Yes, Texas does have medical marijuana, but through a narrow program called the Compassionate Use Program. Only patients with specific diagnoses qualify, the products are limited to low-THC preparations, and smoking cannabis flower is not allowed. The program expanded significantly on September 1, 2025, when House Bill 46 added new qualifying conditions and new delivery methods.
The Texas Department of Public Safety runs the program under Chapter 487 of the Health and Safety Code.1State of Texas. Texas Health and Safety Code 487 – Texas Compassionate-Use Act There are no paper prescriptions and no physical patient card. Everything runs through a secure state database called the Compassionate Use Registry of Texas.2Department of Public Safety. Patients
Who Qualifies
You must be a permanent Texas resident and have a diagnosis that appears on the state’s qualifying list. Patients under 18 need a legal guardian’s consent. Texas does not honor medical marijuana authorizations from any other state, so if you are visiting from somewhere cannabis is legal, your home-state status does not carry over.2Department of Public Safety. Patients
As of September 2025, the qualifying conditions under Section 169.003 of the Occupations Code are:3State of Texas. Texas Occupations Code 169 – Authority to Prescribe Low-THC Cannabis
- Epilepsy or a seizure disorder
- Multiple sclerosis
- Spasticity
- Amyotrophic lateral sclerosis (ALS)
- Autism
- Cancer
- An incurable neurodegenerative disease, which covers conditions like Parkinson’s or Alzheimer’s
- Post-traumatic stress disorder (PTSD)
- Chronic pain, generally continuous or recurring severe pain lasting more than 90 days
- Traumatic brain injury
- Crohn’s disease or other inflammatory bowel disease
- A terminal illness or a condition requiring hospice or palliative care
- A condition approved for an authorized research program
Chronic pain, traumatic brain injury, Crohn’s disease, and the broader terminal illness category are new under HB 46 and represent the biggest expansion the program has seen. For every condition on the list, the prescribing physician still has to decide that the likely benefit outweighs the risks for you specifically.
What “Medical Marijuana” Means in Texas
Texas law defines “low-THC cannabis” as cannabis containing no more than 10 milligrams of tetrahydrocannabinols per dosage unit.3State of Texas. Texas Occupations Code 169 – Authority to Prescribe Low-THC Cannabis This per-dose cap replaced an older 1-percent-by-weight standard when HB 46 took effect. The products are much weaker than what you would find in a recreational market in another state.
Approved forms include oils, tinctures, capsules, lozenges, edibles, and topical lotions and balms. Since September 1, 2025, Texas also permits pulmonary inhalation through approved medical devices such as vaporizers, nebulizers, and inhalers, if your physician documents a medical need for that delivery method.4Texas Legislature. HB 46 Bill Analysis For an inhalation prescription with documented need, the THC per dose can exceed the standard 10-milligram cap.
Smoking raw cannabis flower is not allowed under the program, even for registered patients. You cannot buy or possess cannabis flower for combustion in Texas.
How to Get a Prescription and Buy It
Start with a physician who treats your qualifying condition and is registered with the Compassionate Use Registry. Not every doctor can prescribe low-THC cannabis. The physician must hold an active Texas medical license, be board certified by a board approved by the American Board of Medical Specialties or the Bureau of Osteopathic Specialists in a specialty relevant to your condition, and dedicate a significant portion of their practice to that condition.3State of Texas. Texas Occupations Code 169 – Authority to Prescribe Low-THC Cannabis A neurologist typically handles seizure disorders, for example.
If the physician decides you qualify, they enter your prescription directly into the registry: your name, date of birth, dosage, and method of administration. You will not leave the office with a paper script.
Next, visit a licensed dispensing organization. Texas law authorizes up to 15 dispensary licenses, though only three are currently active while DPS works to issue the remaining 12.5Department of Public Safety. Dispensing Organizations Many dispensaries deliver directly to patients. At pickup or delivery verification, you provide your date of birth and the last five digits of your Social Security number so staff can pull your registry entry and fill the order.
Keep every product in the original dispensary packaging. Texas does not issue a physical card, so that packaging is your proof of legal possession if law enforcement asks.
Cost and Insurance
Insurance will not help. No private plan, Medicare, or Medicaid covers medical marijuana, because cannabis is still a Schedule I controlled substance under federal law. Everything is out of pocket.
Physician evaluations generally run $100 to $200, with some telehealth providers charging less. Tinctures and oils tend to run $80 to $150 per bottle, and capsules and lozenges $60 to $100, though your actual monthly cost depends on dose and refill frequency. Dispensary prices also reflect Section 280E of the Internal Revenue Code, which blocks cannabis businesses from taking standard business deductions and raises their operating costs.
Federal Law Still Applies to You
A valid Texas prescription does not shield you from federal law, and a few areas are worth knowing about before you enroll.
Firearms
Federal law makes it a crime for an “unlawful user of or addicted to any controlled substance” to possess a firearm or ammunition.6Office of the Law Revision Counsel. 18 U.S. Code 922 – Unlawful Acts Because marijuana is still federally Schedule I, being a registered Texas patient can expose you to a federal felony charge for gun possession. ATF Form 4473, required for any firearm purchase, asks whether you are an unlawful user of a controlled substance, and lying on it is itself a federal crime.
Jobs and Drug Testing
Texas law does not require employers to accommodate medical marijuana use. Federal employees and workers in safety-sensitive roles regulated by the U.S. Department of Transportation, including commercial drivers, pilots, and pipeline workers, face mandatory testing where any positive marijuana result is a violation.7U.S. Department of Transportation. DOT’s Notice on Testing for Marijuana DOT rules specifically tell medical review officers not to accept a state medical marijuana authorization as a valid explanation.8eCFR. 49 CFR Part 40 – Procedures for Transportation Workplace Drug and Alcohol Testing Programs Private employers outside DOT settings generally have wide latitude to maintain drug-free workplace policies.
Federally Assisted Housing
If you live in public housing or receive Section 8, using medical marijuana can jeopardize your tenancy. HUD policy prohibits admitting marijuana users to federally assisted housing and lets public housing agencies terminate tenancies when a household member uses a controlled substance.9HUD Exchange. Can a Public Housing Agency (PHA) Make a Reasonable Accommodation for Medical Marijuana
Travel
Taking your medication across state lines is a federal offense. TSA officers do not search for marijuana, but if they find it during screening they are required to refer the matter to law enforcement.10Transportation Security Administration. Medical Marijuana Only products at or below 0.3 percent THC on a dry weight basis, the hemp threshold, are permitted on flights. Amtrak bans marijuana in any form on trains and in stations. Leave your medication at home when you travel out of state.
If You Use Marijuana Outside the Program
Possessing marijuana in Texas without a valid Compassionate Use prescription is still a criminal offense, and penalties escalate quickly with quantity:
- Under 2 ounces: Class B misdemeanor, up to 180 days in jail and a $2,000 fine
- 2 to 4 ounces: Class A misdemeanor, up to one year in jail and a $4,000 fine
- 4 ounces to 5 pounds: state jail felony, up to two years in state jail and a $10,000 fine
- Over 5 pounds: felony charges with increasingly severe prison sentences
These penalties apply to traditional marijuana. Hemp-derived products at 0.3 percent THC or less are legal under both federal and Texas law. If you are a registered patient, keeping your medication in its original dispensary packaging is the simplest way to avoid confusion during any encounter with law enforcement.