The Texas medical marijuana program, explained

Short answer

Texas has a medical cannabis program called the Texas Compassionate Use Program. A registered doctor can prescribe low-THC cannabis (no more than 10 milligrams of THC per dose) to a permanent Texas resident with a qualifying condition, which since September 1, 2025 includes chronic pain, traumatic brain injury, Crohn's disease, PTSD, all cancers and more.

There is no physical medical card. Prescriptions go into a state registry run by DPS, and only state-licensed dispensing organizations can fill them. Smoking is not allowed.

What the program is

The Texas Compassionate Use Program (people shorten it to TCUP) was created by SB 339 in 2015. It lets licensed physicians prescribe "low-THC cannabis" to qualifying patients and lets a limited number of state-licensed businesses, called dispensing organizations, grow, process and dispense it. The Texas Department of Public Safety runs the licensing and the Compassionate Use Registry of Texas, where physicians enter prescriptions (DPS program page). The medical rules for prescribing live in Chapter 169 of the Occupations Code, as amended by HB 46.

For years Texas sat on lists of states without a "real" medical program because the THC cap was so low. The 2025 expansion changed enough that advocacy groups now count Texas as a medical state, while noting it is still one of the more restrictive programs in the country.

Who qualifies

Under the law as amended by HB 46 (enrolled text), a physician may prescribe low-THC cannabis to a patient who is a permanent resident of Texas and is diagnosed with:

• epilepsy or a seizure disorder
• multiple sclerosis
• spasticity
• amyotrophic lateral sclerosis (ALS)
• autism
• cancer (any kind, not only terminal)
• an incurable neurodegenerative disease
• post-traumatic stress disorder (PTSD)
• a condition that causes chronic pain
• traumatic brain injury
• Crohn's disease or another inflammatory bowel disease
• a terminal illness, or a condition for which the patient is receiving hospice or palliative care
• a condition approved for a state research program, if the patient is being treated under that program

"Chronic pain" has a specific legal definition: severe pain, continuous or on and off, lasting more than 90 days, associated with a chronic disease process, not relieved by ordinary pain treatment, and for which THC is a viable treatment. The physician also has to decide the risk is reasonable given the potential benefit. Doctors can ask DSHS to report to the Legislature that another condition may benefit, with medical evidence, but only the Legislature can add it.

What it allows

• THC limits. Low-THC cannabis may contain no more than 10 milligrams of THC per dosage unit. A package, or a device for inhalation, may contain no more than one gram of THC in total. Products may only contain naturally produced cannabinoids.
• Forms. Oral products, plus other routes such as lotions and patches. A doctor can prescribe inhalation of an aerosol or vapor when medically necessary, specifying the dose. Smoking (burning and inhaling smoke) is excluded from the legal definition of medical use.
• Supply. Each prescription covers up to a 90-day supply and can include up to four refills. A doctor may prescribe more than one package in 90 days.
• Local bans are off the table. Cities and counties cannot prohibit the cultivation, production, storage, dispensing or possession of low-THC cannabis that the program authorizes.
• Privacy. Patient identity in the registry is confidential and available only to DPS, registered physicians and dispensing organizations, with release to the patient on request.

How to get started, in general terms

1. Find a registered physician. Only doctors registered with the Compassionate Use Registry can prescribe. DPS maintains the registry, and many patients find a registered doctor through their own care team or the program's public information.
2. Get evaluated. The doctor confirms you are a permanent Texas resident with a qualifying condition and decides whether low-THC cannabis is appropriate for you.
3. Prescription goes in the registry. The doctor enters the prescription electronically. There is no card to carry. Keep your own records of the prescription.
4. Fill it through a licensed dispensing organization. Only state-licensed dispensing organizations can fill prescriptions, at their locations or approved satellite locations. DPS publishes which organizations are licensed.

We do not list or recommend doctors or dispensing organizations. The official source for who is licensed and registered is the DPS Compassionate Use Program page.

How it changed over time

Each of these has an entry with sources in the medical program tracker.

The license expansion

HB 46 requires DPS to issue 15 dispensing licenses in total, if enough qualified applicants apply, and to spread them so patients in every public health region have reasonable access. Texas had three operating licensees when the bill passed. The law set two deadlines for new licenses: at least nine by December 1, 2025 and at least three more by April 1, 2026.

DPS ran the selection in two phases and named conditional licensees, then corrected its scoring in May 2026, which changed some of the names (DPS updates). A conditional license does not let a company grow or sell anything until DPS finishes due diligence and issues a final license, and a licensee then has 24 months to start dispensing. Expect new locations to roll out over the next couple of years rather than all at once.

What it does not cover

• Recreational use, or anyone without a qualifying condition and a registered prescription.
• Smoking, or products above the THC limits.
• Home growing. Only licensed dispensing organizations can cultivate.
• Out-of-state medical cards. Texas does not recognize them, and the program is for permanent Texas residents.
• Driving while impaired. A prescription is not a defense to DWI.
• Employers. The program does not require employers to allow use, and federal rules still govern some jobs (commercial drivers, for example).
• Hemp products. Those are a separate legal category regulated by DSHS, not part of the medical program.