Texas is taking meaningful steps to strengthen the Texas Compassionate Use Program following the passage of HB 46. New qualifying conditions like chronic pain, traumatic brain injury, Crohn’s disease, and hospice care are now in effect, and DSHS has adopted rules for approving inhalation devices and allowing physicians to recommend additional conditions for future legislative consideration.
The big new this week is the licensing of nine new businesses, expanding the number of operators from three to twelve, with three more expected by April. With criteria slanted toward large multi-state companies, Texas companies hardly stood a chance. Here are the newly licensed businesses:
- Verano Texas, LLC
- Lonestar Compassionate Care Group, LLC
- TexaRx
- Trulieve TX, Inc
- Lone Star Bioscience, Inc
- Story of Texas. LLC
- Texas Patient Access, LLC
- PharmaCann
- Dalitso, LLC
Note: These are conditional licenses subject to additional due diligence evaluations such as disciplinary actions, financial suitability, litigation history, and any other information as required by the Department following Phase I of the selection process.
Once officially approved, in addition to their primary location, these businesses will also be able to open satellite locations, improving patient access across the state.
While we appreciate progress, after 10 long years of advocacy, TCUP still has substantial room for improvement. Whole-plant cannabis remains unavailable and patient protections remain weak in areas like employment, parental rights, probation, and firearms. High fees and rigid criteria continue to limit opportunities for small businesses, making it difficult for Texas-based applicants to compete in the current licensing structure.
It’s clear that meaningful work remains if we want a Compassionate Use Program that is truly accessible, fair, and responsive to the needs of patients. We’ll be digging into these issues and discussing solutions at the Texas Cannabis Policy Conference, January 29–31 in Austin.
Registration is now open: https://texascannabisconference.org/registration
New Products, New Patients, New Providers
The good, the bad, and the ugly
The Good
The TCUP expansion under HB 46 continues to roll out in significant ways. Earlier this year, lawmakers added several long-overdue qualifying conditions, including chronic pain, traumatic brain injury, Crohn’s disease and other inflammatory bowel diseases, and any terminal illness requiring hospice or palliative care. They also authorized an expanded list of allowable products types: patches, lotions, suppositories, vaporizers, inhalers, and nebulizers.
On Friday, DSHS finalized rules establishing a formal approval process for inhalation devices, along with a process that allows physicians to recommend additional qualifying conditions for lawmakers to consider in future sessions. While the Legislature must still add conditions through statute, this new pathway ensures medical expertise is part of the policymaking record.
The major development this week is the licensing of nine new businesses to operate under TCUP. Since 2015, just three companies have been permitted to cultivate, manufacture, and dispense medical cannabis in Texas. By April 1, DPS is expected to issue three more licenses, bringing the total to fifteen. Each licensee may also open satellite dispensing locations, increasing access for patients statewide. Earlier this year, DPS also adopted rules clarifying future licensing windows, security standards for satellite sites, and circumstances under which a license may be suspended or revoked—laying groundwork for a more structured and transparent regulatory system.
The Bad
Even with this progress, the program still suffers from major shortcomings that directly affect patients. Foremost among these is the long-standing failure to authorize cannabis flower, which remains the most natural and widely used form of the plant. DPS has chosen not to approve it, despite clear therapeutic value, affordability advantages, and patient preference. Without access to whole-plant cannabis, Texans are denied a foundational medical option recognized in nearly every other medical cannabis state.
There are also persistent vulnerabilities in patient protections. HB 46 improved privacy by restricting access to the patient registry to DPS, registered physicians, and licensed dispensing organizations, but patients remain exposed in critical areas—including employment, parental rights, probation, and federal firearm laws. Participating in a state-legal medical program still carries real personal and legal risks, and Texas has yet to establish robust protections to shield patients from discrimination or punitive consequences.
The Ugly
Perhaps the most troubling aspect of today’s announcement is what it reveals about the structure of TCUP’s licensing system. The fees and criteria remain so extraordinarily high that Texas-owned business could hardly compete with large, well-capitalized marijuana operators.
The state is unnecessarily picking winners and losers in the marketplace. We should be taking a more free market approach, allowing all qualified businesses to be licensed.
Register now for the Texas Cannabis Policy Conference to learn from policy experts, industry leaders, and advocates. Early bird pricing available this month: https://texascannabisconference.org/registration