Texas CUP News & Legislation

10 Essential Changes to the Medical Marijuana Program in Texas (HB 46 Edition)

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Medical Marijuana Doctor Texas Explains HB 46

House Bill 46, signed into law on June 20, 2025, represents the most significant expansion of Texas’ Compassionate Use Program (CUP) since its inception in 2015. While the current program remains in place through August 31, 2025, HB 46’s provisions take effect on September 1, 2025—and patients and physicians should prepare now.

Let’s explore the 10 biggest changes this new law brings to Texans and their Texas medical marijuana prescription..

1. Chronic Pain Officially Qualifies

HB 46 adds chronic pain to the list of qualifying conditions—a monumental shift for thousands of Texans.

How it’s defined: The law defines chronic pain as persistent pain lasting more than 3 months that significantly interferes with daily activities or functioning.

chronic pain back pain knee pain foot pain IBD IBS crohns disease migraine covered by medical mariijuana doctor Texas Floweret MD logo overlayThis includes pain from conditions like back injuries, fibromyalgia, nerve damage, arthritis, post-surgical pain, or autoimmune diseases.

If you’re currently using opioids, muscle relaxants, or antidepressants to manage pain, you may now qualify for medical cannabis with a physician’s evaluation.

2. Incurable Neurodegenerative Conditions Clarified

Texas law has long included “incurable neurodegenerative diseases,” but HB 46 requires the Department of State Health Services (DSHS) to maintain and regularly update a public list of these conditions.

Expect that list to expand as understanding of rare diseases grows. 

3. HB 46 Expands Texas Medical Marijuana Law to Hospice and All Terminal Patients

HB 46 also ensures that patients with a terminal illness or those receiving hospice or palliative care are clearly eligible for medical cannabis in Texas. This update provides compassionate support for people in the most vulnerable stages of life, giving them access to alternative relief options that may ease

4. Legal Protections for Dispensaries and Patients

HB 46 directly states that:

  • a municipality, county, or other political subdivision may not enact, adopt, or enforce a rule, ordinance, order, resolution, or other regulation that prohibits the cultivation, production, storage, dispensing, or possession of low-THC cannabis, as authorized by this chapter.”

HB 46 makes it clear that local governments cannot pass their own rules that interfere with the state’s medical cannabis program. This means patients and licensed dispensaries have the right to access or provide low-THC cannabis without worrying about city or county laws getting in the way. The state’s Compassionate Use Program sets the standard, and local officials must follow it.

While this doesn’t override federal restrictions, of course, it signals growing legal security within Texas state systems.

Again for the people in the back…Protections for Patients!!!

One of HB 46’s boldest provisions prevents local governments from enacting laws that:

  • Prohibit qualified patients from possessing medical cannabis

This clause ensures statewide consistency. Whether you live in Austin, El Paso, or Longview your access to medical cannabis cannot be undermined by city ordinances.

5. Texas CUP Will Allow New Medical Marijuana Products Under HB 46

Another important change under HB 46 is the allowance of new delivery methods for medical cannabis. In addition to oils and tinctures, patients may soon have access to topical lotions, transdermal patches, suppositories, inhalation devices, and vape products. This expansion gives doctors more flexibility to recommend the form that best suits each patient’s condition, symptoms, and lifestyle, especially for those who may not tolerate oral medications well.

6. THC Dosing Will Now Be Based on Milligrams, Not Percent of Weight

One of the most important updates in HB 46 is the shift to milligram-based THC dosing under the Texas Compassionate Use Program. Instead of calculating low-THC cannabis by percentage of product weight, patients and prescribing physicians will now dose based on milligrams of THC per product—similar to how most medications are measured. This allows for more accurate, cleaner formulations without unnecessary filler ingredients. It also gives patients better control and consistency, especially when working with a medical marijuana doctor in Texas to tailor treatment. With this change, Texans can expect greater product variety, easier dosing instructions, and improved symptom management.

7. Clear Privacy Provisions

Patients often worry about who can access their medical cannabis records. HB 46 includes a strong privacy clause:A smiling adult woman in casual clothes reviews a checklist of HB 46 updates on their tablet at a sunny Texas park medical marijuana doctor Texas update

State agencies, local governments, and law enforcement may not publicly disclose information about a patient’s participation in the Compassionate Use Program.

This protection is vital for teachers, parents, veterans, and professionals who fear stigma.

8. New Dispensary Licenses Expand Access Across Texas

As part of HB 46’s rollout, nine new medical cannabis dispensary licenses will be issued by December 1, 2025, with three more expected in early 2026. This expansion means that patients across Texas, especially those in underserved or rural areas, will have better access to dispensary services, including local pickups, shorter delivery windows, and more product options. Increased competition among dispensaries can also lead to improved customer service, broader availability of formulations, and potentially lower prices. For patients, more dispensaries means fewer barriers to consistent, timely care.

9. Texas Medical Marijuana Prescription Up to 1 Year

THC cannabis prescriptions written under the Texas Compassionate Use Program will be valid for one year, with up to FOUR 90-day supply refills. This streamlines access for qualified patients and reduces the burden of repeated appointments. If you’re working with a medical marijuana doctor in Texas, you’ll now be able to stay consistent with your treatment while maintaining compliance—especially helpful for those managing chronic pain or long-term conditions.

10. Implementation Timeline

Though HB 46 was signed in June 2025, the law goes into effect September 1, 2025. Patients can still apply under the current qualifying conditions but should prepare for changes to prescription timeframes, documentation, and legal protections.

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What This Means for Patients

If you suffer from chronic pain, irritable bowel disorders, or a terminal condition, this law expands your legal protections, privacy, and options.

Floweret MD can help you:

Texas is listening. HB 46 proves that patient stories, advocacy, and research are moving policy forward. With expanded access, clearer rules, and stronger protections, 2025 will mark a turning point in compassionate care for Texans.


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Disclaimer

This post is for educational purposes only and does not constitute medical or legal advice. Always consult a licensed provider for guidance.

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