Plans to expand Texas’ medical marijuana program for chronic pain go up in smoke

Despite testimony from advocates about the positive effects of cannabis as medicine and bipartisan support in the House, a proposal to expand Texas’ medical marijuana program appears to have met its end this legislative session.

The bill authored by Fort Worth Republican Stephanie Klick would have extended Texas’ Compassionate Use Program to patients with chronic pain in cases who would have otherwise been prescribed opioids. Currently, under the medical marijuana program, doctors can prescribe low-THC cannabis to treat a limited number of medical conditions, including epilepsy and post-traumatic stress disorders.

In recent sessions, the program has been expanded to fold in more medical conditions, with Klick emphasizing the need to follow the scientific data as its scope widens.

“It’s really disappointing because we have more research on chronic pain, we even have care guidelines, clinical guidelines for it, more so than a lot of conditions,” Klick said. “It’s a really missed opportunity to help patients.”

In addition to adding chronic pain as a qualifying condition, the bill would have given the Department of State Health Services the ability to designate “debilitating medical conditions” for which medical marijuana could be prescribed.

The bill passed out of the house 127-19, but did not get a Senate committee hearing. The Senate removed a chronic pain measure from a 2021 bill expanding the program.

A spokesperson for Lt. Gov. Dan Patrick, president of the Texas Senate, did not immediately return an email seeking comment.

In addition to broadening the program, the bill would have changed how the amount of THC — the chemical that produces a high — is measured in medical marijuana prescribed by doctors, moving to a volumetric measurement rather than weight based. Doctors could prescribe up to 10 milligrams of THC in each dose.

Cannabis prescribed in Texas cannot be smoked, which means it is sometimes consumed in the form of oil. This can cause gastrointestinal issues, Klick said during a March committee hearing.

The switch would allow for a more concentrated product, requiring less to be consumed.

“That was a wonderful way for us to standardize what a normal dose should be of this medication,” Dr. Matthew Brimberry, the medical director for the Texas Cannabis Clinic.

He was among those who supported the bill during a March committee hearing, when speaking before lawmakers.

Denying Texans access to medical marijuana for chronic pain could mean they turn to opioids, which are addictive, or to illegally bringing marijuana to Texas from other states, Brimberry said.

“It’s truly a disservice our citizens not to consider broadening this program to allow physicians to be able to recommend this medicine to patients, to try and keep them out of pain in a safe way, without having to look to other means of obtaining,” he said.

There are a few days left in the legislative session, which ends Monday. And while the general rule of thumb in the legislature is that a proposal isn’t dead until the session’s official end, Klick didn’t see how the the measure could be revitalized.

“We’ll try again next session,” she said. “This really is something that has changed the lives of some patients, and we need to keep working.”