| Perspectives on Texas

It’s a new era for Texas, with a certain kind of medical cannabis now available to qualifying patients.

In recent weeks, state-licensed providers have opened for business under the state’s landmark Compassionate Use Act (Senate Bill 339), which allows qualified physicians to prescribe low-THC medical cannabis to patients diagnosed with intractable epilepsy. Many Texans are wondering how to go about qualifying for and obtaining medical cannabis under this law.

As a neurologist and epileptologist who is approved by the Texas Department of Public Safety to prescribe medical cannabis under the CUA, allow me to illuminate the potential of this kind of medical cannabis for certain patients and clarify the process of qualifying for low-THC cannabis under Texas law.

Cannabidiol for epilepsy

Approximately 30 percent of people with epilepsy continue to have seizures despite conventional treatments. Cannabidiol (CBD), a non-psychoactive compound found in the cannabis plant, has emerged as a promising alternative treatment option.

Research indicates CBD treatments may decrease the frequency of convulsive seizures in some patients suffering with intractable epilepsy. Many patients and caregivers have come forward across the country in recent years reporting positive results to CBD.

CBD first gained recognition as a potentially promising treatment for certain seizure disorders in 1980, when Israeli biochemist Raphael Mechoulam released promising findings from a study on epilepsy patients undergoing CBD treatments.

In 2013, the alternative treatment began garnering mainstream attention in the United States when CNN’s chief medical correspondent Dr. Sanjay Gupta, a neurosurgeon, covered the story of Charlotte Figi, a young girl suffering from a severe form of epilepsy known as Dravet Syndrome, whose symptoms greatly improved with the use of CBD.

Gupta’s coverage set off a wave of scientific interest across the country and paved the way for new legislation in many states allowing for the medical use of CBD for the treatment of epilepsy and seizure disorders, including Texas.

“This bill is a big win for Texas families,” Texas state Rep. Stephanie Klick, co-author and champion of the Texas Compassionate Use Act, wrote in a news release following the bill’s passage in 2015. “Intractable epilepsy is a difficult disease to live with and I am excited that there is another treatment option for those who suffer from it.”

Now that the CUA has been implemented, here’s what it means for Texas patients.

Qualifying for medical cannabis in Texas

Patients seeking to qualify for the medical cannabis program in Texas must be permanent residents of the state who have been diagnosed with intractable epilepsy by a qualified physician who specializes in the field of examining, diagnosing and treating epilepsy.

Texas law defines intractable epilepsy as “a seizure disorder in which the patient’s seizures have been treated by two or more appropriately chosen and maximally titrated antiepileptic drugs that have failed to control the seizures.”

Under the law, patients can not register themselves for the medical cannabis program. Rather, prescribing physicians must register the patient with the DPS Compassionate Use Registry of Texas (CURT) database after diagnosing them with intractable epilepsy and determining the risks associated with low-THC cannabis are reasonable in light of the potential benefits of the treatment.

Only qualified physicians who have also enrolled with the CURT database may write prescriptions for medical cannabis. A growing list of registered physicians is available on the state’s Compassionate Use Program web portal under the “Licensing” tab.

Physicians’ roles in prescribing medical cannabis

Upon proper diagnosis and determination, the qualified physician will register as a patient’s prescriber and submit the patient’s diagnosis and treatment plan to the CURT database. Patients or a guardian must provide information such as date of birth, home address and the last five digits of the patient’s social security number.

For minors or dependent adults, the legal guardian must also provide the last five digits of their own social security number.

A second physician who is also registered in CURT must review the patient’s information and concur with the primary physician’s diagnosis and verify that a CBD trial is reasonable.

The CURT system is a secure online platform accessible 24 hours a day to physicians, dispensing organizations and law enforcement. There are no fees associated with registering as a medical cannabis patient in Texas. Once registered in the database, patients and their legal guardians will be exempt from certain state laws prohibiting the possession of marijuana in Texas.

What type of medical cannabis products are available?

Texas law only allows for the medical use of non-smokable forms of low-THC cannabis oil (which lack the psychoactive effects of high-THC cannabis). The cannabis oil is extracted from plants grown in state-regulated facilities.

A list of dispensing organizations is available on the state’s Compassionate Use Program website (dps.texas.gov/RSD/CUP/). Legal guardians can pick up cannabis oil prescriptions from a dispensing location on behalf of patients, so long as the prescribing physician has submitted the guardian’s information to the state for identification purposes. Licensed dispensing organizations also provide statewide delivery services.

This medicine has the potential to improve the lives of Texans of all ages. When Compassionate Cultivation became the state’s first licensed dispensary to accept patients in February, a 2-year-old boy was among the first patients to receive a prescription for cannabis oil.