Texas Compassionate Use Program (CUP)

What is the Texas Compassionate Use Program?

The Texas Compassionate Use Program was established pursuant to the Texas Compassionate Use Act enacted by the state's legislature in 2015. While not a full-fledged medical marijuana program as it exists in other states in the United States, the Compassionate Use Program is Texas' response to allowing patients with debilitating medical conditions to use cannabis to treat their conditions.

The Texas Compassionate Use Program is administered by the Texas Department of Public Safety (DPS). The DPS maintains a secure online registry of qualified physicians authorized to prescribe low tetrahydrocannabinol to patients with specific qualifying conditions. The registry is known as the Compassionate Use Registry of Texas or CURT.

The CURT prevents a patient from being registered for the CUP by more than one qualified physician. It is accessible to state and local law enforcement agencies and state-licensed dispensaries to verify patients of low-THC marijuana. It also allows a qualified physician to input safety and efficacy information derived from the treatment of patients for whom low-THC marijuana is prescribed. The Texas DPS is also responsible for licensing dispensaries authorized to dispense low-THC marijuana to patients registered in the CURT. Note that according to Chapter 169.001 of the Texas Occupation Code, low-THC marijuana refers to the Cannabis sativa L. plant, any part of the plant or preparation containing no more than 1% by weight of tetrahydrocannabinols. This means that a 1-gram gummy will contain no more than 10 milligrams of THC, while a 2-gram gummy will contain no more than 20 milligrams of THC.

The Texas CUP is strictly open to Texas residents only, with registration applications accepted all year round from eligible patients. The CUP makes no provision for medical marijuana cards or caregivers. No person other than the registered patient for whom a prescription was issued and the patient’s parent or legal guardian has protections from state criminal law prohibiting possession of low-THC cannabis. As long as you have a valid prescription in the CURT, you can visit a prescription pickup location with a valid government ID.

How Old to Join the Texas Compassionate Use Program?

Although the Texas Compassionate Use Act places no specific limitations on the age of participating patients in the Texas CUP, patients under 18 are typically required to have their parents or approved guardians present during their CURT registrations. They will also be required to have their parents or guardians purchase low-THC cannabis for them. Once they turn 18, registrations and purchases can be completed individually without their parents' or guardians' permission or presence.

Texas Compassionate Use Program Qualifying Conditions

Patients with the following approved debilitating conditions can access low-THC cannabis legally under the Texas CUP:

• Spasticity
• Cancer
• Autism
• A seizure disorder
• Epilepsy
• Post-Traumatic Stress Disorder
• Amyotrophic Lateral Sclerosis
• Multiple sclerosis
• An incurable neurodegenerative disease

In 2015, the Texas Compassionate-Use Act only allowed patients with intractable epilepsy to access low-THC marijuana. However, with the expansion of the state’s Compassionate Use Program in 2019 and 2021, many more conditions are now allowed to be treated with low-THC cannabis.

What Practitioners are Eligible to Recommend the Use of Medical Cannabis?

The Texas Compassionate Use Program does not list the categories of healthcare practitioners that may recommend low-THC cannabis use. Per Section 169.002 of the Texas Occupations Code, only a physician qualified in the field related to a patient's specific medical condition may recommend low-THC cannabis to the patient.

Must a Practitioner Obtain a License Before Issuing a Medical Card Recommendation?

Yes. A physician recommending low-THC cannabis under the Texas Compassionate Use Program must:

• Be licensed under Section 169.002 of the Texas Occupation Code;
• Be certified in a medical specialty related to the treatment of the patient's specific medical condition by a specialty board approved by the American Board of Medical Specialties or the Bureau of Osteopathic Specialists; and
• Dedicates an appreciable portion of clinical practice to the evaluation and treatment of the patient's specific medical condition

Do Physicians Need to Manage Patients Before Recommending Them for the Texas Compassionate Use Program?

There are no specific stipulations under Chapter 169 of the Texas Code requiring physicians to manage patients before they can recommend low-THC cannabis to them.

Do Physicians Have to Join the Texas Compassionate Use Program to Recommend Medical Marijuana to Patients?

Yes, physicians are required to enroll in the Texas Compassionate Use Program in order to be eligible to recommend low-THC cannabis to patients.

Can a Texas Compassionate Use Program Practitioner Use Telemedicine for Patient Assessment?

Yes, many of the healthcare practitioners registered with the Texas CUP are available for telemedicine appointments.

How to Find Texas Compassionate Use Program Doctors

You can talk to your primary healthcare provider to see whether they meet the conditions listed above. Note that physicians who intend to prescribe low-THC cannabis to qualifying patients in Texas must register in CURT. If your primary healthcare provider is not authorized to certify you to use low-THC cannabis, you may use the Search Physician feature on the CURT app on the DPS website to find a CUP-participating physician in your area. Note that the results displayed from the search are only for physicians who have allowed their information to be published.

How to Apply for the Texas Compassionate Use Program

To join the compassionate use program, you must be a permanent resident of a Texas jurisdiction and have a qualifying condition. You must fulfill these eligibility conditions as there are no provisions for non-Texas residents and all medical conditions. Next, you must visit a physician registered in the Compassionate Use Registry to enroll you in the registry. You may be required to complete a patient intake form, and the physician will ask for a copy of your medical records and discuss your condition.

Once the physician verifies that you have a qualifying condition, you will receive a low-THC prescription issued on your profile in the CURT. Upon issuing your prescription, you have successfully joined the Compassionate Use Registry and enrolled in the Texas Compassionate Use Program. You may proceed to purchase low-THC cannabis from licensed dispensary organizations.

For more information on joining the Compassionate Use Registry, contact the Texas Department of Safety at:

5805 North Lamar Blvd Austin, TX 78752-4431

OR (mailing address):

P.O. Box 4087 Austin, TX 78773-0001