Texas Officials Post Rules To Let Doctors Recommend New Medical Marijuana Qualifying Conditions And Allow Inhalation Devices

Texas officials have taken another step toward implementing a law to significantly
expand the state’s medical marijuana program—proposing rules to to let
physicians recommend new qualifying conditions for cannabis and to create
standards for allowable inhalation devices in line with legislation enacted
by lawmakers and the governor earlier this year.

About a month after the state Health and Human Services Commission (HHSC)
circulated the draft rules at a meeting, they have now been formally
published in the Texas Register—kicking off a 31-day public comment period
before they’re potentially finalized.

Last month, the Department of Public Safety (DPS) separately posted a set
of additional rules in the Register to increase the number of licensed
medical marijuana dispensaries in Texas under the recently enacted
legislation.

The latest rule HHSC put forward “prescribes the way a physician may
request additional medical conditions be added to the list of qualifying
conditions,” the text says.

Specifically, doctors would be able to submit recommended medical cannabis
qualifying conditions to the Department of State Health Services (DSHS),
which would then forward the recommendation to DPS. That department would
be tasked with submitting the request to lawmakers for consideration in the
next legislative session.

The proposal that’s up for public comment also “defines a pulmonary
inhalation medical device of an aerosol or vapor a physician may prescribe
to a qualified patient and establishes a timeline for reviewing and
approving such devices.”

The rules must be finalized by October 1, 2025.

A section on the potential benefits of the proposal states that “the public
may benefit from the use of pulmonary inhalation devices for low-THC
cannabis treatment through the Texas Compassionate Use Program.”

The state “also determined for the first five years the rules are in
effect, there are no anticipated economic costs to persons who are required
to comply with the proposed rules,” it says. “The rules are intended to
provide guidance for low-THC cannabis pulmonary inhalation devices for
treatment under the Texas Compassionate Use Program.”

In addition to increasing the number of dispensaries, revising physician
recommendation policies and setting standards for vaping devises, the law
signed by the governor also expands the state’s list of medical cannabis
qualifying conditions to include chronic pain, traumatic brain injury
(TBI), Crohn’s disease and other inflammatory bowel diseases, while also
allowing end-of-life patients in palliative or hospice care to use
marijuana.

That policy change was automatically adopted via the enacted statute when
the law took effect on September 1, so it did not require further
rulemaking.

DPS, for its part, will ultimately be issuing 12 new licenses for
dispensaries across the state. Currently there are only three. The
additional licensees will go through a competitive process, with officials
prioritizing Texas’s public health regions to optimize access.

The first round of licenses will be awarded to nine of 139 applicants who
submitted their forms during an earlier application window in 2023. DPS
will select those nine licensees on December 1. The 2023 applicants that
didn’t receive a license, as well as any new prospective licensees, will
have another shot at getting their license during a second round where
awardees will be announced on April 1, 2026.

The 2023 group can still revise their applications up until September 15.
New would-be dispensary owners have until that date to submit their
applications as well.

DPS has separately previewed future rulemaking to comply with the medical
marijuana expansion law.

That includes proposals to establish “security requirements for dispensing
organization satellite locations if approved by the department,” creating
rules to revoke licenses for dispensaries that fail to dispense cannabis
within two years of a license issuance and setting a timeline for
“reviewing and taking action on dispensing organization licenses.”


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Meanwhile, last week the Republican governor of Texas said people should
“stay tuned” on future action to regulate hemp products containing THC after
the legislature failed to address the issue this year.

Without going into details, Gov. Greg Abbott (R) signaled on Friday that
the issue isn’t going away—even after lawmakers were unable to pass
legislation to address intoxicating hemp products during two consecutive
special sessions he convened this summer.

The governor hasn’t been a proponent of an outright ban that some
Republican lawmakers have pushed, and has instead called for a regulatory
model focused on age limits and public health. Abbott went so far as to
veto a ban bill during the regular session, and so it remains to be seen
what type of forthcoming action he’s expecting to see.

The primary reason for the special sessions was to pass an electoral
redistricting bill that would likely benefit conservative candidates. But
both times, measures were also filed to prohibit hemp with any quantifiable
amount of THC, which industry stakeholders have said would effectively
eradicate the market.

Last month—shortly after the governor signed a proclamation to convene a
second special legislative session—the Senate passed the hemp ban measure
again, sending it back to the House. The prior version didn’t advance in
the chamber, due in large part to the fact that many Democrats left the
state to prevent a quorum that would be necessary to pass a redistricting
measure.

Abbott vetoed an earlier version of the controversial proposal that passed
during this year’s regular session, and he more recently outlined what he’d
like to see in a revised version of the bill.

Some, including Lt. Gov. Dan Patrick (R) and Senate bill sponsor Perry,
have insisted that an outright ban is a public safety imperative to rid the
state of intoxicating products that have proliferated since the crop was
federally legalized in 2018. Others say the legislature should instead
enact regulations for the market to prevent youth access while still
allowing adults 21 and older to access the products and preserving the
massive industry.

During the first special session, Rep. Nicole Collier (D) introduced a
one-page bill, HB 42, designed to protect consumers in the state from
criminal charges if what they believed was a legal hemp product turned out
to contain excessive amounts of THC, making it illegal marijuana. It would
prevent the criminalization of someone found in possession of a product
that’s labeled as hemp but is determined to contain “a controlled substance
or marihuana.”

In order for the person to obtain the legal protection, the product would
need to have been purchased “from a retailer the person reasonably believed
was authorized to sell a consumable hemp product.”

Another bill—HB 195, introduced by Rep. Jessica González (D)—would legalize
marijuana for people 21 and older, allowing possession of up to 2.5 ounces
of cannabis, with no more than 15 grams of that amount being in
concentrated form.

Yet another proposal would order state officials to conduct a study on
testing for THC intoxication.

*Image element courtesy of AnonMoos.*

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Marijuana Qualifying Conditions And Allow Inhalation Devices appeared first
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