HB46

HB46 expands Texas’s prescription low-THC cannabis program, adds qualifying conditions and calls for more licensed suppliers and local pickup/storage sites. It does not establish recreational marijuana sales or allow smoking cannabis. Signed June 20, 2025, it took effect September 1, 2025. Final law; official history.

Who can qualify: the law adds a condition causing chronic pain, traumatic brain injury, Crohn’s disease or other inflammatory bowel disease, and terminal illness or a condition for which a patient receives hospice or palliative care. Existing categories—including epilepsy, seizure disorders, multiple sclerosis, spasticity, ALS, autism, cancer, incurable neurodegenerative disease, PTSD and approved research-program treatment—remain. Patients must be permanent Texas residents, and a qualified, registered physician must determine that the potential benefit reasonably justifies the risk. Eligibility is not a promise that cannabis is appropriate for every patient. Final law, Sections 14–15; physician qualifications and registry requirements.

“Chronic pain” is specifically defined: pain not relieved by the listed acute, surgical, procedural or persistent non-chronic pain treatments, associated with an ongoing disease process causing continuous or intermittent severe pain for more than 90 days, and for which THC is a viable treatment. The final definition does not require a prior opioid prescription. General physician-specialty requirements still apply; HB46 did not enact the Senate’s separate pain-medicine certification requirement. Final law, Section 14; Occupations Code Section 169.002.

Dose, supply and methods of use: the law replaces the former 1%-by-weight definition with no more than 10 milligrams of THC per dosage unit. A package/container or pulmonary-inhalation device may contain no more than one gram of THC in total. These are different limits—not a one-gram dose or a one-package limit per patient. A prescription provides a 90-day supply based on the prescribed dosage, may authorize up to four 90-day refills, and may include more than one package in a 90-day period. These statutory ceilings are not dosing advice. Final law, Sections 10 and 14–15.

The law expressly includes absorption and insertion as medical-use routes and permits a physician to prescribe inhaled aerosol or vapor when medically necessary, specifying THC per dose. Burning and inhaling smoke remains excluded. The Health and Human Services Commission must establish rules for inhalation devices and a reasonable approval timeline; the statute alone does not prove that a particular device is approved or available. Products may contain only cannabinoids meeting the law’s definition of plant-derived “phytocannabinoids,” which includes the specified extraction and non-catalytic decarboxylation processes. Final law, Sections 11, 14 and 16–17.

More suppliers and storage sites: DPS must issue 15 dispensing-organization licenses if enough qualified applicants apply, using competitive evaluation and ensuring access in each public-health region. This is 15 total licenses, not 15 additional licenses; DPS described it as 12 new licenses alongside the three then active. The law required at least nine new licenses by December 1, 2025 from applications submitted before July 1, 2025, then at least three more by April 1, 2026, subject to applicant eligibility. Those are statutory deadlines, not a claim that every license or facility was operational by those dates. Final law, Sections 7 and 18; DPS explanation.

Licensed organizations may use approved satellite sites for secure storage and distribution without obtaining another dispensing-organization license. DPS must act on satellite applications within 180 days. An organization cannot operate a second satellite in one public-health region until it operates one in every region; pickup sites approved before September 1, 2025 are treated as approved satellites and may continue pickups and store products. Organizations must start dispensing within 24 months of receiving a license and continue dispensing, with revocation rules for nonuse. Local governments may not prohibit storage authorized by the program, adding storage to the existing protection for other authorized activities. Final law, Sections 3, 5–8 and 13.

The law adds owners and members to registration and related licensing provisions. Its criminal-background-check section exempts people without direct control of daily operations; that should not be read as deleting every other registration requirement. Applicants that have never held a dispensing license lose the statutory hearing entitlement when an initial application is denied. Other licensing and safety requirements remain. Final law, Sections 1, 4–5, 7, 9 and 12; Health and Safety Code Chapter 487.

Patient-identifying registry information, including the fact of enrollment, is made confidential and exempt from public-information disclosure, with specified program access and patient-requested release. The existing statute also retains a law-enforcement provision for verifying prescriptions and whether they were filled; this is not a promise that all official verification access disappears. Physicians can submit evidence asking the health department to report potential benefits for another condition to the Legislature. HB46 does not give the department the broader power to add ordinary qualifying conditions that earlier House language proposed; approved research programs remain a separate route. Final law, Sections 2 and 15; registry and research provisions.