Medical pot hits Texas market
Advocates hope more conditions will be eligible
The first delivery of prescription marijuana in Texas went out last week, a historic but limited step in a state playing catchup to 29 others that already have legalized cannabis for medical use.
For many of the 150,000plus Texans living with intractable epilepsy, it felt like an answered prayer.
“It has the potential to be life-changing for my family,” a tearful Terri Carriker said, recalling the decadelong wait to treat her daughter’s epileptic seizures with a low-THC strain of cannabis.
Her 15-year-old daughter, Catherine, has suffered seizures daily since she was 3. The family tried just about every drug on the market to soothe the relentless pain, but the girl consistently failed to improve, and the side-effects grew more severe.
Under the state’s Compassionate Use Program, Catherine now qualifies to receive prescribed low THC cannabis medication — a promising, though not guaranteed, shot at a better life. Her family expects to pick up her first prescription from a local dispensary by the end of the month.
“I can hardly think about it without getting emotional,” Carriker said.
The family’s story highlights the hope of a new option for a devastating medical condition, but advocates worry about limited access to Texas’ program. Because the Carrikers live in Austin, for example, their daughter won’t have to leave her hometown to get care. But with just three dispensaries in a state as large as
Texas, families in fartherflung locales could have a much more difficult time, they say.
Narrow scope
Signed into law in 2015, and overseen by the Department of Public Safety, Texas’ Compassionate Use Program is limited to helping only patients diagnosed with intractable epilepsy who have exhausted all other medicinal options and can prove no negative side effects from the drug.
This means the program excludes the son of Carriker’s friend, Bonnie Jensen of League City. While 12-year-old Micah Jensen has epilepsy, his specific type and the frequency of his seizures disqualify him for medical cannabis under the program’s narrow scope.
“He would be close to qualifying, but it’s hard to get a diagnosis for intractable epilepsy,” said Jensen, who would like to try medical marijuana.
Even if Micah were to qualify, Jensen, unlike Carriker, would need to either drive a longer distance or rely on a delivery service to physically get the medicine.
Last year, DPS licensed only three dispensaries that can grow, process and sell medical marijuana. Two are in Austin; the other is in Schulenburg, 80 miles west of Houston.
Further restricting access, just 17 physicians — none in West Texas or south of San Antonio — were registered to prescribe cannabis as of Feb. 1.
The dearth of both dispensaries and physicians concerns advocates and patients alike.
“We simply can’t go forward with three dispensaries for a state this size,” said Frank Snyder, a Texas A&M University law professor who studies the legal marijuana industry.
When asked of the possibility of opening more in the future, a DPS spokesman pointed to the law enforcement agency’s website where it states that “a decision to increase the number will be made if and when it is determined that more licenses are required in order to ensure reasonable statewide access.”
6 in Houston area
Health care providers worry about patients’ access to the consultations needed for a prescription in the first place.
Under the program’s regulations, an eligible patient must seek consultation from a doctor registered in the program, then acquire a second opinion. Only then can the registered doctor input the patient’s information into a registry and prescribe lowTHC cannabis.
Since there isn’t sufficient data regarding proper dosage amounts, doctors will want to monitor their patients carefully on a regular basis, said Valerie Coffman, coordinator at Kelsey-Seybold Clinic’s Epilepsy Support Group.
This could lead to costly trips out of town for families who don’t live near a registered doctor, Coffman said.
Kelsey-Seybold in Houston has two doctors registered with the program. There are six doctors total in Greater Houston, including Katy and The Woodlands.
While acknowledging concerns over lack of federally approved studies on the drug, Coffman noted that preliminary research points to some benefits with few downsides.
“If it improves their quality of life in any way, that’s the goal here,” she said.
Kelsey-Seybold is already getting calls from new patients seeking consultation. Coffman knows of at least 10 current adult patients who would qualify for the program.
The clinic’s Dr. Michael Newman said he’s not concerned about the possibility of losing his medical license for prescribing what is still a federally illegal drug. He noted that DPS is strictly monitoring the program and that the level of THC allowed in the medicine is too low to serve any hallucinogenic purpose.
Yet Heather Fazio of the lobbying group Marijuana Leadership Campaign warned that doctors could face an issue with the U.S. Drug Enforcement Administration.
Unlike other states with medical marijuana programs, Texas requires doctors to prescribe, not recommend, the drug. In light of U.S. Attorney General Jeff Sessions’ actions and rhetoric, seen by some as part of a larger effort to curtail marijuana legalization, Fazio and others worry about the DEA removing doctors’ registration to prescribe all drugs.
Though the Texas program defines prescription differently than the DEA, it’s still leaving doctors with only a technicality as protection, Fazio and others said.
‘It’s history’
Despite their concerns, Fazio and other advocates see the Compassionate Use Program as a success.
“There are legal marijuana plants growing in Texas. It’s history,” said Patrick Moran, co-founder of the Texas Cannabis Industry Association. He added that he sees no chance of the program being undone at the federal level.
Moran points to the existing economic investment. Each of the three licensed dispensaries has invested a minimum of $4 million in building out their facilities and personnel, Moran said. The twoyear renewable license alone costs $488,520.
During the bidding process for the licenses, 40 other companies applied, marking at least $32 million of investment in the application process overall, Moran added.
The licensed dispensaries are already shipping orders or soon will be, further adding to the program’s economic impact.
Cansortium Texas in Schulenburg delivered its first prescription to a 6-year-old girl in Central Texas on Thursday. The company charges $90 for 600 milligrams of its lowTHC medication, and $135 for 900 milligrams. There is no delivery fee for orders above $250.
Cansortium Texas is owned by Knox Medical, a Florida company with operations in Florida, Pennsylvania and Puerto Rico. CEO Jose Hidalgo said Texas was its next big target, with California on the agenda, as well.
On Thursday, Compassionate Cultivation in Austin, the only Texas-based dispensary of the three, will begin sales, said CEO Morris Denton. There, 750 milligrams will go for $105 and 1,500 milligrams will go for $200. Orders above $250 will be charged a flat $25 delivery fee.
The other dispensary, Surterra Texas in Austin, did not respond to requests for comment.
Push for expansion
As orders continue to go through, and patients like Carriker’s daughter at last get the medicine they’ve been waiting for, advocacy efforts will continue to push for an expansion of the program to include patients with more conditions such as other forms of epilepsy, multiple sclerosis and cancer.
A bipartisan bill requesting such an expansion managed to exit committee in the Texas Legislature last year, and advocates hope to revive it during the next session.
Carriker recalls being in the Capitol gallery in Austin when the deciding vote to create the Compassionate Use Program was cast nearly three years ago. She had first considered medical marijuana for her daughter in 2013, when a friend emailed her a Colorado news story about how the drug abated a little girl’s seizures without the often-severe side effects most other drugs tend to create.
Now, Carriker hopes Jensen and other families currently excluded from the program can soon participate and judge it for themselves.