A major overhaul of Texas’ medical cannabis program is poised to become law, following the near-unanimous passage of House Bill 46 — a long-debated measure aimed at expanding access to low-dose THC products for patients across the state.
The bill passed the Texas House 138–1 on Sunday after weeks of behind-the-scenes negotiations and public sparring between key lawmakers, most notably Lt. Gov. Dan Patrick and Rep. Tom Oliverson (R-Cypress). Their dispute centered around which medical conditions would be covered under the Texas Compassionate Use Program (TCUP), particularly the inclusion of “chronic pain.” After heated exchanges on social media, the two officials eventually reached a compromise.
Key Provisions of HB 46
The final version of the bill — now headed to Gov. Greg Abbott’s desk — marks the most significant expansion of TCUP since its inception. Among the most notable changes:
Expansion of qualifying conditions: “Chronic pain” and “traumatic brain injury” are now officially covered, alongside existing conditions such as epilepsy and PTSD. The inclusion of chronic pain was the central sticking point during negotiations.
Revised definition of chronic pain: Initially, the Senate tied eligibility to patients who had experienced pain for over 90 days after receiving an opioid prescription. That wording drew criticism from House members who argued it excluded many patients seeking cannabis as an alternative to opioids. The conference committee ultimately adopted a broader definition, allowing prescriptions where THC is deemed a “viable method of treatment,” regardless of opioid use.
Increased dispensary access: The number of licensed dispensary locations will increase from three to 15, with a preference given to Texas-based applicants. Three of the six newly created licenses will go to applicants who had already applied under previous rounds.
Prescription flexibility: Doctors will be allowed to issue cannabis prescriptions for anywhere from 1 to 90 days, rather than being limited to shorter-term scripts.
On-site storage and fingerprinting: Dispensaries will now be permitted to store products on-site, and owners will be subject to fingerprinting for added regulatory oversight.
Legislative input from physicians: The new law permits doctors to petition the Department of State Health Services (DSHS) to consider additional qualifying conditions for legislative review.
Veterans and Opioid Alternatives Take Center Stage
On the House floor, Rep. Ken King (R-Canadian), who helped guide HB 46 through final negotiations, emphasized the bill’s potential to reduce opioid dependency — especially among veterans.
“The Senate had defined ‘chronic pain’ as pain that continues for more than 90 days after a prescription of an opioid,” King explained. “This was not acceptable.”
Rep. Tony Tinderholt (R-Arlington), a veteran himself, pressed for clarity during floor debate.
“Veterans are covered?” he asked bluntly.
“Yes,” King confirmed.
Tinderholt concluded, “And this may actually, in a lot of instances — at least with veterans — this may decrease opioid addiction, by passing this law.”
A Balancing Act With Senate Bill 3
HB 46’s passage comes alongside a more restrictive measure — Senate Bill 3 — which bans the manufacture, sale, and possession of most THC products in Texas. The dual-track legislation represents a balancing act between lawmakers supporting medical access and those pushing for tighter regulations on recreational or unregulated THC.
While both bills now await the governor’s signature, SB 3 has drawn sharp criticism from hemp farmers, small retailers, and business advocacy groups, who argue it would devastate Texas' growing hemp industry. These stakeholders are urging Gov. Abbott to veto SB 3, even as they praise the passage of HB 46.
What Happens Next?
If signed into law, HB 46 would mark a significant shift in Texas’ approach to medical cannabis, increasing patient access and potentially setting the stage for broader reforms in the years to come.
Gov. Abbott has not yet indicated whether he will sign either bill. His decision could determine whether Texas expands its tightly regulated cannabis program while avoiding a clampdown on the broader THC market — or whether it sends mixed signals to patients and producers alike.
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