In 2019 Governor Greg Abbott silently signed HB 3703 expanding the Texas Compassionate Use Program (TCUP) into law on June 14th shortly after 4 P.M. Legislators voted 133-10 in the House and a unanimous vote of 31-0 in the Senate.
Even in the new session, 87th legislature, everything still has not magically changed for the better or increased access.
Learn how to become a medical cannabis patient in Texas
So, what changed as far as conditions go back in 2019?
Legislators changeed the original condition. The TCUP condition of intractable epilepsy changed to just epilepsy. No longer do you need to try two medications per the TCUP law Texas had beforehand. Medical cannabis an option in the formulary for epilepsy patients just like any other medication for epilepsy treatment.
Conditions added include autism, terminal cancer, incurable neurodegenerative diseases, ALS, multiple sclerosis, and spasticity. The term incurable neurodegenerative disease is as follows:
SECTION 1.Section 169.001, Occupations Code, is amended by adding Subdivisions (1-a) and (6) and amending Subdivision (3) to read as follows: (1-a)”Incurable neurodegenerative disease” means a disease designated as an incurable neurodegenerative disease by rule of the executive commissioner of the Health and Human Services Commission, adopted in consultation with the National Institutes of Health.
HB 3703 enrolled version
SECTION 4. Not later than December 1, 2019, the executive commissioner of the Health and Human Services Commission, in consultation with the National Institutes of Health, shall adopt rules designating diseases as incurable neurodegenerative diseases for which patients may be prescribed low-THC cannabis for medical use under Chapter 169, Occupations Code, as amended by this Act.
Did the THC limit go up?
Unfortunately, the THC limit of 0.5% remains. This means that the total content of THC in the medicine cannot be more that 0.5% of the volume of the prescription. Think of it like the alcohol content one would see on the side of a beer or bottle of wine. As well, legislators removed the CBD floor language from the bill on amending the definition of cannabis. It originally said that it could not be less than 10% by weight of CBD, meaning that it could not be less than 10% CBD by volume.
Amongst activists and concerned consumers, some are asking what the overall benefit is of having 0.2% more than what the current hemp law allows, which is 0.3% THC. For a few that extra amount may help them. The legal benefit is the allowance of THC in a drug test performed by the state. There are instances where that could be typically used in factoring a decision for a legal case.
Texas Health and Safety Code §481.111(e)(1) provides exemptions from state laws prohibiting possession of marijuana for patients (and their legal guardians) for whom low-THC cannabis is prescribed under a valid prescription from a dispensing organization. This provides an entrance to having protection in civil cases involving children as well.
Bryan Hughes’ bill in the 87th legislative session could solidify this. The family cases concern agencies as a child may be getting their hands on an unknown tainted product. Or the parent is negligent to the child in their needs from alleged drug use. Obviously, if the criminal component is no longer a factor, criminality cannot be used as a factor in a civil/family court. That does not mean that a DFPS worker cannot remove a child for that issue, but it will be much more difficult to use in a case as long as there is a valid entry into the Compassionate Use Registry of Texas (CURT). The biggest factor in those cases is the county you live in and the judge voted into office to oversee the cases.
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With these new conditions, who can prescribe low-THC cannabis?
Sec. 169.002. PHYSICIAN QUALIFIED TO PRESCRIBE LOW-THC CANNABIS TO PATIENTS WITH CERTAIN MEDICAL CONDITIONS.
(a) Only a physician qualified with respect to a patient’s particular medical condition as provided by this section may prescribe low-THC cannabis in accordance with this chapter to treat the applicable medical condition.
HB 3703 enrolled version
(b) A physician is qualified to prescribe low-THC cannabis with respect to a patient’s particular medical condition [to a patient with intractable epilepsy] if the physician:
(1) is licensed under this subtitle;
(2) is board certified in a medical specialty relevant to the treatment of the patient’s particular medical condition by a specialty board approved by the American Board of Medical Specialties or the Bureau of Osteopathic Specialists; and
(3) dedicates a significant portion of clinical practice to the evaluation and treatment of the patient’s particular medical condition
All of this means that for the condition that a patient would qualify for under the TCUP law, the doctor prescribing low-THC cannabis must specialize in that area, and spend a good chunk of their time practicing that specialized area. This means your PCM cannot register with CURT to enter prescriptions. Perhaps one of the only conditions listed that will have two different providers available to prescribe will be the condition of Autism, which is treated both by neurologist and psychiatrists. As well, the language stating that two doctors need to sign off has been stricken from the law, and now patients will only need to see one qualifying doctor.
Was the finally language changed to say recommend instead of prescribe?
Unfortunately, the language still says prescribe. The major upside is that the definition of prescribing when relating to the TCUP law was changed to now mean “an entry into the compassionate use program.”