How Expanded Medical Cannabis Access Impacts Texas Veterans with PTSD and Chronic Pain

What Texas Changed (HB 46)

Texas passed HB 46, the most significant update to the Compassionate Use Program (TCUP) since its start in 2015. Effective September 1, 2025, the law brings these key changes:

• More qualifying conditions added: chronic pain, Crohn’s/IBD, traumatic brain injury, and terminal illness/hospice (joining PTSD and existing conditions). (MPP)
  
• Modernized dosing rules: replace the “≤1% by weight” rule with ≤10 mg THC per dosage unit and a ≤1 g THC per package cap. Physicians retain the flexibility to set dosing. (MPP)
  
• Medical inhalation allowed (no smoking): aerosol/vapor devices permitted when prescribed; smoking remains prohibited. Agencies must set device standards. (MPP)
  
• Longer prescription duration: recommendations valid for up to 1 year, with four 90-day refill periods and partial fills allowed. (MPP)
  
• Expanded supply and licensing: DPS must issue enough licenses to reach 15 dispensaries statewide. The first new application window ran from August 15–September 15, 2025. (Texas DPS)
  
• Preemption of local bans: cities/counties may not prohibit cultivation, production, storage, dispensing, or possession of state-authorized low-THC cannabis. (Capitol Texas)
  

Bottom line: HB 46 isn’t just about adding diagnoses—it reshapes eligibility, dosing, delivery, and supply so clinicians can better match products and routes of care to veterans’ needs. (MPP)

What Veterans Will Notice

For veterans, these changes feel practical. With more qualifying conditions and year-long prescriptions, the process is smoother and less repetitive—cutting down extra visits and giving veterans more stability in their care. (MPP)

As DPS licenses more dispensaries, expanded storefronts and delivery options will make access less of a burden. That progress brings optimism and a sense of forward momentum. (Texas DPS)

Safety guardrails are built in, too. Clear per-dose and per-package limits, plus medical device standards for inhalation, give veterans confidence that safety is being taken seriously. (MPP)

How the Process Works (Texas)

Here’s what the process looks like under HB 46:

1. See a CUP-registered physician. If they find cannabis appropriate, they’ll enter the prescription directly into CURT, the state’s secure electronic system—no paper scripts needed.
   
2. Pick up your medication from a state-licensed dispensing organization after your ID is verified in CURT.
   
3. Available formats include oils, tinctures, capsules, lozenges, and aerosols/vapors. Smoking is still prohibited.
   
4. Duration: Up to 1 year with four 90-day refills, depending on your doctor’s plan. (Texas DPS)
   

The Texas Retail Hemp / Vaping Context (Separate from TCUP)

It’s worth noting what’s happening outside of TCUP:

• THC vape sales ban: As of September 1, 2025, Texas banned the sale and marketing of THC vape pens. Possession rules vary. (The Texas Tribune)
  
• New age-gating rules: On September 10, 2025, Gov. Abbott ordered 21+ age verification for THC/THC-A retail sales. This does not affect TCUP prescriptions. (Houston Chronicle)
  

In short, the medical program is expanding, while general retail hemp THC rules are tightening. (Texas DPS)

Federal & VA Rules (Unchanged for Now)

• Federal law: Cannabis remains a Schedule I substance until the DEA finalizes its pending rescheduling proposal. For now, it’s still federally illegal. (Moritz College of Law)
  
• VA policy: VA clinicians may talk with veterans about cannabis and document use, but they cannot prescribe, certify, or pay for it. State-legal use won’t cost you your benefits, but don’t bring cannabis onto VA property. (VA Public Health)
  

What This Means for Nonprofits (Gifting & Compliance)

For 501(c)(3) veteran-serving nonprofits:

Allowed: education, outreach, neutral sponsor acknowledgments, and grants for non-cannabis supports like housing, utilities, or transportation.

Not allowed: funding cannabis products, paying for certifications, or promoting vendors. Federal law and IRS rules still prohibit direct cannabis support. Keep sponsor recognition brand-neutral (just name/logo, no product claims). (Moritz College of Law)

Where TCUP Meets VA Care

Veterans should share cannabis use with their VA clinicians. This ensures safe coordination with PTSD therapies, pain management, medications like sedatives or blood thinners, and workplace/driving safety. VA benefits are not at risk for state-legal use. (VA Public Health)

Quick Checklist for Veterans & Caregivers

• Confirm eligibility: PTSD, chronic pain, TBI, Crohn’s/IBD, etc. (MPP)
  
• Find a CUP-registered physician and plan out your one-year prescription and refills. (Texas DPS)
  
• Know your formats: oils, capsules, lozenges, and aerosols/vapors (no smoking). (MPP)
  
• Expect expanded access as DPS rolls out new licenses. (Texas DPS)
  
• If you’re in a safety-sensitive job, review drug testing policies and talk to your clinicians about risks. (VA Public Health)
  

FAQs (Texas-Specific)

Is smoking medical cannabis legal?
No. HB 46 allows inhalation via aerosol/vapor devices only. Smoking is still prohibited. (MPP)

How much THC per dose?
Up to 10 mg THC per dosage unit; max 1 g THC per package. (MPP)

Will there be a dispensary near me?
DPS is licensing up to 15 organizations, with applications accepted August 15–September 15, 2025. (Texas Department of Public Safety)

Can my city block a dispensary?
No. Local governments cannot prohibit authorized TCUP activities. (Capitol Texas)

Will VA pay for cannabis?
No. VA cannot prescribe or pay for cannabis or certifications, but you can discuss your use openly with VA clinicians. (Public Health VA)

Sources to Bookmark

• HB 46 (enrolled text & summary) — eligibility, dosing, devices, licensing, local preemption. (Capitol Texas)
  
• DPS TCUP Licensing Updates & Application Window — August 15–September 15, 2025. (Texas Department of Public Safety)
  
• Texas THC Vape Sales Ban / Retail Hemp — current restrictions. (The Texas Tribune)
  
• Federal / VA Policy — rescheduling status; VA discussion-allowed/ no-prescribing. (Moritz College of Law)

Takeaway

Texas law now supports clinician-guided, non-smoked cannabis for more conditions, with clear dosing rules and wider access. But since federal law hasn’t caught up, veterans and nonprofits should stay compliant with state rules, keep cannabis activities brand-neutral, and always loop VA clinicians into their care.