Low-THC Cannabis Medical Use
Texas qualified physicians may prescribe low-THC cannabis for the treatment of approved medical conditions, under conditions established in Texas laws and regulations. In 2015, Governor Greg Abbott signed Senate Bill 339, known as the Texas Compassionate-Use Act, authorizing low-THC cannabis to be prescribed to treat patients with intractable epilepsy. Since then, the Texas Legislature has expanded the list of approved conditions for medical treatment.
The Texas Legislature also tasked the Texas Health and Human Services Commission (HHSC) with creating rules to:
- designate “incurable neurodegenerative diseases” for which patients may be prescribed low-THC cannabis; and
- designate the medical conditions for which a patient may be treated with low-THC cannabis as part of a compassionate-use institutional review board (CIRB) approved research program.
- define pulmonary inhalation devices that may be prescribed for low-THC cannabis use and establish a timeline for reviewing and approving such devices.
The executive commissioner of HHSC charged rule development to the Texas Department of State Health Services (DSHS). This webpage provides information on the medical use of low-THC cannabis in Texas, DSHS rules, and provides guidance for CIRBs’ reports.
Additional Information
The Texas Department of Public Safety (DPS) administers the licensing of dispensing organizations, employee registration as part of the dispensing organization license, and physician registration in the Compassionate Use Registry. For more information, including information on related rules in DPS’ purview, visit the DPS Compassionate Use Program website.
Legislation
Rules
The executive commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), has adopted the following rules relating to low-THC cannabis for medical use:
25 Texas Administrative Code, Section 1.61 designates incurable neurodegenerative diseases eligible for prescription of low-THC cannabis. This rule was required by House Bill 3703, 86th Legislature, Regular Session, 2019. It took effect December 5, 2019.
25 TAC Section 1.65 provides guidance for a compassionate-use institutional review board (CIRB) to evaluate, approve, and oversee research programs to study the medical use of low-THC cannabis. This rule also requires CIRBs to submit written reports that describe and assess the research findings to HHSC and the Legislature. The rule was necessary to comply with House Bill 1535, 87th Legislature, Regular Session, 2021. It took effect November 17, 2021.
25 TAC Section 1.63 defines a pulmonary inhalation device a physician may prescribe to a qualified patient and establishes a timeline for reviewing pulmonary inhalation devices. The rule was necessary to comply with House Bill 46, 89th Legislature, Regular Session, 2025.
DSHS defines a pulmonary inhalation device as a device designed, marketed, and dispensed to allow a patient to inhale an aerosolized or vaporized substance. A pulmonary inhalation device must not burn or ignite a substance for the purpose of inhaling smoke.
Bills and Statutes
House Bill 3703 – Enacted by the 86th Texas Legislature, Regular Session, 2019. It amended Texas Occupations Code, Chapter 169 and required the executive commissioner of HHSC, in consultation with the National Institutes of Health, to adopt a rule designating incurable neurodegenerative diseases eligible for prescription of low-THC cannabis. This bill took effect September 1, 2019.
House Bill 1535 – Enacted by the 87th Legislature, Regular Session, 2021. It amended Texas Health and Safety Code, Chapter 487 by requiring the executive commissioner of HHSC to adopt rules designating the medical conditions for which a patient may be treated with low-THC cannabis as part of an approved research program. The bill also authorizes the establishment of one or more CIRBs to evaluate, approve, and oversee research programs to study the medical use of low-THC cannabis and requires CIRBs to submit written reports that describe and assess the research findings to HHSC and the Texas Legislature.
House Bill 46 - Enacted by the 89th Legislature, Regular Session, 2025. It amended Texas Health and Safety Code, Chapter 487, to allow qualified physicians to submit to DSHS a request that DPS report to the legislature that low-THC cannabis may be beneficial to treat a specific medical condition not already listed in statute. Such requests must be accompanied by medical evidence such as peer-reviewed published research. House Bill 46 requires the executive commissioner of HHSC to adopt rules prescribing the manner of such requests. The bill also requires the executive commissioner to adopt rules related to devices for the pulmonary inhalation of low-THC cannabis and a timeline for reviewing and granting approval for such devices. Both requests must be made through the submission of the Request to Add Medical Conditions for Which a Physician May Prescribe Low-THC Cannabis or Add Pulmonary Inhalation Devices for Low-THC Cannabis form.
Incurable Neurodegenerative Diseases
Physicians can submit a request to add Incurable Neurodegenerative Diseases to 25 Texas Administrative Code, Section 1.61 (b) by submitting the required form to HPCDPSprovider@dshs.texas.gov.
If the condition is approved, the submitter will be notified, and the rule will be amended during the next rule-making project. If the condition is declined, the submitter will be notified of the decision not to add.
Non-Neurodegenerative Diseases
Physicians can submit a request to add Non-Neurodegenerative Diseases to 25 Texas Administrative Code, Section 1.61 (b) by submitting the required form to HPCDPSprovider@dshs.texas.gov. DSHS will review and route requests to the DPS Texas Compassionate Use Program.
If the non-neurodegenerative disease is approved, the requestor will be notified through email, and the rule will be amended during the next rulemaking project. If the non-neurodegenerative disease is declined, the requestor will be notified through email of the decision not to add.
Approved Pulmonary Inhalation Devices for Low-THC Cannabis
DSHS will maintain a list of approved pulmonary inhalation devices for low-THC cannabis on this page.
How to Submit Research Findings Report on Medical Use of Low-THC Cannabis
25 Texas Administrative Code, Section 1.65 requires each compassionate-use institutional review board (CIRB) established to evaluate and approve proposed research to study the medical use of low-THC cannabis, in accordance with Texas Health and Safety Code, Section 487.253 to:
Submit a written report that describes and assesses the research findings of each approved research program to the Texas Department of State Health Services. Only electronic reports are accepted, please do not mail a hard copy of the report. The report is due no later than October 1 of each year.
Report may be submitted to:
Texas Department of State Health Services
Community Health Improvement Division
Health Promotion and Chronic Disease Prevention Section
HPCDPSprovider@dshs.texas.gov- Submit a written report that describes and assesses the research findings of each approved research program to the Texas Legislature. The report is due by October 1 of each even-numbered year.
Report may be submitted to:
The Lieutenant Governor and the Speaker of the House of Representatives of the Texas Legislature.
Contact Information
Texas Department of State Health Services
Community Health Improvement Division
Health Promotion and Chronic Disease Prevention Section
MC 1965
PO Box 149347 Austin, TX 78714-9347
1100 West 49th Street
Austin, TX 78756
Phone: (512) 458-7111