Texas Is Likely to Expand Medicinal Marijuana Laws, But Access Is Still an Issue

Last week, the Texas House of Representatives resoundingly passed House Bill 1805, which expands the state’s Compassionate Use Program for medicinal cannabis, meaning individuals who suffer from chronic pain are now eligible for prescriptions. Despite the bipartisan support (the bill passed the House 127-19), the Department of Public Safety rules that govern medicinal marijuana’s distribution mean that distributors face storage burdens that can prevent patients from getting their medication for weeks.

Fort Worth representative Stephanie Klick has been responsible for nearly all medicinal marijuana legislation in the state, and her bill began the compassionate use program in the state in 2015. Cannabis was allowed to be prescribed for a narrow set of neurological disorders and was gradually expanded over the years. In 2021, cancer and post-traumatic stress disorder were added to the list of conditions that can be prescribed medicinal marijuana, which often comes in the form of oil tinctures or gummies.

HB 1805 expands the program to include those suffering from chronic pain and will allow the Texas Department of State Health Services to add conditions to the eligible list rather than state law. The bill will also change the way the active ingredient in marijuana, tetrahydrocannabinol (THC), is measured in the medicine. It was previously measured by concentration, but the new law sets one dose at 10 mg, meaning patients can get the prescribed volume of THC more efficiently.

The new law could massively increase the number of people eligible to receive THC. A Centers for Disease Control study found that one in five people suffer from chronic pain, and around 30 percent of elderly and rural residents suffer from chronic pain. According to DPS, more than 50,000 patients and 700 physicians are registered in the Compassionate Use Program. At the beginning of 2021, less than 5,000 patients were registered in the program, and just 263 physicians were registered to prescribe medicinal cannabis. If the bill passes the State Senate, those numbers are likely to continue to grow exponentially. A UT Dallas study found that one in three people suffer from chronic pain, around 10 million in Texas alone.

But DPS rules make it difficult for the distributors of medicinal marijuana to reach the patients in time. Designed to protect the medications, they have some unintended consequences. The regulations say that license holders must serve the entire state but are only allowed to store the medicine in the manufacturing plant. Texas Original is the only Texas-based license holder in the state, and its Austin dispensary is the only place the company’s cannabis product is allowed to be stored. This means that employees are driving (the medicine can’t be mailed, either) all over the state on delivery routes and to temporary drop-off points each day, driving hundreds of miles to El Paso, Amarillo, the Rio Grande Valley, or Texarkana, making deliveries before returning for the night.

Suppose a patient cannot pick up their medication from a Texas Original delivery. In that case, it may be weeks before another delivery route can reach them, especially in rural areas. Most Texas Original patients are in the Texas Triangle between San Antonio, Dallas, and Houston, but service to other cities throughout the state are less frequent.

“Those delivery routes fill up quickly, and then you have to get pushed out to the next one, which can be three or four weeks out,” says Nico Richardson, interim CEO at Texas Original. “So you end up having long wait times, pushing patients out of our system and into the unregulated market. We’ve made it far too cumbersome from a distribution standpoint.”

Patients who miss their medication may turn to illegal marijuana or unregulated hemp, or Delta 8, but they are most likely to switch to opioids, which have risks. A National Institutes of Health study found a 64-75 percent reduction in opioid dosage when combined with medical cannabis. Other studies have shown significant decreases in opioid overdose deaths with increases in medicinal and recreational cannabis.

While patients can go to numerous pharmacies and pick up equally, if not more potent, and addictive opioids, medical cannabis has to be kept in one location per license. So all medicinal cannabis must make it to patients or back to Texas Original’s headquarters daily. Even if more licenses were given, businesses would concentrate where most patients live, leaving rural and outlying locations in a lurch when it comes to delivery. Texas Original dispenses about 6,000 orders each month, with deliveries consisting of about 10-15 patients per day. Given the size of the state, the resources needed to get medicine to patients are massive. It hampers business growth but has ramifications for patients as well.

The distribution rules are made by DPS and aren’t impacted by the legislation. Richardson says Texas Original and others are in touch with DPS and that changes to regulations like this usually occur after the legislative session.

Austin-based Texas Original is bullish on the future of the industry in the state, proving it by expanding its operation by a factor of ten. The organization is moving from its 7,500-square-foot headquarters in South Austin to a 75,000-square-foot facility in Bastrop, east of Austin. The new space will still dispense and manufacture medical cannabis but will also feature a 45,000-square-foot greenhouse to increase growing capabilities. If the rules remain as they are, the opening of the Bastrop facility will mean the South Austin location will have to close.

HB 1805 has yet to pass the Senate. Still, given the overwhelming support in the house and the history of Klick’s bills getting to the Governor’s desk, Richardson feels good about its prospects while acknowledging other changes would make distribution easier.

“I feel hopeful. There are a lot of good things in this bill,” Richardson says. “It’s widely supported by patients and Texans in general. It’s a strong piece of legislation that helps a lot of people.”


Will Maddox

Will is the senior editor for D CEO magazine and the editor of D CEO Healthcare. He’s written about healthcare…

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