Texas Compassionate Use Program

June 2015

100 years after the first legal clampdown on cannabis, Governor Greg Abbott signed Senate Bill 339, known as the Compassionate Use Act, allowing for medical cannabis as a prescription treatment for intractable epilepsy.

October 2017

Texas Original, the state's leading medical cannabis dispensary, planted their first cannabis seeds.

February 2018

Texas Original serves its first patient living with intractable epilepsy.

June 2019

The Texas Compassionate Use Program expands the eligible conditions to over 100 qualifying medical conditions. The passage of this bill also removed the need for the approval of a second physician, requiring only one physician to prescribe medical cannabis.

June 2021

HB1535 passes, expanding the CUP to include all cancer diagnoses and PTSD. The THC cap is raised from 0.5% to 1% for the final weight of products.

January 2025

Texas’ 89th Legislative Session

June 2025

Governor Abbott signed House Bill 46, expanding eligible conditions, product options and accessibility.

September 2025

House Bill 46 becomes law, expanding the Compassionate Use Program by adding chronic pain, Crohn’s disease, traumatic brain injury, inflammatory bowel disease and patients receiving hospice or palliative care to the list of qualifying conditions. It also removes the 1% THC by weight limit and replaces it with a cap of 10 mg THC per dose and 1,000 mg THC per package. The bill also adds pulmonary inhalation as a method of administration and authorizes satellite dispensing locations, improving access for patients across the state.

Compassionate Use Program Qualifying Conditions

Patients are eligible to receive a medical cannabis prescription for the following conditions:

Chronic Pain
Crohn's Disease
Inflammatory Bowel Disease (IBD)
Traumatic Brain Injury (TBI)
Terminal illnesses and patients under hospice care
Post-traumatic stress disorder (PTSD)
Cancer
Peripheral Neuropathy (Nerve Pain)
Spasticity (Muscle Spasms)

ALS
Autism
Cerebral Palsy
Multiple Sclerosis
Alzheimer’s Disease and other Dementias
Seizure disorders 
Parkinson’s/Huntington’s Diseases
Over 100 other incurable neurodegenerative diseases

Under the provisions of the Texas Compassionate Use Act, medical cannabis can be used in the medical treatment of approved conditions under the guidance of a registered physician. Texas does not issue medical marijuana cards; instead, prescriptions are submitted digitally to the Compassionate Use Registry of Texas. It is still a crime to possess cannabis (over 0.3% THC by weight) not prescribed by a registered doctor for an approved condition in the state of Texas. Additionally, smokeable products are not permitted in Texas under the current law.

Patient information in the Compassionate Use Registry is confidential and protected by law and may only be accessed by the department, registered physicians, and dispensing organizations. Additionally, a patient's participation in the Compassionate Use Program does not, in itself, disqualify an individual from obtaining or maintaining a License to Carry (LTC). The Department of Public Safety (DPS) has stated that they do not consider participation in the CUP as a reason to disqualify an individual from possessing firearms.

After the passage of the 2018 Farm Bill, over-the-counter hemp-derived products began to enter the market. Unlike medical cannabis, hemp-derived products are not required to meet consistent in-state batch testing or labeling standards. Synthesized hemp-derived Delta 8, 9 and 10 THC products may pose risks for consumers due to harmful solvents and chemicals being added without adequate testing or regulation. While some manufacturers conduct independent testing, lack of oversight means potency, purity and safety can vary. Additionally, these products are not required to be packaged in child-resistant containers, increasing the risk of accidental exposure.

Certification and Testing

Medical-grade cannabis products should be provided with a thorough Certificate of Analysis (CoA) that is available online or attached to the package.
A thorough CoA certifies that the product meets quality and safety standards by identifying potency (by weight), and the presence of toxins, including heavy metals, residual solvents, pesticides, and microbial.

Quality and Transparency

Medical-grade cannabis products should be made with a rigorous cultivation, manufacturing and certification process that ensures patients receive a high-quality product every time. In addition, medical-grade cannabis products should provide transparency into how they are made, including making product ingredients and testing results easily accessible to patients.

Optimized for Relief

Medical-grade cannabis products should be optimized to appropriately treat a variety of medical conditions and symptoms. Patient trials, testing, and research should inform the formulation of medical-grade cannabis products.

A medical cannabis dispensary should:

Provide a thorough Certificate of Analysis (CoA) that is available online or attached to the medicine package.
Make medical-grade cannabis products with a rigorous quality process and provide transparency into how they are made, including making product ingredients and testing results easily accessible to patients. 
Abide by state regulations and ensure all products are made in-house through a vertical integration model.
Utilize patient trials, testing, and research to inform the formulation of medical-grade cannabis products that are optimized to appropriately treat a variety of medical conditions and symptoms.

Texas Compassionate Use Program

June 2015

October 2017

February 2018

June 2019

June 2021

January 2025

June 2025

September 2025

Compassionate Use Program Qualifying Conditions

CBD, Cannabis and Marijuana: What is Legal in the State of Texas

Medical Cannabis Patient Protections and Privacy

What Makes a Cannabis Product “Medical Grade”?

Certification and Testing

Quality and Transparency

Optimized for Relief

What to Look for in a Medical Cannabis Dispensary

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