In 2025, the Texas Legislature expanded the very limited Texas Compassionate Use Program (TCUP) into a more comprehensive medical cannabis program. After the bill took a tumultuous path though the House and Senate, the final fate of expanding the program was settled in a conference committee. Gov. Greg Abbott (R) signed the bill — HB 46 — into law on June 21, 2025.
The final version of HB 46 includes many improvements to the very limited TCUP program. The new law takes effect on September 1, 2025. The changes made by HB 46 include:
Adding the following qualifying conditions: chronic pain (continuous or intermittent severe pain for more than 90 days), Crohn’s disease, traumatic brain injury, terminal illnesses, and being in hospice care.
Adding methods of delivery including lotions, patches, suppositories, and non-smoked pulmonary inhalation. Inhalation devices — nebulizers, inhalers, and vaporizers — will have to be approved by the Department of State Health Services and directed by the patient’s doctor. (Unfortunately, raw, flower cannabis is still prohibited.)
Replacing the current limit of 1% THC by weight with an up to 10 milligrams per dose and a package not to exceed 1 gram of THC.
Making recommendations good for one year with four 90-day refills, which can be partially filled within each 90-day period.
Directing the Department of Public Safety to issue 12 more licenses for dispensing organizations, for a total of 15 total. Dispensing organizations must become operational within 24 months after the license is issued. Those providers will be able to open satellite brick-and-mortar dispensaries.
Requiring monitoring of dispensed cannabis by the Texas Board of Pharmacy via the Prescription Monitoring Program.
Providing that any person owning 10% or more in a dispensing organization will need to submit fingerprints for background checks.
Providing information within the registry regarding patient identification, including the fact that a person that is listed as a patient in the registry is confidential and may only be accessed by the department, registered physicians, and dispensing organizations. On request by a patient, the department may release patient information contained in the registry to the patient or a person designated by the patient.
