There are 3,519 Texans registered with the state to use medical marijuana, though advocates say 2 million people are eligible based on current law.
Five years after Texas legalized medical marijuana for people with debilitating illnesses, advocates and industry experts say the state’s strict rules, red tape and burdensome barriers to entry have left the program largely inaccessible to those it was intended to help.
But with a new legislative session gaveling in next month, some Texas lawmakers see an opportunity to fix the state’s medical cannabis program — known as the Compassionate Use Program — by further expanding eligibility and loosening some restrictions so Texas’ laws more closely resemble those of other states that allow the treatment.
There are 3,519 Texans registered with the state to use medical marijuana, though advocates say 2 million people are eligible based on current law.
Texas’ program pales in overall participation and scope compared with other states: It has fewer enrolled patients and businesses than most other states with medical marijuana programs. At least some form of medical marijuana is legal in 47 states nationwide, but Texas’ restrictions put it in the bottom 11 in terms of accessibility, according to the National Conference of State Legislatures.
“We’re pretty dang close to the bottom. We’re pretty far behind,” said state Sen. José Menéndez, D-San Antonio, referring to how access to Texas’ medical marijuana program fares compared with other states. Menéndez will push legislation in the next session to further expand the program.
Oklahoma, home to 25 million fewer people than Texas, has more than 100 times as many registered patients who can access medical marijuana. This December, two years after the passage of Oklahoma’s medical cannabis program, there were 365,464 people enrolled. To the east, Louisiana, with a fifth of Texas’ population, had 4,350 patients in 2019, and to the west, New Mexico had enrolled more than 82,000 people in its program as of the same year.
Industry experts say Texas’ narrowly designed program is also hindering a market that could help drive Texas’ economic recovery from the coronavirus pandemic.
“Here’s this … billion dollar bird’s nest that’s sitting on the South Lawn of the Capitol, waiting for the right legislator to come pick it up and take it inside, and to present it to the other legislators and say, ‘Here you go. Here’s a way for us to … [help] our citizens,”’ said Morris Denton, CEO of Compassionate Cultivation, one of the state’s three licensed medical cannabis businesses, at this year’s Texas Marijuana Policy Conference in November.
The business costs in Texas associated with the medical marijuana industry are sky high. At the same time, advocates and business leaders already in the market complain the state has one of the most restrictive caps on the amount of tetrahydrocannabinol, or THC — the psychoactive ingredient in marijuana that makes people feel high — that medical cannabis products are legally allowed to contain. Only six states that allow medical marijuana have THC caps lower than Texas’, according to the National Conference of State Legislatures.
The program is so limited that the National Organization for Reforming Marijuana Laws doesn’t recognize it as a true medical marijuana program. Instead, the group labels Texas a “medical CBD” state for its emphasis on cannabidiol — derived from hemp and containing only traces of the psychoactive compounds found in cannabis — over THC for medicinal use.
Jax Finkel, executive director for Texas NORML, said the reason Texas is often not considered a true medical marijuana state is because it caps medical cannabis at 0.5% THC, and over-the-counter hemp products are capped at 0.3%. That means people who get prescriptions from their doctors and pay for medical marijuana would be getting a product that has only marginally more THC than a CBD-oil or tincture purchased at a local store.
“While there is a difference there that has an added value and there is also value to being a registered patient, that does create somewhat of a problem,” Finkel said. “And so a lot of people don’t really see our program as a fully functioning program.”
But some Texas lawmakers hope to change that. As of Dec. 14, at least seven bills had been filed by lawmakers seeking to expand the Compassionate Use Program. Menéndez is authoring a far-reaching bill that would make more patients eligible, strike the THC cap and lower business fees, among other changes.
“I think we’d see a lot more participation if we had a real medical cannabis program,” said Heather Fazio, director of Texans for Responsible Marijuana Policy.
In the past, medical cannabis bills have faced opposition from lawmakers who see it as a path to legalizing recreational marijuana, Menéndez said. But he says expanding the program will put decisions about who can access the medicine into the hands of doctors.
“I come at this with a highly guarded sense of danger of the direction that this might take us to recreational use,” Birdwell said. “I wouldn’t be comfortable going any further than this because of what I’m seeing in Colorado, Washington and Oregon and what’s happening in those states. I am highly guarded.”
A push to expand the law
Advocates say among the biggest failures of Texas’ medical cannabis program is its narrow “disease profile” — the list of conditions that qualify Texans to register as medical cannabis users. Fazio said most states with successful programs count post-traumatic stress disorder and chronic pain among qualifying conditions, and neither is on Texas’ list.
In 2015, Texas’ list of qualifying medical conditions had one item: intractable epilepsy. The 2019 expansion of the law added diseases such as terminal cancer, multiple sclerosis, Parkinson’s disease and Lou Gehrig’s disease, or ALS.
The number of registered patients has steadily climbed since 2017. After lawmakers tweaked the program in 2019 to include more patients, the number of registered patients more than doubled from about 1,300.
But the bar for eligibility is still high. This legislative session, Fazio is pushing lawmakers to expand the state’s disease profile to include PTSD and chronic pain, which would particularly benefit Texas’ veteran population — the second largest in the country as of 2017.
One Texan who is left out of the state’s program is April Martinez, a U.S. Army veteran from Killeen. In 2006, Martinez was a chemical specialist in Afghanistan as part of a signal unit.
After returning home, she has experienced constant migraines, muscle fatigue and cognitive issues. Martinez said she has tried everything from Botox to Alzheimer’s medication to treat her pain.
She moved to Washington for a few years and gave medical cannabis a try, and saw immediate results. She said she stopped taking seven of her eight medications and could once again read, spend quality time with her kids and go out in the sun without experiencing excruciating pain.
“It felt like I was finally starting to see the sun through the clouds, and then we came back to Texas once my husband retired from the military,” Martinez said at a panel during the Texas Marijuana Policy Conference in November.
Martinez doesn’t qualify to use medical cannabis under Texas law.
“Having to look at the rest of your life, you can see every single day is, you are just going to feel beaten up and overwhelmed and not enough energy and everything that you do is going to cause you some amount of pain, is a really hard way to imagine the rest of your life,” Martinez said in an interview with The Texas Tribune.
Advocates say they want lawmakers to leave the decision-making to doctors. Louisiana and Oklahoma, among other states, allow physicians to decide who qualifies for medical cannabis. Under Texas’ current law, Menéndez said, lawmakers pick winners and losers through their strict criteria for medical cannabis use.
“I don’t understand what the lack of trust in Texas and the people of Texas is, because that’s what this is,” he said in an interview. “At the end of the day, they’re trying to keep cannabis out of the hands of everyone except for the people who they’ve laid out that can have access to it.”
The lack of autonomy for patients and physicians is a major issue in Texas’ medical marijuana system, said Dr. Robert S. Marks, chief executive officer of Diagnostic Pain Center in Austin. Marks is one of the 240 Texas physicians who can enter patients into the compassionate use registry.
He said that while the system is better than nothing, it’s a bit “disjointed” and could be more effective. The list of patients who can receive medical cannabis is both specific and broad, leaving it “ripe for both exploitation as well as limitation,” Marks said. For example, he said the list allows for people to receive cannabis for “spasticity,” a broad term but a legitimate reason to use cannabis.
“It’s challenging due to the fact that there are a lot of people that don’t qualify based on this list of diagnoses,” Marks said at a panel during the Texas Marijuana Policy Conference. “But yet there’s no question that this particular medicine would be a safer, viable option compared to alternatives.”
By allowing for more autonomy, Marks said, the state’s system could cut down on the time it takes physicians to provide medical cannabis and better satisfy patients with products that work.
“Cannabis is the only medicine where doctors are being told a dosing maximum, which is an incredible low dosage of THC,” Fazio said. “We trust doctors with far more dangerous substances.”
A potential boon for business
Texas officials approved three companies to grow and sell medical cannabis in 2017, two years after the Compassionate Use Program was signed into law. Under the watchful eyes of state regulators, those three companies serve about 3,500 patients across Texas.
But they say that’s not enough patients for businesses to be profitable.
Together with high licensing fees and strict rules for transporting and storing inventory, it is challenging — and costly — for medical cannabis businesses to operate in Texas, said Denton, of Compassionate Cultivation. For example, the $7,300 application fee to open a dispensing organization in Texas is nearly three times as costly as in Oklahoma. Louisiana’s fee is just $450.
“The capital requirements in order to build out a vertically integrated business are not insignificant; in fact, they’re very high,” Denton said. “The ability to make money in this kind of an industry is nonexistent at this point.”
Denton says his business alone has the ability to serve the entirety of the state’s legal market. In Oklahoma, more than 9,500 licensed businesses collectively serve the state’s more than 365,000 patients. Louisiana, with 4,350 patients as of 2019, has approved two businesses to grow medical cannabis and nine to sell it.
Medical marijuana is already an economic engine in other states. In Oklahoma, which has the biggest program in the country on a per capita basis, sales since 2018 rose above $1 billion last month, according to reports.
During the 2021 legislative session, Compassionate Cultivation will also ask lawmakers to allow licensed companies to open retail, or dispensing, locations across the state. Under current regulations, the businesses are prohibited from storing inventory outside their facilities, making it difficult to deliver medicine to patients hundreds of miles away, Denton said.
“I believe that this business is arguably the most regulated business in the state of Texas right now,” Denton said. “We operate a business … in a fishbowl, under a microscope.”
This article originally appeared in The Texas Tribune.
The Texas Tribune is a nonprofit, nonpartisan media organization that informs Texans — and engages with them — about public policy, politics, government and statewide issues. Disclosure: Texans for Responsible Marijuana Policy, Compassionate Cultivation and The National Conference of State Legislatures have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.
Top Pennsylvania Official Restores Marijuana Flag After GOP Lawmakers Allegedly Got It Removed
Lt. Gov. John Fetterman’s (D) marijuana and LGBTQ flags are waving again at his Capitol office after state officials removed them Monday night, allegedly at the behest of certain GOP lawmakers who feel strongly about the activist decor.
The day after their removal, the lieutenant governor proudly announced on Twitter that he’d restored the flags—one rainbow-themed and the other displaying cannabis leaves.
“I really can’t emphasize this enough, my issue isn’t with the individuals that came to take them down. They’re kind of caught in the middle of it so it’s not them,” Fetterman told Marijuana Moment. “But the Pennsylvania GOP exerted enough pressure and made enough drama so they felt that they needed to do something and they took them down. When I realized that, I just put them back up.”
I even had to rehang this one. 🙄 pic.twitter.com/NPuADtb1Lt
— John Fetterman (@JohnFetterman) January 26, 2021
The flags have been an unusual source of controversy for some members of the legislature. In November, Republican lawmakers passed budget legislation that included a provision targeting his cannabis-themed office decor, making it so only the American flag, the Pennsylvania flag and those honoring missing soldiers could be displayed at the Capitol building.
It’s kinda flattering that they changed Pennsylvania law just for me. 🥺👉👈
Speaking of changing laws…
I’ll take them down when we get:
LEGAL WEED 🟩 FOR PA + EQUAL PROTECTION UNDER THE LAW for LGBTQIA+ community in PA.
— John Fetterman (@JohnFetterman) November 20, 2020
“There’s one great way to get them down for good and we can end this,” the lieutenant governor said. And that’s by enacting legislative reform.
“It shouldn’t have to be this way. These are not controversial things. These are very fundamentally American things. It’s freedom-related. It’s individuality-related. It’s jobs. It’s revenue,” he said. “These are not controversial, but these flags are. For the party that thinks it’s A-OK to talk about how an election that was secure was rigged, they sure have a real thin skin when it comes to free speech.”
A spokesperson for the state Department of General Services confirmed to Marijuana Moment that it was tasked with removing the flags and did so “in order to comply with section 1724-E of the fiscal code.” Asked whether lawmakers from the legislature’s Republican majority influenced the recent action, the representative repeated: “All I can say is the Department of General Services removed the flag in order to comply with section 1724-E of the fiscal code.”
Marijuana Moment reached out to the offices of the Senate majority leader and House speaker for comment, but representatives did not respond by the time of publication.
Defying the flag order is par for the course for Fetterman, a longtime marijuana reform advocate who is weighing a run for the U.S. Senate. His enthusiastic embrace of the issue has often put him in the spotlight, and he said he’d take that advocacy to Congress if he ultimately decides to enter the race and is elected.
“I’m the only person that’s actually called out my own party for its failure to embrace it when it is appropriate,” he said, referring to his repeated criticism of the Democratic National Committee’s rejection of a pro-legalization platform. “There has never been—or would ever be—a more committed advocate to ending this awful superstition over a plant for the United States.”
🚨🚨 PENNSYLVANIA *AND* DNC IS BEING LAPPED ON LEGAL WEED BY THE DAKOTAS NOW
— John Fetterman (@JohnFetterman) January 26, 2021
On his campaign website, the lieutenant governor touts his role in leading a listening tour across the state to solicit public input on the policy change. He noted that, following his efforts, Gov. Tom Wolf (D) “announced his support for legalization for the first time.”
It remains to be seen when legalization will happen in Pennsylvania, however. Despite Fetterman and Wolf’s support for legalization and the pressure they’re applying on lawmakers, convincing Republican legislative leaders to go along with the plan remains a challenge.
Fetterman previously told Marijuana Moment that pursuing reform through the governor’s budget request is a possibility. But in the meantime the administration is exploring the constitutionality of issuing “wholesale pardons for certain marijuana convictions and charges.”
Since adopting a pro-legalization position in 2019, Wolf has repeatedly called on the legislature to enact the policy change. He’s stressed that stressed that marijuana reform could generate tax revenue to support the state’s economic recovery from the coronavirus pandemic and that ending criminalization is necessary for social justice.
In September, he took a dig at the Republican-controlled legislature for failing to act on reform in the previous session. And in August, he suggested that the state itself could potentially control marijuana sales rather than just license private retailers as other legalized jurisdictions have done.
Fetterman previously said that farmers in his state can grow better marijuana than people in New Jersey—where voters approved a legalization referendum in November—and that’s one reason why Pennsylvania should expeditiously reform its cannabis laws.
He also hosted a virtual forum where he got advice on how to effectively implement a cannabis system from the lieutenant governors of Illinois and Michigan, which have enacted legalization.
Shortly after the governor announced that he was embracing the policy change, a lawmaker filed a bill to legalize marijuana through a state-run model.
A majority of Senate Democrats sent Wolf a letter in July arguing that legislators should pursue the policy change in order to generate revenue to make up for losses resulting from the COVID-19 pandemic.
Photo courtesy of Twitter/John Fetterman.
Hawaii Could Legalize Psychedelic Mushroom Therapy Under New Senate Bill
Hawaii could legalize the use of psychedelic mushrooms for therapy under a newly filed bill in the state legislature.
The measure, if approved, would direct the state Department of Health to “establish designated treatment centers for the therapeutic administration of psilocybin and psilocyn,” two psychoactive substances produced by certain fungi.
It would also remove the two compounds from the state’s list of Schedule I controlled substances and create a seven-person psilocybin review panel to assess the impacts of the policy change.
Few other specifics are provided in the bill, SB 738, introduced in the state Senate on Friday. It doesn’t specify who would qualify for the therapy, for example, or how precisely the drugs—which remain federally illegal—would be administered. The legislation simply says the Department of Health “shall adopt rules” in accordance with state law.
The new legislation comes less than a year after Hawaii lawmakers introduced bills to begin studying the therapeutic use of psychedelic mushrooms with the goal of eventually legalizing them, though those measures did not advance.
Entheogens—including other substances like ayahuasca and ibogaine—have emerged as a promising treatment for severe depression, anxiety and other conditions, although research remains ongoing.
In November, voters in Oregon approved a ballot measure to legalize psilocybin therapy that the state is now in the process of implementing.
The new Hawaii bill was introduced by Sens. Stanley Chang, Laura Clint Acasio, Les Ihara Jr. and Maile Shimabukuro, all Democrats. It has not yet been scheduled for a hearing, according to the state legislature’s website.
Marijuana Moment is already tracking more than 400 cannabis, psychedelics and drug policy bills in state legislatures and Congress this year. Patreon supporters pledging at least $25/month get access to our interactive maps, charts and hearing calendar so they don’t miss any developments.
Learn more about our marijuana bill tracker and become a supporter on Patreon to get access.
The Hawaii proposal is one of a growing number of broader reform bills to have been introduced across the country this year as the debate on drug policy moves beyond marijuana. A measure introduced in New York earlier this month would remove criminal penalties for possessing small amounts of any controlled substance, instead imposing a $50 fine. Similar measures are expected to be introduced in California and Washington State this year.
A Florida lawmaker recently announced plans to introduce legislation to legalize psilocybin for therapeutic purposes in the state.
Lawmakers in New Jersey last month sent a bill to Gov. Phil Murphy (D) that would reduce criminal charges for the possession of psilocybin, but so far Murphy hasn’t signed the measure.
Voters, meanwhile, have been broadly supportive of drug reform measures in recent years. In addition to the psilocybin. measure, Oregon voters in November also approved an initiative to decriminalize possession of all drugs. Washington, D.C. voters overwhelmingly enacted a proposal to decriminalize the possession of psychedelics.
Despite the growing discussion of drug reform at statehouses across the country, some high-profile advocates are setting their sights on the 2022 election. Dr. Bronner’s CEO David Bronner, a key financial backer of successful reform efforts in Oregon, told Marijuana Moment last month that he’s expecting both Washington state and Colorado voters will see decriminalization or psilocybin therapy on their 2022 ballots.
Meanwhile, a new advocacy group is pushing Congress to allocate $100 million to support research into the therapeutic potential of psychedelics.
Photo courtesy of Wikimedia/Workman
Minnesota Governor Urges Lawmakers To Pursue Marijuana Legalization Amid Budget Talks
The governor of Minnesota on Tuesday implored the legislature to look into legalizing marijuana as a means to boost the economy and promote racial justice.
During a briefing focused on his budget proposal for the 2022-23 biennium, Gov. Tim Walz (D) was asked whether he is open to allowing sports betting in the state to generate tax revenue. He replied he wasn’t closing the door on that proposal, but said he is more interested in seeing lawmakers “take a look at recreational cannabis.”
Not only would tax revenue from adult-use marijuana “dwarf” those collected through sports betting, he said, but legalization would also help address “the equity issue and, quite honestly, the racial impact of our cannabis laws.”
Watch the governor discuss marijuana legalization below:
“I will say this, I will certainly leave open that possibility. Our neighboring states have done both of those things,” Walz said of legalizing sports gambling and cannabis. “I obviously recognize that that’s not a 100 percent slam dunk for people, and they realize that there’s cost associated with both. But my message would be is, I don’t think this is the time for me to say I’m shutting the door on anything.”
The Minnesota governor did say in 2019, however, that he was directing state agencies to prepare to implement reform in anticipation of legalization passing.
Earlier this month, the House majority leader said he would again introduce a bill to legalize marijuana in the new session. And if Senate Republicans don’t go along with the reform, he said he hopes they will at least let voters decide on cannabis as a 2022 ballot measure.
Heading into the 2020 election, Democrats believed they had a shot of taking control of the Senate, but that didn’t happen. The result appears to be partly due to the fact that candidates from marijuana-focused parties in the state earned a sizable share of votes that may have otherwise gone to Democrats, perhaps inadvertently hurting the chances of reform passing.
House Speaker Melissa Hortman (D) said this month that “Senate Republicans remain the biggest obstacle to progress on this issue.”
“Minnesota’s current cannabis laws are doing more harm than good,” she told The Center Square. “By creating a regulatory framework we can address the harms caused by cannabis and establish a more sensible set of laws to improve our health care and criminal justice systems and ensure better outcomes for communities,” she said.
Senate Majority Leader Paul Gazelka (R), for his part, said that while he would be “open to expanding medical use or hearing criminal justice reforms,” he doesn’t “believe fully legalized marijuana is right for the state.”
“Other states that have legalized marijuana are having issues with public safety,” he argued, “and we are concerned that we haven’t fully seen how this works with employment issues, education outcomes and mental health.”
Last month, the Minnesota House Select Committee On Racial Justice adopted a report that broadly details race-based disparities in criminal enforcement and recommends a series of policy changes, including marijuana decriminalization and expungements.
Another factor that might add pressure on lawmakers to enact the reform is the November vote in neighboring South Dakota to legalize adult-use cannabis.
Also next door, Wisconsin Gov. Tony Evers (D) is pushing lawmakers to enact marijuana reform and recently said that he is considering putting legalization in his upcoming budget request.
Photo courtesy of Philip Steffan.