Update Applicable to:	Effective Date
All Covered Entities	September 1, 2025   DPS and DSHS rules: October 1, 2025

What happened?

On June 21, 2025, Texas passed HB 46, a new law that significantly expands the Compassionate Use Program (CUP), allowing broader access to medical cannabis for patients with chronic and serious health conditions.

Overview:

Highlights

• New Qualifying Conditions: Includes chronic pain, traumatic brain injury, Crohn’s disease, terminal illnesses, and hospice/palliative care. Veterans may qualify for any debilitating condition.

• Expanded Product Options: Permits lotions, patches, suppositories, inhalers, nebulizers, and vape pens. Smoking remains prohibited.

• THC Limits Redefined: Up to 10 mg THC per dose and 1 gram per package. Only natural Phyto cannabinoids are allowed.

• Dispensary Expansion: DPS must issue up to 15 licenses, with locations spread across Texas’ public health regions. Satellite locations are permitted with approval.

• Prescription Rules: Valid for 1 year with up to four 90-day refills. Physicians may request new conditions be added based on medical evidence.

Additional Information:

SECTION-BY-SECTION SUMMARY

SECTION 1–2: Registry and Confidentiality

• Expands registration for dispensaries.
• Patient data is confidential and accessible only to authorized parties.

SECTION 3–5: Licensing and Eligibility

• Organizations may operate satellite storage sites.
• Applicants must show technical, financial, and security readiness.

SECTION 6: Satellite Locations

• Satellite sites must be approved by DPS.
• One per public health region before expanding further.

SECTION 7–8: Licensing Rules

• DPS must issue 15 licenses if enough qualified applicants apply.
• Licensees must begin operations within 24 months.

SECTION 9–10: Personnel and THC Limits

• All staff must be registered and pass background checks.
• THC capped at 1 gram per package/device.

SECTION 11: Phyto cannabinoid Restriction

• Only natural cannabinoids are allowed; synthetic ones are banned.

SECTION 12–13: Registration and Local Authority

• All personnel must register.
• Local governments cannot ban CUP activities.

SECTION 14–15: Definitions and Prescription Rules

• Defines chronic pain and low-THC cannabis.
• Expands qualifying conditions.
• Prescriptions allow 90-day supply with up to 4 refills.

SECTION 16: Pulmonary Inhalation

• Physicians may prescribe inhaled cannabis if medically necessary.
• Rules for devices to be set by the Health Services Commissioner.

SECTION 17–18: Implementation Timeline

• DPS and Health Services must adopt rules by October 1, 2025.
• 9 licenses by Dec. 1, 2025; 3 more by April 1, 2026.

SECTION 19: Effective Date: HB 46 takes effect on September 1, 2025.

Source References

• Texas SB 46 – Relating to the medical use of low-THC cannabis under and the administration of the Texas Compassionate-Use Program; requiring registration
• Texas Governor Press Release
• Texas Cannabis Information – Press Release

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