Texas Lawmakers Approve MMJ Expansion. Will the Governor OK It?

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Texas lawmakers took a significant step toward creating a more comprehensive medical cannabis program over Memorial Day weekend, sending a bill to Gov. Greg Abbott (R) that aims to open the program to thousands more patients.

The passage of House Bill 3703 salvaged what, for a time, appeared to be a relatively unproductive legislative session for cannabis issues. The Legislature took up a number of bills this session, including one that would have decriminalized cannabis statewide, but the only other major proposal to pass was a bill legalizing hemp and CBD oil.

HB 3703 removes the two-physician requirement and expands the state's qualifying conditions list.

HB 3703 was authored by Republican state Rep. Stephanie Klick of Fort Worth, who wrote the state’s original Compassionate Use Act in 2015. Klick did not support expansion in 2017 but has since changed her mind on the issue in light of “more data that has come out.”

The measure now heads to the governor, who has been hesitant to expand legalization of any kind of cannabis in Texas. Though Abbott has not publicly commented on whether he intends to sign the bill, KTXA-TV reported last week that he was expected to sign it, and The Dallas Morning News reported that Klick believes Abbott will support the bill.

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What the Bill Does

HB 3703’s most significant feature is that it expands the list of qualifying conditions for which a physician can prescribe medical cannabis.

The only condition that currently can be treated legally with medical cannabis is intractable epilepsy—and only if two physicians concur that other treatments have proven ineffective and that medical cannabis is necessary for the patient.

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HB 3703 removes the two-physician requirement and expands the qualifying conditions list to include:

  • Epilepsy (no longer specifically “intractable” epilepsy)
  • Seizure disorders
  • Multiple sclerosis
  • Spasticity
  • Amyotrophic lateral sclerosis (ALS)
  • Autism
  • Terminal cancer
  • Incurable neurodegenerative diseases (e.g. Alzheimer’s, Parkinson’s, Huntington’s)

Prescribing physicians must be “board certified in a medical specialty relevant to the treatment of the patient’s particular medical condition by a specialty board approved by the American Board of Medical Specialties or the Bureau of Osteopathic Specialists,” the bill says, and must dedicate a “significant portion of clinical practice to the evaluation and treatment of the patient’s particular medical condition.”

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What the Bill Does NOT Do

While the passage of HB 3703 is a notable victory for cannabis legalization advocates in Texas, it falls short in a few areas.

The bill retains the state’s current 0.5% THC limit on cannabis products, which means state-legal products generally won’t produce a cannabis high. That amount is significantly lower than what’s available in medical cannabis available in other states, where cured cannabis can contain up to about 30% THC and concentrates can contain even more.

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The bill also doesn’t include some qualifying conditions that supporters fought hard to incorporate, such as chronic pain or post-traumatic stress disorder (PTSD). Advocates will have to look to the 2021 legislative session for that.

State Sen. Donna Campbell (R), who sponsored the bill in the Senate, said during debate on the Senate floor that research did not justify expanding medical cannabis to those suffering from PTSD.

“We just don’t have the data—good scientific data—that supports PTSD that we can put in the bill at this time,” Campbell said, according to The Texas Tribune. “To our veterans and our first responders: Thanks for speaking out. We hear you. But most importantly, we thank you for your service. I hope—I hope—that we can get the definitive research necessary to be able to include PTSD, traumatic brain injury, and those other illnesses that are very difficult to measure.”

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An Uphill Battle

HB 3703’s passage was far from a sure thing. Lt. Gov. Dan Patrick has stonewalled cannabis legalization bills in the Senate before. This time around, however, Patrick reportedly worked with lawmakers to amend the bill in the Senate before its ultimate passage.

Although the Texas Republican Party officially began supporting the expansion of the Compassionate Use Act last year, there are still some Republicans, such as state Sen. Brian Birdwell, who are concerned that this small step will inevitably lead to legalization of cannabis for all adults.

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That fear of a slippery slope has caused some Republican lawmakers to oppose allowing access to medical cannabis for patients who could greatly benefit from it.

For his part, Birdwell worries it’s more of a “cliff” than a slope, and expressed concern that cannabis in Texas could become “the next opioid crisis.” [Editor’s note: While opioids are co-responsible for thousands of overdose deaths each year, cannabis has caused no fatal overdoses in recorded history, and preliminary studies indicate that cannabinoids may actually help reduce opioid dependence.]

“I come at this with a highly guarded sense of danger of the direction that this might take us to recreational use,” Birdwell said during Senate debate. “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.”

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Some Democrats had reservations of their own about HB 3703, but their concerns were generally that the bill didn’t go far enough and excluded too many potential patients by not including PTSD and other conditions.

Gov. Abbott has until June 16 to sign or veto the bill, which would take effect Sept. 1.