Texas Compassionate Use Act: Qualifying, Prescriptions & Limits

The Texas Compassionate Use Program lets Texas residents with specific medical conditions get a legal, physician-issued prescription for low-THC cannabis, dispensed through a small number of state-licensed organizations and tracked in an electronic registry rather than on a patient card.¹ The program began under Senate Bill 339 in 2015 and was most recently overhauled by House Bill 46, which took effect September 1, 2025, and expanded qualifying conditions, raised THC limits, allowed inhalation devices, and increased the number of licensed dispensaries from three to fifteen.² The Texas Department of Public Safety administers it.

Who Qualifies

You must be a permanent Texas resident. There is no minimum age; a parent or legal guardian handles the consultation and dispensary pickup for a patient under 18.³ The physician verifies residency before entering anything into the registry.

Texas Occupations Code Chapter 169 sets the qualifying conditions. As of 2026, a physician may prescribe low-THC cannabis for any of the following:⁴

Epilepsy or a seizure disorder
Multiple sclerosis or spasticity
Amyotrophic lateral sclerosis (ALS)
Autism
Cancer (HB 46 broadened this from terminal cancer only to any cancer diagnosis)
An incurable neurodegenerative disease, a category that covers conditions like Alzheimer’s, Parkinson’s, and Huntington’s⁵
Post-traumatic stress disorder (PTSD)
A condition that causes chronic pain
Traumatic brain injury
Crohn’s disease or other inflammatory bowel disease
A terminal illness or a condition receiving hospice or palliative care

HB 46 added a separate pathway for honorably discharged veterans: a physician may prescribe low-THC cannabis to a qualifying veteran who would benefit from it for a medical condition, even if that condition is not on the list above.⁶ Patients enrolled in an approved research program under Chapter 487 of the Health and Safety Code may also qualify for conditions being studied in that program.⁴

How to Get a Prescription

Texas is unusual among medical cannabis states because physicians write actual prescriptions rather than “recommendations.” The prescribing physician must be registered with the Compassionate Use Registry of Texas, known as CURT, which is the secure electronic system DPS maintains.¹ You do not register in CURT yourself and you do not receive a card. Everything about your participation lives in the entry your physician makes.

Before prescribing, the physician certifies to DPS that you have a qualifying diagnosis and that the potential benefit outweighs the risk for you specifically.⁴ A second-physician concurrence used to be required but was removed in 2019, so one qualified physician can now prescribe on their own.

Each prescription covers up to a 90-day supply at the prescribed dosage and may include up to four refills, which means a single prescription can run for more than a year before you need a new one. The physician specifies dosage, delivery method, and quantity directly in CURT.⁴ Law enforcement and dispensing organizations verify your status by looking you up in the registry, so there is nothing you need to carry.

The consultation itself typically costs between $150 and $300 out of pocket. Most health plans do not cover medical cannabis evaluations.

What Products You Can Get

HB 46 rewrote the definition of “low-THC cannabis.” The old cap was one percent THC by weight. Effective September 1, 2025, the limit is 10 milligrams of THC per dosage unit with a total cap of one gram of THC per package.²

Smoking raw cannabis is still prohibited regardless of your diagnosis. HB 46 did open the door to pulmonary inhalation through vaporizers, inhalers, and nebulizers when a physician determines there is a medical necessity for that delivery method. Inhalation products can exceed the 10mg-per-dose limit, but the total THC in the device cannot exceed one gram and the prescription must specify the amount per dose.²

Beyond inhalation devices, the program allows edibles, tinctures, oils, topical balms, lotions, transdermal patches, and suppositories. All products must contain only naturally occurring cannabinoids from the cannabis plant; synthetic cannabinoids are not allowed.⁶ Possessing any cannabis product that falls outside these definitions remains a criminal offense in Texas. Products generally run from about $45 to $155 per unit depending on type and potency, and because cannabis is federally controlled no insurer or pharmacy benefit plan covers the cost.

Where to Pick Up Your Prescription

Only licensed dispensing organizations may cultivate, process, and dispense low-THC cannabis in Texas.⁷ The program is scaling from three to fifteen licensed organizations. DPS was required to license at least nine new dispensing organizations by December 1, 2025, and at least three more by April 1, 2026.⁸ HB 46 also allows dispensing organizations to operate satellite locations across the state, which should improve access outside the major metro areas.⁶

At the dispensary, staff look you up in CURT, verify your identity, and dispense the product the physician specified. Dispensing organizations also deliver prescriptions directly to patients’ homes, though scheduling and delivery areas vary by organization.⁷

If you were already enrolled before September 2025, you do not need to re-register. Existing prescriptions remain valid, and your physician can update dosages and delivery methods in CURT as new product types become available.

What a Texas Prescription Does Not Protect You From

A valid state prescription does not shield you from federal consequences. Marijuana is still a Schedule I controlled substance under federal law.⁹ A few places this matters:

Federal jobs. Executive Order 12564 requires federal employees to refrain from using illegal drugs, defined as Schedule I or II controlled substances, and agencies must initiate disciplinary action against employees who use them.¹⁰ The order technically exempts substances used under a valid prescription, but no federal law treats a cannabis prescription as valid, so the exemption does not apply.

HUD-assisted housing. Federal law requires public housing agencies to prohibit admission of controlled-substance users, and HUD has stated it cannot make exceptions for state-legal medical marijuana. Continued use can be grounds for eviction.¹¹

Air travel. TSA screening focuses on security threats, not drugs, but if an officer discovers cannabis during screening they are required to refer the matter to law enforcement.¹² Crossing state lines with cannabis creates federal jurisdiction issues even between two states with medical programs. Leaving your products at home when you fly is the safe choice.

Private employment. Texas has no law prohibiting private employers from firing or refusing to hire someone who tests positive for THC, even with a valid compassionate use prescription. If your employer has a drug-free workplace policy, a positive test can cost you your job regardless of your status in the state program.

1
Texas Department of Public Safety. Compassionate Use Registry of Texas (CURT)
2
Texas Legislature Online. 89(R) HB 46 – Enrolled Version – Bill Text
3
Texas.gov. Texas Medical Marijuana
4
State of Texas. Texas Occupations Code 169.003 – Prescription of Low-THC Cannabis
5
State of Texas. Texas Occupations Code 169.001 – Definitions
6
Texas Legislature Online. HB 46 Bill Analysis – Senate Research Center
7
Texas Department of Public Safety. Dispensing Organizations
8
Texas Department of Public Safety. Licensed Dispensaries
9
Office of the Law Revision Counsel. 21 USC 812 – Schedules of Controlled Substances
10
National Archives. Executive Order 12564 – Drug-Free Federal Workplace
11
HUD Exchange. Can a Public Housing Agency (PHA) Make a Reasonable Accommodation for Medical Marijuana
12
Transportation Security Administration. Medical Marijuana