The Evolution of the Texas Compassionate Use Program

In 2015, the Texas Legislature enacted the Texas Compassionate Use Act, Senate Bill 339, establishing the Texas Compassionate Use Program (TCUP). Under TCUP, the Texas Department of Public Safety (“DPS”) would create a secure registry for licensed physicians to prescribe low tetrahydrocannabinol (THC) medical marijuana to patients suffering from intractable epilepsy. 

The registry, known as the Compassionate Use Registry of Texas (“CURT”), prevents more than one qualified physician from registering as the prescriber for a single patient, verifies patients of low-THC cannabis for dispensing organizations, and allows physicians to input safety and efficacy data derived from their patients who have been prescribed low-THC cannabis. 

Since its establishment, the Texas Compassionate Use Program (“TCUP”) has vastly expanded, with significant developments in 2019 and 2021.

The 2019 Expansion of the TCUP

In 2019, the Texas legislature broadened the TCUP via H.B. 3703 to expand the list of qualifying medical conditions and include incurable neurodegenerative diseases like Alzheimer’s Disease, Spinal Muscular Atrophy, Vascular Dementia, Huntington’s Disease, Parkinson’s Disease, Kearn Sayers Syndrome, and Galactosemia. For incurable neurodegenerative diseases not listed in the 2019 amendment, physicians were instructed to submit requests to the Texas Department of State Health Services (“DSHS”) to obtain approval for their low-THC prescription.

With H.B. 3703, the former requirement of consulting with a secondary physician prior to obtaining a prescription for low-THC cannabis was eradicated. This expansion allowed physicians to proceed directly from their patient treatment plan to prescription entry. 

The 2021 Expansion of the TCUP

In September of 2021, the 87th Session of the Texas Legislature further expanded the Texas Compassionate Use Program. 

The list of medical conditions eligible for low-THC cannabis prescription was once again expanded to include non-terminal cancer, post-traumatic stress disorder, and medical conditions designated by the Health and Human Services Commission for approved research programs. As a result, the legislature also established compassionate-use institutional review boards (“IRBs”) to review these proposed research programs and study the medical use of low-THC cannabis. 

Additionally, the maximum THC level of low-THC cannabis allowed to be prescribed under TCUP was increased to 1% by weight, though the draft bill originally included a 5% cap.

State of the TCUP Today

As the Texas Compassionate Use Program continues to expand, the number of registered physicians and patients utilizing low-THC cannabis has also grown. From January 2021 to January 2022, the number of physicians approved by the Regulatory Services Division to prescribe low-THC cannabis through TCUP increased by approximately 96%. The number of patients registered also increased, growing by over 330% between the beginning of 2021 and the beginning of 2022. 

In April 2022, DPS filed a notice of intent to review TCUP and consider it for readoption, amendment, or repeal with the Texas Register. Required by Government Code Sec. 2001.039, this provision is called the Agency Review of Existing Rules and requires that agencies reevaluate their rules at least every four years. As a part of this reevaluation process, the department may consider if the reasons for adopting or readopting these rules still exist, if the rules are obsolete, if the rules reflect current legal and policy considerations, and if the rules accurately reflect current procedures of the department. 

Along with other Texas-based members of the International Cannabis Bar Association, cannabis attorney Chelsie Spencer assisted in the drafting and submission of a letter with comments proposing potential rule and program changes for the Texas Compassionate Use Program to DPS. In her role as Vice President on the Board of Directors for Texas Cannabis Council (TCC), she also assisted in the drafting and submission of comments to DPS from TCC. As of July 2022, no updates or rules revisions for TCUP have been enacted, and the department is still engaged in reviewing and assessing the public comments received.

INCBA Comments

TCC Comments

Given the growing use of THC products in the medical industry, it’s important to stay informed on developments in the cannabis community. As an experienced attorney, Chelsie Spencer offers years of experience and unique insight into understanding marijuana, hemp, and CBD law. She and the rest of the team at Ritter Spencer are prepared to help your hemp or cannabis business navigate changes in the cannabis industry. Contact Ritter Spencer or give us a call at 214.295.5070 for more information.

Ritter Spencer, PLLCThe Evolution of the Texas Compassionate Use Program

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