OCCUPATIONS CODE CHAPTER 169. AUTHORITY TO PRESCRIBE LOW-THC CANNABIS TO CERTAIN PATIENTS FOR COMPASSIONATE USE

OCCUPATIONS CODE

TITLE 3. HEALTH PROFESSIONS

SUBTITLE B. PHYSICIANS

CHAPTER 169. AUTHORITY TO PRESCRIBE LOW-THC CANNABIS TO CERTAIN PATIENTS FOR COMPASSIONATE USE

Sec. 169.001. DEFINITIONS. In this chapter:

(1) "Chronic pain" means pain that is not relieved with acute, post-surgical, post-procedure, or persistent non-chronic pain treatment and is associated with a chronic pathological process that causes continuous or intermittent severe pain for more than 90 days and for which tetrahydrocannabinol is a viable method of treatment.

(1-a) "Department" means the Department of Public Safety.

(1-b) "Executive commissioner" means the executive commissioner of the Health and Human Services Commission.

(2) "Incurable neurodegenerative disease" means a disease designated as an incurable neurodegenerative disease by rule of the executive commissioner, adopted in consultation with the National Institutes of Health.

(3) "Low-THC cannabis" means the plant Cannabis sativa L., and any part of that plant or any compound, manufacture, salt, derivative, mixture, preparation, resin, or oil of that plant that contains not more than 10 milligrams of tetrahydrocannabinols in each dosage unit.

(4) "Medical use" means the ingestion, absorption, or insertion by a means of administration other than by smoking of a prescribed amount of low-THC cannabis by a person for whom low-THC cannabis is prescribed under this chapter.

(5) "Smoking" means burning or igniting a substance and inhaling the smoke. The term does not include inhaling a medication or other substance that is otherwise aerosolized or vaporized for administration by pulmonary inhalation.

Added by Acts 2015, 84th Leg., R.S., Ch. 301 (S.B. 339), Sec. 4, eff. June 1, 2015.

Amended by:

Acts 2019, 86th Leg., R.S., Ch. 1300 (H.B. 3703), Sec. 1, eff. June 14, 2019.

Acts 2019, 86th Leg., R.S., Ch. 1300 (H.B. 3703), Sec. 3, eff. June 14, 2019.

Acts 2021, 87th Leg., R.S., Ch. 660 (H.B. 1535), Sec. 2, eff. September 1, 2021.

Acts 2021, 87th Leg., R.S., Ch. 660 (H.B. 1535), Sec. 5, eff. September 1, 2021.

Acts 2025, 89th Leg., R.S., Ch. 710 (H.B. 46), Sec. 14, eff. September 1, 2025.

Sec. 169.0011. PRESCRIPTION FOR MEDICAL USE. A reference in this chapter, Chapter 487, Health and Safety Code, or other law to a prescription for medical use or a prescription for low-THC cannabis means an entry in the compassionate-use registry established under Section 487.054, Health and Safety Code.

Added by Acts 2019, 86th Leg., R.S., Ch. 1300 (H.B. 3703), Sec. 2, eff. June 14, 2019.

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.

(b) A physician is qualified to prescribe low-THC cannabis with respect to a patient's particular medical condition 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.

(c) A physician is qualified to prescribe low-THC cannabis for the treatment of a patient with a medical condition approved by rule of the executive commissioner of the Health and Human Services Commission for treatment in an approved research program conducted under Subchapter F, Chapter 487, Health and Safety Code, if the physician is:

(1) licensed under this subtitle; and

(2) certified by a compassionate-use institutional review board created under Section 487.253, Health and Safety Code, that oversees patient treatment undertaken as part of that approved research program.

Added by Acts 2015, 84th Leg., R.S., Ch. 301 (S.B. 339), Sec. 4, eff. June 1, 2015.

Amended by:

Acts 2019, 86th Leg., R.S., Ch. 1300 (H.B. 3703), Sec. 2, eff. June 14, 2019.

Acts 2021, 87th Leg., R.S., Ch. 660 (H.B. 1535), Sec. 3, eff. September 1, 2021.

Sec. 169.003. PRESCRIPTION OF LOW-THC CANNABIS. (a) A physician described by Section 169.002 may prescribe low-THC cannabis to a patient if:

(1) the patient is a permanent resident of the state;

(2) the physician complies with the registration requirements of Section 169.004; and

(3) the physician certifies to the department that:

(A) the patient is diagnosed with:

(i) epilepsy;

(ii) a seizure disorder;

(iii) multiple sclerosis;

(iv) spasticity;

(v) amyotrophic lateral sclerosis;

(vi) autism;

(vii) cancer;

(viii) an incurable neurodegenerative disease;

(ix) post-traumatic stress disorder;

(x) a condition that causes chronic pain;

(xi) traumatic brain injury;

(xii) Crohn's disease or other inflammatory bowel disease;

(xiii) a terminal illness or a condition for which a patient is receiving hospice or palliative care; or

(xiv) a medical condition that is approved for a research program under Subchapter F, Chapter 487, Health and Safety Code, and for which the patient is receiving treatment under that program; and

(B) the physician determines the risk of the medical use of low-THC cannabis by the patient is reasonable in light of the potential benefit for the patient.

(b) Each prescription issued by a physician to a patient for low-THC cannabis:

(1) may only provide for a 90-day supply of low-THC cannabis based on the dosage prescribed to the patient; and

(2) may provide up to four refills of a 90-day supply of low-THC cannabis.

(d) A physician may submit to the Department of State Health Services a request that the department report to the legislature that low-THC cannabis may be beneficial to treat a specific medical condition not listed in Subsection (a)(3)(A). The request must be accompanied by medical evidence such as peer-reviewed published research demonstrating that low-THC cannabis may be beneficial to treat that medical condition. The executive commissioner by rule shall prescribe the manner in which a physician may submit a request under this subsection.

Added by Acts 2015, 84th Leg., R.S., Ch. 301 (S.B. 339), Sec. 4, eff. June 1, 2015.

Amended by:

Acts 2019, 86th Leg., R.S., Ch. 1300 (H.B. 3703), Sec. 2, eff. June 14, 2019.

Acts 2021, 87th Leg., R.S., Ch. 660 (H.B. 1535), Sec. 4, eff. September 1, 2021.

Acts 2025, 89th Leg., R.S., Ch. 710 (H.B. 46), Sec. 15, eff. September 1, 2025.

Sec. 169.004. LOW-THC CANNABIS PRESCRIBER REGISTRATION. (a) Before a physician qualified to prescribe low-THC cannabis under Section 169.002 may prescribe or renew a prescription for low-THC cannabis for a patient under this chapter, the physician must register as the prescriber for that patient in the compassionate-use registry maintained by the department under Section 487.054, Health and Safety Code. The physician's registration must indicate:

(1) the physician's name;

(2) the patient's name and date of birth;

(3) the dosage prescribed to the patient;

(4) the means of administration ordered for the patient; and

(5) the total amount of low-THC cannabis required to fill the patient's prescription.

(b) The department may not publish the name of a physician registered under this section unless permission is expressly granted by the physician.

Added by Acts 2015, 84th Leg., R.S., Ch. 301 (S.B. 339), Sec. 4, eff. June 1, 2015.

Amended by:

Acts 2019, 86th Leg., R.S., Ch. 1300 (H.B. 3703), Sec. 2, eff. June 14, 2019.

Sec. 169.005. PATIENT TREATMENT PLAN. A physician described by Section 169.002 who prescribes low-THC cannabis for a patient's medical use under this chapter must maintain a patient treatment plan that indicates:

(1) the dosage, means of administration, and planned duration of treatment for the low-THC cannabis;

(2) a plan for monitoring the patient's symptoms; and

(3) a plan for monitoring indicators of tolerance or reaction to low-THC cannabis.

Added by Acts 2015, 84th Leg., R.S., Ch. 301 (S.B. 339), Sec. 4, eff. June 1, 2015.

Sec. 169.006. ADMINISTRATION OF LOW-THC CANNABIS BY PULMONARY INHALATION. (a) A physician may prescribe pulmonary inhalation of an aerosol or vapor as a means of administration of low-THC cannabis if the physician determines that based on the patient's condition there is a medical necessity for that means of administration.

(b) The prescription under Subsection (a) must specify the amount of tetrahydrocannabinols in each dosage unit to be administered by pulmonary inhalation that is medically necessary based on the patient's condition.

(1) related to medical devices for pulmonary inhalation of low-THC cannabis; and

(2) establishing a reasonable timeline for reviewing and granting approval for medical devices for pulmonary inhalation.

Added by Acts 2025, 89th Leg., R.S., Ch. 710 (H.B. 46), Sec. 16, eff. September 1, 2025.