On June 1, 2015, Texas Governor Greg Abbot signed the Texas Compassionate Use Act (codified at Tex. Health & Safety Code § 487) into law. The Texas Compassionate Use Act allows qualifying patients to receive recommendations for “low-THC cannabis,” often in the form of cannabidiol oil. Low THC cannabis is defined under the Compassionate Use Act as:

the plant Cannabis sativa L., and any part of that plant or any compound, manufacture, salt, derivative, mixture, preparation, resin, or oil of that plant that contains:

(A) not more than 0.5 percent by weight of tetrahydrocannabinols; and

(B) not less than 10 percent by weight of cannabidiol.

Tex. Occ. Code § 169. The Texas Department of Public Safety (“DPS) is the agency in charge of administering Texas’ Compassionate Use Act program.

Originally, the only qualifying condition for which a low-THC cannabis recommendation could be made in Texas was intractable epilepsy. However, the Texas Legislature expanded the list of qualifying conditions in 2019. Currently, epilepsy, seizure disorders, multiple sclerosis, spasticity, amyotrophic lateral sclerosis, autism, terminal cancer, or an incurable neurodegenerative disease are the only conditions that qualify to receive a recommendation from a doctor for medical marijuana. Patients must be permanent Texas residents.

Texas physicians may prescribe low-THC to a patient with a qualifying condition only if the physician determines that the risk of the medical use of low-THC cannabis by the patient is reasonable in light of the potential benefit for the patient. To prescribe low-THC cannabis in Texas, physicians must register with the Compassionate Use Registry of Texas (“CURT”). All currently registered physicians issuing recommendations for medical marijuana under the Texas Compassionate Use Act may be found by searching the Texas Department of Public Safety’s (“DPS) CURT system online.

Texas is a vertical integration State, which means that dispensing organizations in the State must handle the marijuana plant from soil to oil to sale: the dispensing organization is required to cultivate the marijuana plants, process the plants, and distribute the low-THC cannabis directly to the patient. A license is required for a dispensing organization in Texas. To qualify for a license as a dispensing organization, an applicant must demonstrate the technical and technological ability to cultivate and produce low-THC cannabis and to secure resources, personnel, and premises that allow for reasonable access by patients in the Compassionate Use registry, an ability to maintain accountability for the marijuana throughout the entire process (from raw material, to growth, to the finished product, to by-products, etc.), and a financial ability to maintain operations for at least two years from the date of the application.

Currently, only three organizations have received licenses from Texas DPS as dispensing organizations under the Compassionate Use Act: Cansortium Texas, Compassionate Cultivation, and Surterra Texas. Any licensed dispensing organization is responsible for ensuring that a patient filling a prescription is listed in the Compassionate Use registry, that the prescription matches the registry’s notation of the total amount of low-THC cannabis to be prescribed, and that it has not been filled by another dispensary. Dispensing organizations are required, at all times, to maintain their eligibility requirements. If they fail to do so, DPS may suspend or revoke the license.

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Ritter Spencer, PLLCMedical Marijuana