Texas House Bill 46 Considers Expansion of Medical Cannabis Access

As legislation to prohibit hemp-derived THC products in Texas is coming closer to law (1), another bill would expand medical cannabis access in the state. House Bill 46 (HB 46) relates to the medical cannabis program in Texas and the expansion of locations and qualifying conditions (2). As noted by the nonprofit Texas Cannabis Policy Center, HB 46 had been approved with significant amendments on May 23 by the Senate State Affairs Committee and is now awaiting a Senate vote (3).

Further changes to the final version of the bill were added a few days later. On May 25, the Office of the Lieutenant Governor Dan Patrick posted an update on X, explaining that after discussion with one of the bill’s authors, Representative Tom Oliverson, MD, chronic pain had been added as a qualifying condition to the Texas Compassionate Use Program (TCUP) (4). Additional updated were also stated in the post. “We are expanding licenses from 3 (current law) to 12 and adding satellite locations in each public health region of the state for the first time ever,” the post reads. “We’ve also added terminal illness and hospice care to the list of qualifying medical conditions for the TCUP program. Additionally, we’ve increased and standardized the dosage, while giving physicians autonomy to prescribe the right dose for each patient’s needs, along with metered dose inhalation delivery systems.”

Representative Oliverson posted a similar statement on X, noting requirements for Department of Public Safety (DPS) to ensure geographical representation and an expedited 90 day approval process for the satellite locations (5).

The DPS administers the Compassionate Use Program, manages the licensing of dispensaries for patients, and keeps a registry of physicians who are qualified to prescribe low-THC cannabis to patients (6). According to the most recent data on registered patients, 112,495 patients were listed by their physicians in the Compassionate Use Registry in April 2025.

The executive summary of the 2024 Compassionate Use Program Analysis, posted by the DPS, had explained how the program had not yet met the requirement to provide reasonable statewide access to low-THC products for registered patients, as outlined by legislation in 2015 that had initially created the program.

“In general, Texas’ huge geographic spread creates unique problems for both patients and dispensing organizations trying to provide statewide access,” the summary stated. “The legislature’s expansion of qualifying conditions and increasing patient enrollment have not been matched by comparable increases in enrolled prescribing physicians or dispensary locations.” The report recommended recruiting additional qualified physicians, additional physical locations outside of Central Texas, and increasing dispensary locations.

References

1. McEvoy, E. Texas House Passes Senate Bill 3, a Prohibition on Hemp-Derived THC https://www.cannabissciencetech.com/view/texas-house-passes-senate-bill-3-a-prohibition-on-hemp-derived-thc (accessed May 27, 2025).
2. Texas Legislature Online. House Bill 46. https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB46 (accessed May 27, 2025).
3. Texas Cannabis Policy Center. House Bill 46: Improves and Expands the Texas Compassionate https://texascannabispolicy.org/texas-hb-46-overview#f066c145-48f5-4972-bbea-c14181d13d48 (accessed May 27, 2025).
4. Office of the Lieutenant Governor Dan Patrick (@LtGovTX). “Rep. @TomOliverson and I have come to an agreement to add chronic pain as a qualifying medical condition to TCUP (compassionate use program) for those who suffer…” Twitter May 25, 2025, 5:25PM. https://x.com/LtGovTX/status/1926796742466417101
5. Tom Oliverson, M.D. (@TomOliverson). “Today LtGov @DanPatrick and I had a chance to sit down and work together on a new final version of #TCUP HB46 which is a truly amazing expansion of our program!” Twitter May 25, 2025, 5:23PM. https://x.com/TomOliverson/status/1926796299413676103
6. Texas Department of Public Safety. Compassionate Use Program. https://www.dps.texas.gov/section/compassionate-use-program (accessed May 27, 2025).