Texas Governor Signs Landmark Bill to Expand the State’s Medical Marijuana Program

In a major step forward for cannabis reform in Texas, Governor Greg Abbott (R) has officially signed into law a bill that significantly broadens the state’s restrictive medical marijuana program. The move represents the most substantial expansion since the program’s inception and comes amid intensifying debates over the state’s approach to cannabis policy.

The new legislation, championed by Rep. Ken King (R), greatly expands patient access, introduces new delivery methods, increases the number of medical cannabis business licenses, and adds several new medical conditions to the list of qualifying diagnoses.

Expanded List of Qualifying Conditions Now Includes Chronic Pain, TBI, and End-of-Life Care

Among the most impactful provisions of the new law is the expansion of the list of qualifying medical conditions. Patients suffering from chronic pain, traumatic brain injury (TBI), Crohn’s disease, and other inflammatory bowel diseases are now eligible for medical cannabis under the Texas Compassionate Use Program.

The legislation also provides access to patients receiving palliative or hospice care. This addition is widely seen as a compassionate move aimed at improving quality of life for terminally ill Texans.

Diverse Range of Cannabis Product Types Now Approved for Medical Use

In a significant change to product accessibility, the new law expands the variety of cannabis products that patients can use. The approved forms now include patches, lotions, suppositories, inhalers, nebulizers, and vaping devices.

Previously, the program allowed only low-THC, non-smokable cannabis oils. This broader range of administration methods is expected to offer better therapeutic outcomes tailored to individual patient needs.

Business Licensing Expansion Will Increase the Number of Dispensaries Across Texas

The law mandates a fivefold increase in the number of medical cannabis business licenses—jumping from three to 15. Additionally, licensed dispensaries will now be allowed to open satellite locations, bringing cannabis access to more parts of the state.

This expansion is anticipated to reduce geographic barriers for patients, particularly those living in rural areas who have faced difficulties accessing the limited number of dispensaries operating under the previous structure.

Legislative Compromises Helped Secure Passage Following Senate Pushback

The path to passage was not without friction. The House initially passed a broader version of the bill, which included glaucoma, spinal neuropathy, and degenerative disc disease as qualifying conditions. It also would have allowed military veterans to become eligible for medical cannabis for any diagnosed condition and would have empowered the Texas Department of State Health Services (DSHS) to add more qualifying conditions administratively.

However, the Senate State Affairs Committee substantially narrowed the bill, removing key provisions and adding restrictions. In response, House lawmakers pushed back and worked to reach a compromise. Ultimately, conditions like chronic pain and TBI were reinserted into the bill, thanks to a floor amendment and a conference committee agreement.

Notably, the Senate had initially attempted to require chronic pain patients to first undergo a 90-day opioid trial before becoming eligible for cannabis. This stipulation was successfully removed in the final version of the bill.

Conference Committee Restores Crohn’s Disease and Clarifies Dosage and Prescription Limits

During final negotiations, lawmakers also restored Crohn’s disease and other inflammatory bowel diseases to the list of qualifying conditions. Sen. Charles Perry (R) acknowledged that these conditions were “inadvertently left out” due to last-minute drafting errors.

The final bill also includes specific regulatory language clarifying prescription standards. Under the new rules:

• Patient registrations will be valid for one year.
  
• Physicians may prescribe up to four refills of a 90-day cannabis supply.
  
• Cannabis product packaging can contain up to 1 gram of total THC.
  
• The dosage limit per product is set at 10 milligrams of THC.
  

Additionally, physicians are explicitly permitted to prescribe more than one package of low-THC cannabis to a patient within a 90-day window, offering increased flexibility in treatment.

Petition Based Pathway Introduced for Adding New Qualifying Conditions

While the final bill did not grant DSHS independent authority to expand qualifying conditions, it does introduce a new petition-based process. Physicians can now formally petition the department to report to the legislature if cannabis appears to be therapeutically beneficial for a medical condition not currently covered.

This mechanism creates a potential pathway for further expansion in future legislative sessions and gives clinicians a role in shaping policy based on evolving medical evidence.

Patient Privacy Protections Strengthened Under New Law

To address concerns about patient confidentiality, the bill includes robust data protection provisions. Patient information will be accessible only to the Department of Public Safety (DPS), registered physicians, and licensed dispensaries. Unauthorized access or disclosure of patient data is prohibited.

Additionally, DPS is required to issue rules for the expanded program no later than October 1, setting the stage for implementation in the latter half of 2025.

Context: Texas Continues to Wrestle With Conflicting Cannabis Policies

While the signing of this legislation is seen as progress, it comes against a backdrop of continued tension surrounding cannabis laws in Texas. Governor Abbott is also reviewing a controversial bill that would ban consumable hemp products containing any THC—despite federal law allowing up to 0.3 percent THC in hemp.

Simultaneously, the Texas Legislature is advancing a separate measure that would block municipalities from using ballot initiatives to decriminalize cannabis or other controlled substances. This move threatens to override local decriminalization laws passed in cities like Austin and San Marcos, despite previous court rulings upholding such ordinances.

Although multiple legal challenges remain ongoing, the state appears poised to restrict local authority over cannabis enforcement, even as it cautiously expands the medical program.

Public Opinion Shows Strong Support for Legalization and Expanded Access

Polls continue to show that Texans overwhelmingly support cannabis reform. A recent survey found that four out of five voters back some form of marijuana legalization, and a majority favor further relaxing cannabis regulations.

This growing public support stands in contrast to the cautious pace of reform at the state level. Nonetheless, the newly signed law represents a meaningful step forward that reflects some responsiveness to public sentiment.

Activists Target New Local Reform Measures Despite State Pushback

Even as the state government works to rein in local cannabis reform efforts, activists are not backing down. A campaign is underway to place a decriminalization initiative on the ballot in Kyle, Texas this November, continuing a grassroots strategy to push reform city by city.

Advocates say that local initiatives remain a critical tool for change in a state where comprehensive legalization remains politically out of reach.