Texas May Expand Medical Marijuana Program in 2019

Texas’ 2019 legislative session kicks off next month, and the state’s cannabis industry is anxiously awaiting legislation that would make key changes to the state’s strictly regulated medical marijuana program.

Lawmakers will likely address four distinct areas of the program, according to Morris Denton, CEO of Compassionate Cultivation, one of the state’s three licensed vertically integrated cannabis companies. Denton expects a “cleanup” bill to make it easier for doctors to recommend cannabis to patients, additional qualifying conditions, a provision to allow for research into cannabis and legislation that will address how Texas will regulate hemp and CBD under the newly passed Farm Bill.

“I think the 2019 legislative session is going to have a huge impact on the cannabis industry in Texas,” Denton told Cannabis Business Times. “Our legislature only meets every other year, so the last session was in 2017, and a lot of things have changed in the year and a half or so since our legislature dismissed. … The pace of change [and] the adoption [and] momentum of the cannabis industry just seems to accelerate. So, the likelihood of there being some significant adjustments to the program, I think, is pretty large.”

The Texas Compassionate Use Act was enacted in 2015 to allow patients with intractable epilepsy to access low-THC, high-CBD medical marijuana. The state’s Department of Public Safety set to work creating a registry of doctors who could prescribe medical marijuana, and it licensed three dispensing organizations—Compassionate Cultivation, Surterra Texas and Knox Medical—that can grow, process and dispense cannabis to patients.

Compassionate Cultivation's grow facility. Photo courtesy of Compassionate Cultivation.

While Denton doesn’t expect a full  medical marijuana market with THC products to come out of the 2019 legislative session, he does foresee some progress in increasing patient access to the program.

“I think that they’ll open it up to other conditions to get access to this medicine,” he said. “I think they’ll reduce some of the complexity and challenges of the existing legislation—the existing statutes that have perhaps been a little bit restrictive—and then I think that there’s work that needs to be done to figure out how they’re going to regulate the outcome of the Farm Bill and its impact on a state like Texas.”

Denton said the state seems interested in allowing patients with conditions that are positively impacted by the low-THC, high-CBD form factor access to medical marijuana, which means that conditions with a similar neurological pathology to epilepsy—such as multiple sclerosis, autism, Parkinson’s, spasticity, PTSD and cancer—could be added to the state’s list of qualifying conditions.

Denton also foresees changes to how doctors can prescribe cannabis to patients. Under the current law, a doctor who wants to prescribe medical marijuana must first meet certain qualifications, including working for a practice that has a certain percentage of epilepsy patients.

“In other words, they have to be specialized,” Denton said.

A doctor who meets these qualifications can then become registered to prescribe medical cannabis, and Texas is the only state that requires doctors to prescribe rather than recommend cannabis to their patients. And before a doctor can write the prescription, he or she must have a second doctor attest to the treatment plan and verify that prescription, Denton adds.

“I think that will be addressed to where you don’t have to have two doctors involved—it’s just a single doctor,” he said. “And furthermore, I think they’ll leave it to the doctor’s discretion as to when the patient can get access to this medicine. Right now, the patient has to have tried and failed at least two other readily available forms of anti-seizure medication, which in effect makes this almost a path of last resort instead of a first option, or an option that is at the doctor’s discretion to make that decision.”

In addition to changes to qualifying conditions and doctor participation, Denton said lawmakers are likely to create a legal framework for licensees to work with universities, hospital systems or doctor groups in a scientifically-focused research program, which would facilitate clinical trials to test and better understand the efficacy of cannabis and its various forms and formulations on a variety of medical conditions.

The state will also have to figure out how to regulate hemp and CBD now that Congress has approved the 2018 Farm Bill, which federally legalized industrial hemp.

“Texas right now is not really taking an active position toward what I call the consumer CBD space, and as a result, we’ve got a flood of consumer CBD products that are frankly bootlegged CBD products that are of unknown quality, unknown consistency and unknown ingredients,” Denton said.

Compassionate Cultivation is very involved in cannabis policy reform in the state legislature, he added, to ensure that these issues get resolved.

“When you look at the cannabis industry in Texas, there are only three players that are part of the legal industry. It’s us and the two other licensees,” Denton said. “And as a result, we are very involved with the Texas Legislature in providing feedback around what works and what needs to be improved. We’re very involved and collaborative with our regulator, the Department of Public Safety. We feel that it’s our responsibility to help grow this industry in Texas in a manner that protects the interest of the patients, first and foremost, because they need access to safe, legal, quality, consistent medicine that helps save their lives.”

Currently, under the state’s restrictive law, fewer than 600 of the estimated 150,000 epilepsy patients are benefiting from the program, and Denton said Compassionate Cultivation is operating at about 25 percent of total capacity. The company remains focused on representing the best interests of patients and incorporating feedback from patients and doctors to become more efficient.

Looking ahead to 2019, nearly half a dozen cannabis-related bills have already been filed for the Texas Legislature’s 86th legislative session, encompassing everything from an expansion of the medical program to decriminalization of the possession of small amounts of marijuana, according to a Houston Chronicle report.

Denton is optimistic that some of the bills will transform the regulatory landscape in Texas. “I think when 2019 rolls around and Texas goes through what it’s going to go through, a lot of people on the national level are going to have to pay attention to Texas because I think we’ll surprise some folks."