Texas Expands Access to Cannabis for Medical Use

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Rachael Luken Carp

October 2, 2025

On September 1, 2025, several amendments to the Texas Compassionate Use Act and the Texas Occupations Code went into effect, expanding access to low-THC cannabis[1],[2] for medical purposes.  The new amendments increase access to medical cannabis in Texas in the following ways:

 

  1. Larger list of qualifying conditions: The list of medical conditions for which a physician can prescribe cannabis has been augmented to include conditions that cause chronic pain,[3] traumatic brain injuries, Crohn’s disease or other inflammatory bowel diseases, terminal illnesses or conditions for which a patient is receiving hospice or palliative care, and medical conditions approved for a research program under relevant state law and for which a patient is receiving treatment. For a full list of medical conditions for which cannabis can be prescribed, see Occ. Code §169.003.  Physicians also may request that the Department of State Health Services provide information to the legislature concerning specific medical conditions not currently listed that medical cannabis may be effective in treating.  See Texas Occ. Code. §169.003(d).
  2. Ingestion methods expanded to include inhalation: Prior to the amendments, Texas did not permit doctors to prescribe medical cannabis in an inhaled form. Now, physicians may prescribe pulmonary inhalation of an aerosol or vapor as a means of administration.  See Occ. Code §169.006(a).
  3. More licenses will be authorized and satellite locations will be permitted: The Department of Public Safety will issue 15 licenses to dispensing organizations following a competitive application process and will do so in a manner intended to expand access to low-THC cannabis in each of the state’s public health regions. Moreover, following approval by the Department, licensees now may operate one or more satellite locations in addition to their primary location without having to apply for a new license.  The satellite locations may be used only to store the licensee’s cannabis products for distribution unless previously approved by the Department as a patient pick-up location.  See Health & Safety Code §487.103(b)(3); §487.1035; §487.104.
  1. Dispensing limit: Packages containing medical cannabis and medical devices for pulmonary inhalation may not contain more than one gram of THC. See Health & Safety Code §487.107(c).
  1. Patient identification and information are confidential: The amendments confirm that patient information contained in the Compassionate Use Registry, including the mere fact that a person is listed as a patient in the registry, is confidential and not subject to disclosure except as explicitly provided. See Health & Safety Code §487.054(c).

State laws concerning the use and regulation of cannabis for medical and recreational purposes are evolving constantly.  Texas is one of 40 states, plus the District of Columbia, with an expansive medical cannabis program.  Twenty-four states, not including Texas, plus the District of Columbia, permit some form of recreational cannabis use.  This patchwork is further complicated by the fact that all cannabis use remains illegal at the federal level.  For a comprehensive look at cannabis regulation across the country, the National Conference of State Legislatures (NACL) has several informative charts and graphics.  See NACL State Medical Cannabis Laws.

Employers with a multistate presence should stay abreast of the evolving cannabis landscape and update their policies and procedures accordingly.  Employees, even those with a state-approved medical cannabis prescription or recommendation, should review their employer’s policies and consult with human resources prior to using medical cannabis on the job, especially in safety-sensitive positions.

 

The author of this article, Rachael Luken Carp, is a member of the Bars of New Jersey, New York, and Pennsylvania.  This article is designed to provide one perspective regarding recent legal developments, and is not intended to serve as legal advice in New Jersey, New York, Pennsylvania, Texas, or any other jurisdiction, nor does it establish an attorney-client relationship with any reader of the article where one does not exist.  Always consult an attorney with specific legal issues.

 

 

[1] Cannabis, more commonly referred to as marijuana, refers to the dried leaves, flowers, stems, and seeds of the cannabis plant.  THC (tetrahydrocannabinol) is a chemical compound in cannabis that has intoxicating effects.  See National Institute of Health definition of cannabis.

[2] “Low-THC cannabis” means 10 milligrams or less of tetrahydrocannabinols per dosage unit. See Tex. Occ. Code §169.001(3).

[3] Chronic pain is a newly defined term in the Occupations Code meaning “pain that is not relieved with acute, post-surgical, post-procedure, or persistent non-chronic pain treatment and is associated with a chronic pathological process that causes continuous or intermittent severe pain for more than 90 days and for which tetrahydrocannabinol is a viable method of treatment.”  See Tex. Occ. Code §169.001(1).

 
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