program. And though newly passed legislation fell short of many advocates’ hopes, the Texas Compassionate Use Program is set to expand eligibility.
If signed by Gov. Greg Abbott, House Bill 1535 would allow hundreds of thousands of Texans to join roughly 2 million residents in qualifying for the state’s medical marijuana program. Despite that, only 6,000 Texans are currently enrolled in the program.
Though it remains one of the most restrictive medical marijuana programs in the country, Texas’ Compassionate Use Program has come a long way.
First passed during the 84th Legislative Session in 2015, the program was only extended to Texans who have been diagnosed with intractable epilepsy. The dosage limit on products with THC could not exceed 0.5%.
In 2019, under the same dosage caps, lawmakers expanded the program to include Texans who live with a number of other incurable neurodegenerative diseases, along with epilepsy, seizure disorders, autism and terminal cancer.
This session, lawmakers in the Texas House hoped to expand the program further with House Bill 1535. The initial bill, authored by members of both parties, added cancer, Post-Traumatic Stress Disorder (PTSD), and chronic pain as eligible diagnoses. It also increased the dosage of allowable THC to 5%.
The bill faced headwinds in the Texas Senate, however, where it stalled for a few weeks before it was referred to a committee.
“It was like we had to drag this bill,” said Heather Fazio, director of Texans for Responsible Marijuana Policy.
Fazio said she and other advocates, including former Dallas Cowboy Jay Novacek, had to publicly call on Lt. Gov. Dan Patrick to refer the bill and move it along the legislative process.
The bill was eventually referred, but the Senate approved more restrictive amendments in the process, striking the chronic pain diagnosis from the program and raising the THC cap to 1%, down from 5% threshold approved by the House.
“There was nothing said on the record,” Fazio said about the Senate’s amendments. “And that is so frustrating because they refuse to have an open conversation.”
With time running out in the legislative session, the House voted to approve the Senate amendments.
“The bill was watered down, unfortunately,” Fazio said. “Thankfully, we were able to carry it across the finish line.”
The fight to include PTSD
Veterans with PTSD have been lobbying for years to get their diagnosis eligible for the state’s medical marijuana program.
In the 2019 legislative session, an organization titled Texas Veterans for Marijuana attempted to make the expansion, but the effort was unsuccessful, partially due to misguided statistics cited in the Texas Senate, which was reported by the Texas Observer.
Edwards, an El Paso native who now lives in San Antonio, has been involved in those efforts.
She enlisted in the military when she was 17, serving for years before she received a medical retirement in June 2015. Edwards spent part of her time serving in mortuary affairs in Kandahar, Afghanistan, which contributed to her own PTSD.
“That kind of changed the trajectory of my life,” Edwards said.
Edwards struggled after coming home, dealing with physical and emotional issues.
She only truly experienced relief from her PTSD when she tried medical cannabis during a trip to California — relief that her medication alone could not deliver.
“The first time I tried cannabis . it brought me to tears, simply because there was a silence in my body that I hadn’t felt in a long time,” she said. “But I was also brought to tears because I knew that I couldn’t access this in Texas.”
Edwards, who has since become a nonresident scholar on drug policy for the Baker Institute for Public Policy, conducted a survey that showed she was not alone.
In a survey of 2,866 Texas residents who use medical cannabis, Edwards found that 52% of veteran respondents, 579 of those surveyed, had used cannabis to treat PTSD.
More than half, 61% of respondents, reported that they have been able to replace prescription opioids with medical cannabis. An overwhelming majority of those surveyed, 84% of respondents, said they have considered leaving the state of Texas due to its restrictive policies on marijuana.
The decision to include PTSD marks a change in how lawmakers are viewing the issue. In 2019, Edwards recalled one state legislator opposing the inclusion because “PTSD is an easy diagnosis to receive.”
“It was a big blow to a lot of people with PTSD,” Edwards said. “I don’t think what we went through was very easy.”
Though Edwards is pleased with the changes, she doesn’t think the program would benefit her given the low cap on THC.
“Unfortunately, it’s counter productive,” she said. “That THC cap is still extremely hindering to so many patients out there.”
Fazio said she and other advocates will continue to fight for more reform in future sessions, acknowledging that public polling shows support for expanded access to marijuana, and that upcoming elections may shake the makeup of the Texas government.
“Texas has an opportunity for new leadership,” Fazio said. “And because I care about liberty, because I care about sensible government and meaningful policy, I hope that we will see new leadership in the state of Texas.”
Texas Medical Marijuana
Eligible Texans have access to medical marijuana through the State’s compassionate use program (CUP) administered by the Texas Department of Public Safety (DPS). Texans with certain medical conditions may qualify. Learn more about its use and who can get a prescription.
On this page
Texas’s Compassionate Use Program (CUP) allows certain physicians to prescribe low tetrahydrocannabinols (THC) cannabis for medical purposes.
Low-THC comes from the plant Cannabis Sativa L. All parts of the plant and any resulting compounds, salts, resins, oils and derivatives that contain no more than 0.5 % by weight of THC are considered Low-THC. Medical use of these substances is limited to swallowing, not smoking, the prescribed dose of low-THC.
By law, CUP is limited to Texas patients with:
- Seizure disorders
- Multiple sclerosis
- Amyotrophic lateral sclerosis
- Terminal cancer
Medical marijuana prescriptions
Patients may get Low-THC cannabis prescribed if:
- The patient is a permanent resident of Texas
- The patient has one of the medical conditions listed above
- A CUP registered physician prescribes
- That qualified physician decides the benefit outweighs the risk
There is no age limit for prescriptions. Patients under 18 may need a legal guardian.
Getting a prescription:
- The physician will enter a prescription in the Compassionate Use Registry of Texas (CURT)
- After, the patient or legal guardian can go to any licensed dispensary to get the prescription
- The patient or legal guardian will need to provide ID and patient’s, last name, date of birth, and last five digits of their Social Security Number
CURT is an online system provided by DPS and used by Qualified physicians to input and manage low-THC prescriptions.
Dispensaries use the CURT system to search for the patient’s information before filling any related prescriptions.
A physician’s qualifications to prescribe low-THC is outlined in Section A169.002 of Senate Bill 339 (PDF).