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Compassionate Use Registry of Texas

Senate approves one medical marijuana bill

A pleasant surprise.

Rep. Stephanie Klick

Marijuana advocates were handed an unlikely victory Wednesday after the Texas Senate advanced a bill greatly expanding the list of debilitating medical conditions that can legally be treated by cannabis oil in the state.

Although the upper chamber’s leadership once opposed bills that would relax the state’s pot policies, the Senate unanimously voted in favor of a bill by state Rep. Stephanie Klick, R-Fort Worth, that expands the state’s Compassionate Use Program, which currently allows the sale of cannabis oil only to people with intractable epilepsy who meet certain requirements.

The bill now heads back to the Texas House, where lawmakers can either approve the Senate changes or opt to iron out their differences in a conference committee before lawmakers adjourn in five days. Klick did not immediately respond to a request for comment on whether she’d accept the Senate changes to her bill.

The version of the bill approved by the Senate would expand the list of conditions that qualify for the medicine to include all forms of epilepsy; seizure disorders; multiple sclerosis; spasticity; amyotrophic lateral sclerosis, or ALS; terminal cancer; autism and incurable neurodegenerative diseases. The bill also axes a requirement in current statute that says those wanting access to the medicine need the approval of two licensed neurologists, rather than one.

“This bill is about compassion,” said state Sen. Donna Campbell, R-New Braunfels, the Senate sponsor of the bill. “For patients participating in the [Compassionate Use Program], they have had a remarkable and life-altering change because of this. That’s compassion.”

Under Campbell’s version of the bill, the Texas Department on Public Safety would still have oversight of the Compassionate Use Program. Her revised bill also keeps intact the 0.5% cap on the amount of the psychoactive element in marijuana, known as THC, that medical cannabis products are legally allowed to contain. Campbell’s version also axes a provision in Klick’s bill that calls for a research program to assess how effective cannabis is as a medical treatment option for various conditions.

See here for the background. For whatever the reason, Dan Patrick decided to cooperate and play nice, and so here we are. It’s not much, and it brings us no closer to the criminal justice reform part of this, but it’s a step forward, and the more of those the better. The House still needs to approve the Senate changes, and Greg Abbott still needs to sign it, but I feel good about this one going the distance.

House passes two bills to expand medical marijuana use

Bill Number One:

Rep. Eddie Lucio III

The Texas House on Monday advanced a bill that would expand the list of debilitating conditions that allow Texans to legally use medical cannabis.

House Bill 1365 would add Alzheimer’s, Crohn’s disease, muscular dystrophy, post-traumatic stress disorder, autism and a bevy of other illnesses to an existing state program that currently applies only to people with intractable epilepsy who meet certain requirements.

The bill would also increase from three to 12 the number of dispensaries the Texas Department of Public Safety can authorize to begin growing and distributing the product and authorizes the implementation of cannabis testing facilities to analyze the content, safety and potency of medical cannabis.

After a relatively short debate, the lower chamber gave preliminary approval to Democratic state Rep. Eddie Lucio III’s bill in a 121-23 vote. But the legislation still faces major hurdles in the more conservative Texas Senate before it can become law.

“Today, I don’t just stand here as a member of this body but as a voice for thousands of people in this state that are too sick to function or that live in constant, debilitating pain,” Lucio, D-Brownsville, told other lawmakers.

The Compassionate Use Act, signed into law in 2015, legalized products containing high levels of CBD, a non-euphoric component of marijuana, and low levels of THC, the psychoactive element in marijuana, for Texans with intractable epilepsy whose symptoms have not responded to federally approved medication.

Patients also must be permanent state residents and get approval from two specialized neurologists listed on the Compassionate Use Registry of Texas. While Lucio’s bill strikes the residency requirement, state Rep. John Zerwas, R-Richmond, successfully tacked on an amendment Monday saying those wanting to try the medicine only needed approval of one neurologist from the registry and a second physician who only needs to be licensed in the state of Texas and have “adequate medical knowledge” in order to render a second opinion.

Lucio’s bill is one of two which aim to expand the scope of the narrow Compassionate Use Act that have gained traction this legislative session. Another measure by Fort Worth Republican Stephanie Klick, an author of the 2015 program, is scheduled to get debated by the Texas House later in the week.

See here, here, and here for some background. The Compassionate Use Act was a big step forward, but it was also very limited, which this bill aims to improve on. As does Bill Number Two:

Four years after state Rep. Stephanie Klick authored legislation that legalized the sale of medical cannabis oil to Texans suffering from intractable epilepsy, the House gave tentative approval Tuesday to a bill by the Fort Worth Republican that would expand the list of patients eligible for the medicine.

House Bill 3703 would add multiple sclerosis, epilepsy and spasticity to the list of debilitating medical conditions that qualify for cannabis oil.

Her bill would also allow the state’s three dispensaries that are eligible to grow and distribute the medicine to open other locations if the Texas Department of Public Safety determines more are needed to meet patients’ needs. And the legislation calls for a research program to assess how effective cannabis is as a medical treatment option for various conditions.

[…]

The Compassionate Use Act, authored by Klick in 2015, legalized products containing high levels of CBD, a non-euphoric component of marijuana, and low levels of THC, the psychoactive element in marijuana, for Texans with intractable epilepsy whose symptoms have not responded to federally approved medication.

Under the law, Texans with intractable epilepsy only qualify for the oil if they’ve tried two FDA-approved drugs and found them to be ineffective. Patients also must be permanent state residents and get approval from two specialized neurologists listed on the Compassionate Use Registry of Texas.

Klick successfully added an amendment to her bill Tuesday saying the second doctor only needed to be a licensed physician, rather than a specialized neurologist.

Unlike Klick’s bill, Lucio’s strikes the residency requirement and says those wanting to try the medicine only need approval of one neurologist from the registry and a second physician who must be licensed in the state of Texas and have “adequate medical knowledge” in order to render a second opinion.

Either or both bills would be fine, and would do a lot to help people who need it. Alas, we live in a state that has unwisely chosen to give a lot of power to Dan Patrick. Sucks to be us.

No cannabis for you

Good luck getting your hands on medical marijuana in Texas.

It’s been about a year since the first legally grown marijuana plants were harvested in Texas for their medicinal oils. But since then, fewer than 600 patients have seen any benefit out of the estimated 150,000 who suffer uncontrollable epileptic seizures that the medicine is meant to help.

Roughly 45 doctors, mostly concentrated in urban areas, have signed up to prescribe the cannabidiol. Just three companies in Central Texas have been licensed to distribute the drug. One doesn’t seem to have opened its doors, and another reports losing money with such a small client base.

“The way to assure the Compassionate Use Program has a future is by expanding access to more patients,” said Morris Denton, CEO of Compassionate Cultivation in the Austin area. “The worst thing that can happen is nothing gets done, because then we set the program back.”

Texas’ therapeutic marijuana program is among the strictest in the nation, giving only patients with intractable epilepsy access to cannabidiol that’s low in THC, the element that gives pot users a high.

[…]

The Texas Compassionate Use Act became law in 2015, but the rollout has been slow and rocky.

Despite getting more than 40 applications, the Texas Department of Public Safety licensed just three companies last year to distribute cannabidiol, the minimum number allowed by the law.

Patients need sign-off from two doctors to use the marijuana-derived oil. But so far, fewer than 50 certified epileptologists and neurologists have registered to participate. None is in the Rio Grande Valley or West Texas, records show, meaning patients there must travel far to see a qualified physician.

Some doctors are reluctant to enroll because Texas law requires they prescribe the drug instead of recommending it, a phrase other states use to sidestep federal marijuana prohibitions, advocates said. So far, 574 patients have been issued prescriptions, according to the Texas Department of Public Safety, which oversees the program.

See here for some background, and here for a map of where the registered doctors are. If you live west of San Antonio, it’s Amarillo or nothing. There will be bills introduced to expand medical marijuana in Texas – Sen. Jose Menendez has already filed one such bill – and they may have a chance to get through. Greg Abbott has softened his stance, both party platforms are calling for marijuana reform, there’s popular support, and so forth. It’s just that it’s not easy to get any bill passed, and if a given bill isn’t a priority then it will be in line behind those that are. I don’t think there’s much in the way of opposition to expanding medical marijuana, and maybe to some other reforms, but I don’t think it’s a priority, either.

Medical marijuana is now available in Texas

To a very limited number of people, and only under a very strict set of circumstances.

Modern medicine has helped Laura Campbell’s 27-year-old daughter, Sierra, fight off many of her persistent seizures. At her peak, Sierra suffered from more than three seizures a day. Now, she’s down to one or two per month.

But the gains come with their own frustrations.

“She takes five pills twice a day, plus more if she needs an emergency supplement in case of a seizure. It damages her brain every time she has [a seizure]. Her IQ has gone down and her neurological functions are suffering,” Campbell said, trailing off between tears. “With every seizure she has, it just gets worse for her.”

Now Campbell, an Austin resident, is hoping she can wean her daughter off the “harsh” meds and turn to cannabis oil instead. That treatment was legalized in 2015, and a dispensary in Schulenburg made its first delivery of the oil to a young Texas child last week.

But as dispensaries are opening, Texans like Campbell’s daughter might still have a hard time getting access to the oil from marijuana plants. Currently, fewer than 20 doctors across the state are registered with the Texas Department of Public Safety to prescribe it.

They are able to do so under the Texas Compassionate Use Act, which legalized the sale of a specific kind of cannabis oil for a small group of Texans: epilepsy patients, like Sierra, whose symptoms have not responded to federally approved medication.

But to qualify for the medicine, Texans must have tried two FDA-approved drugs and found them to be ineffective. The patients also must be permanent residents of Texas and get approval from two of the 18 doctors listed on the Compassionate Use Registry of Texas.

Under the law, a physician can only sign up for the state registry if, among several other requirements, the doctor has dedicated a significant portion of his or her clinical practice to the evaluation and treatment of epilepsy and is certified by the American Board of Psychiatry and Neurology in either epilepsy or neurology.

The bill in question was passed in 2015, so it’s taken awhile just to get to this point. There are only three dispensaries in the state, and there’s not likely to be many more doctors on the registry, at least not while Jeff Sessions is on a reefer madness kick. The effect of this law should be big for those who are able to take advantage of it, but the number of such people will be very small. I hope that effect is enough to allow for a broader bill in the next Legislature, but the surer route to that destination is to vote for candidates who are willing to support that outcome. The Chron has more.