Texas House lawmakers approved a bill May 13 that would expand prescription access to medical cannabis through the state’sCompassionate Use Program. Under the program, Texans can use low-THC cannabis to treat conditions such as epilepsy, cancer and post-traumatic stress disorder.

The overview

House Bill 46 would nearly double the number of conditions eligible for the Compassionate Use Program, adding conditions such as Crohn’s disease, traumatic brain injuries and chronic pain to the list. The Texas Department of State Health Services would also have the authority to add other conditions.

Military veterans would have broader access to the program under HB 46. Licensed physicians would have the option to prescribe low-THC products to veterans with any medical condition that they believe “would benefit from medical use,” according to the bill.

The bill would also allow up to 15 medical cannabis dispensaries to operate in Texas, up from three under current law. Licensed dispensaries would have the option to create satellite locations to store medication, which proponents have said would make it easier for patients to pick up their prescriptions.

“Texans still struggle to get access to the medicine that they are legally allowed to receive,” bill author Rep. Ken King, R-Canadian, said on the House floor May 12.

House members passed HB 46 with a 122-22 vote May 13 and sent it to the Texas Senate. A similar proposal, Senate Bill 1505, would allow six licensed dispensaries to operate in Texas and authorize satellite locations. SB 1505 was approved by a Senate committee in March, although it has not been sent to the full chamber.

State lawmakers have until late May to pass legislation, and the 140-day regular legislative session ends June 2.

Zooming in

On the House floor, Rep. Penny Morales Shaw, D-Houston, said HB 46 would help rural Texans access low-THC medications.

“Right now, too many of our fellow Texans are forced to either suffer or self-medicate because they don’t have sufficient access,” she said May 12. “This is an amazing alternative to addictive, harmful opioids, which we know is a huge problem. This bill empowers individuals and families to avoid those dangerous drugs.”

Texas’ three medical cannabis providers—Texas Original, goodblend and Fluent—are all based in Central Texas. Patients can pick up medications in other parts of the state; however, current law prohibits medical cannabis providers from storing their products in multiple locations.

This means providers and patients will often drive hours to transport and pick up medication, Texas Original CEO Nico Richardson said.

“While we lease the space and we have employees out there, we don’t actually keep medicine there. We keep it here in Austin, and we wait until a patient orders from us online or calls us, and then we’ll drive that medicine to Houston or Dallas or [the] Rio Grande Valley,” Richardson told Community Impact in an April 25 interview. “We’ll drop the medicine there in the morning, and if the patient doesn’t come and pick it up, … we then have to drive it back to Austin, call the patient, ask them when they can come back into that pickup location and then send it back out.”

Richardson said there are “incredible barriers” to access under the current program.

“It’s not set up to succeed right now, and it’s not set up to provide reasonable access to patients,” he said. “The law that we operate under says that we have to provide reasonable access to patients across Texas, and our regulations are not allowing us to do that.”

If HB 46 becomes law, Richardson said Texas Original’s pickup locations would operate like traditional pharmacies, allowing most patients to receive medication on the same day it’s ordered. He noted that this would also “dramatically reduce” the cost of medications, which are not covered by insurance.

Texas is among 47 U.S. states that allow cannabis use for medical purposes, according to the U.S. Centers for Disease Control and Prevention. Nine states, including Texas, limit medical cannabis use to CBD or low-THC products only. Thirty-eight other states, including Oklahoma, Louisiana and Florida, allow for broader medical use of cannabis products.

More details

Texas medical cannabis providers can currently sell topical medications, tinctures and edible products, like gummies or beverages. Under HB 46, doctors would also be able to prescribe aerosol and vaporized products, which can be inhaled.

Dr. Matthew Brimberry, an Austin physician who is licensed to prescribe medical cannabis, told Community Impact that allowing patients to inhale products would be “another tool in our toolbox … that is missing at this point.”

Brimberry said edible products are not effective for some patients, because they do not take effect immediately. Some people may also metabolize edible medications too quickly or too slowly for them to work properly, he said.

“On average, [an edible product] takes about 45 minutes to an hour to initiate, and then it lasts for about four to six hours,” Brimberry said in an April 25 interview. “If you have somebody with extreme nausea, it’s going to be very difficult for them to take something orally. If you have somebody with tremendous muscle spasms and they need to make it from their car to an event or to their house, they can’t wait 30 to 45 minutes for the medicine to start working.”

Also of note

As House lawmakers discussed HB 46 on May 12, King noted that his bill is separate from SB 3, which would tighten restrictions on THC products sold in Texas.

“The other bill will be coming to a House floor near you soon,” King said May 12.

The House State Affairs Committee, which King leads, approved a heavily-amended version of SB 3 on April 30. The original proposal, by Sen. Charles Perry, R-Lubbock, would ban all forms of consumable hemp and THC from being sold in Texas outside of the medical cannabis program.

“This is potent poison that’s being sold in smoke shops, and they package it for kids,” Lt. Gov. Dan Patrick told Community Impact during an April 2 interview. “There was a bag of gummies in the store that I went in—750 milligrams [of THC]. That’ll put you on your rear end … and cause potential life-altering health issues.”

King called the House committee’s version of SB 3 “a regulatory bill.” He said April 30 that the proposal would ban synthetic hemp products and hemp vapes, while allowing stores to continue offering edibles, tinctures and the “Delta-9 natural flower that’s grown and sold in Texas.”

Individual counties would have the option to hold an election to prohibit local hemp sales under the amended bill. Municipalities can currently elect to limit or bar alcohol sales, according to the Texas Alcoholic Beverage Commission.

Patrick has dismissed pushes to increase guardrails on the hemp industry in lieu of an outright ban.

“People say, ‘Why do you want to close down these THC shops?’ Because people who are buying it have no idea what’s in it,” he told Community Impact. “And some people said we should regulate it, but we can’t regulate and check on 8,000 shops. We just have to close them down.”

SB 3 is scheduled to be debated in the House on May 20.