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Potential patients can follow this five-step process to obtain medical cannabis in Texas BY TRAVIS E. POLING
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here’s a good chance a little bit of cannabis daily can ease many common ailments from epilepsy and muscle spasms to PTSD and the side effects of cancer. Low doses of medical cannabis are legally approved in Texas, but don’t expect to swing by your neighborhood pharmacy to fill the prescription along with a vial of insulin and blood pressure pills. The state’s Compassionate Use Program for medical marijuana, put in place by the Texas Legislature in 2015 and expanded in 2019 and 2021, is among the most restrictive in the nation. There are a lot of caveats, and it’s overseen by the state agency best known for issuing driver’s licenses and speeding tickets. According to the Regulatory Services Division of the Texas Department of Public Safety, which oversees medical cannabis for the state, there were 22,221 patients registered for the program in March, up from fewer than 5,000 a year prior. Those numbers are expected to grow, but without a retail-like dispensary system found in other states, it takes some work to go from diagnosis to receiving the medication. Here’s a five-step guide to navigating the Texas system.
1. Diagnosis A physician can recommend cannabis to treat a patient’s symptoms, but it takes a doctor approved by and registered with DPS to prescribe tinctures, gummies and lozenges containing state-approved amounts of THC, the psychoactive compound in cannabis. Potential patients can check the DPS Compassionate Use Program website at dps.texas.gov/section/compassionate-use-program for a list of qualifying conditions, contact a licensed cannabis clinic directly or start the process through one of the state’s few producers. Texas Original Compassionate Cultivation, based in Manchaca on the outskirts of Austin, also has a list of approved uses on its website and an
online form people can use to obtain an appointment with a clinic. Staff at a partner clinic will review the patient’s medical records and see if there’s anything that would qualify them for a prescription. For example, a person with diabetes might be eligible because of foot pain from neuropathy or qualify for treatment of spasticity because of a previous prescription for muscle relaxants. “You don’t have to be eligible right off the bat,” said Rodrigo Cravey, head of patient experience at Texas Original. By the time the updated Compassionate Use Program expanded last fall to include PTSD, or post-traumatic stress disorder, many Texas veterans had already been diagnosed, and Cravey said there was a figurative “line at the gates.” That addition to the law has been a primary cause of the spike in medical cannabis demand over recent months, he said. People with schizophrenia, which could worsen with cannabis, aren’t eligible. Also, women who are pregnant or breastfeeding babies can’t get a prescription because it’s unknown what effect the cannabis could have on the unborn, and THC concentrates by about 40 times in breast milk.
2. Registration A physician with a specialty in cannabis sees the patient to figure out the best route to take for their ailment, then enters the patient’s name with a state registry. While the state collects the data, it’s still covered by federal privacy laws and only authorized physicians and registered dispensary staff can access those details on their patients and clients. Both staff and physicians have gone through DPS background checks.
3. Prescription Dr. Matthew Brimberry, who opened Texas Cannabis Clinic in 2019 and now has more than 2,000 patients, said it’s important to have a relationship with a physician with abundant experience
Courtesy Photo / Texas Original Compassionate Cultivation
with the uses of medical cannabis. Ensuring the right form and dosage of the medicine isn’t a one-size-fits-all endeavor. For example, a child with epilepsy or a geriatric patient with anxiety from dementia might have vastly different needs than a young military veteran with PTSD who already has experience using cannabis. Experienced physicians should take those factors into account, so a patient gets the maximum medical benefit from ingesting the THC without reaching the level of inebriation, or high, sought by recreational users. Recreational cannabis found in states where it’s legal has much higher THC levels by volume than the Texas’ medical formulation, which is capped at 1%. Medical doses can range from 1.25 milligrams to 5 milligrams taken orally once or twice a day, Brimberry said. For most people, inebriation from THC starts at about 7 milligrams, but the compound connects to everyone’s receptors differently.
4. Pickup Once the patient is registered, seen by the doctor and the prescription sent to a registered dispensary, coordinators for the dispensary work with the patient on what form the THC will come in, such as a chewable gummy or a drinkable tincture. The dispensary will take payment in what equates to cash, such as a check, money order, direct withdrawal from a bank account
or a bank debit card, Cravey noted. Because cannabis is still illegal at the federal level, regulations prevent the use of credit cards. Federal prohibition also prevents delivery by mail, and Texas law requires dispensaries to be vertically integrated. That means the same facility grows the marijuana plants, harvests the flower buds, processes them, manufactures the delivery forms and stores them. To make products available to consumers, growers deliver to cities throughout the state at fixed drop-off points. Texas Original, for example, makes deliveries to a San Antonio pickup spot near the South Texas Medical Center every Tuesday from 11 a.m. to 2 p.m. As demand picks up across the state, the company is adding routes, and a new facility is in the works in Bastrop.
5. Follow-up While the state doesn’t require a specific follow-up period for a patient to see the doctor, clinics schedule appointments to check how the treatment is working. Brimberry said his clinic typically schedules a follow-up and subsequent appointments every six months. The doctor must renew the patient’s spot on the state registry every year for prescriptions to continue. For children, the elderly and first timers, also known as the “cannabis naïve,” the first follow-up is usually just two to three weeks after the substance is prescribed, Brimberry said.
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