A note from the publisher: Since the publication of this article, the FDA has approved a CBD-based prescription drug for two special types of epilepsy.
It has been nearly two full years since Republican Gov. Greg Abbott passed the Texas Compassionate Care Act, allowing access to low-THC cannabis for intractable epilepsy, and Texans are still wondering, “Is CBD Oil Legal in Texas?”
The uncertainty about CBD oil in Texas continues due to the challenging nature of patient access. Not to mention the fact that is was only on February 1, 2018, that the first patient received the very first delivery under the new Compassionate Care Act. Many people are still curious about the legal status of CBD oil in Texas. What’s the hold up to access? [1][2]
There are more than 40 different types of epilepsy, but collectively, they are described as, “a chronic unpredictable neurological condition characterized by intermittent electrical and chemical disturbances in the brain that cause seizures which affect awareness, movement, or sensation.” [3]
According to the Epilepsy Foundation of Central and South Texas, close to 520,000 Texans live with some version of the disease. Although there are conventional pharmaceuticals on the market to help reduce the severity and frequency of seizures, 30 to 40 percent of people do not find relief. The adverse side effects, while preferable over seizures, are still hard to manage.
CBD Oil Developments in Texas
The fight for legal access to cannabis-derived CBD oil in Texas has been a long one. Although there are now 29 states across America with full-fledged medicinal cannabis programs, Texas was not one of them before it started its CBD journey. The state is relatively new to the realm of cannabis as medicine, and as such it’s taken a while to get its program off the ground.
RELATED: Is CBD Hemp Oil Legal in All 50 States?
According to Laura Campbell, a Texas mother fighting to source legal CBD for her 27-year-old daughter, the matter is not as easy as knowing CBD oil is legal in Texas. Even for the patients with the most severe cases of epilepsy, getting access to CBD oil is still a problem.
Unlike in other states, where it's easy to walk into the dispensary around the corner to find the appropriate cannabinoid with or without a prescription, in Texas, it’s a different story. It’s so far a bit of a struggle for the patients, and even more so for the doctors and dispensaries working within the system. Not all doctors can issue prescriptions, and those who can must first be registered. Once a patient finds one willing doctor, their new prescription must be approved by a second. Plus, there are currently only three certified CBD dispensaries.
Campbell is frustrated, “I’m going through this list thinking that I’m going to have to call these doctors and see if they even accept new patients. Then if we’re lucky enough to get in, how am I going to pay for these doctors? I’m not sure insurance will cover it.” For Campbell and her daughter, the process feels prohibitive.[4]
RELATED: The Ways CBD Oil Benefits Childhood Epilepsy
What Restrictions do Texans Face Sourcing CBD Oil for Seizures?
Patients must meet a list of requirements before receiving a prescription for legal low-THC cannabidiol in Texas.
- The Compassionate Care Act only allows patients with intractable epilepsy to receive CBD oil prescriptions. No other illnesses or diseases are approved yet.
- Patients must be permanent residents of Texas, which prohibits out of state medical tourism allowed in other states with medical cannabis legislation.
- Only certified physicians specializing in epilepsy or neurology, and registered under the Compassionate Care Act (CCA), can prescribe CBD. To date, there are only 18 listed in Texas. They must be certified by the American Board of Psychiatry and Neurology or the American Board of Clinical Neurophysiology.
- Patients must seek approval from two physicians on the list. The first is the diagnosing and prescribing doctor, who examines and recommends the patient as a candidate for CBD oil treatment. The second physician, who also needs to be registered per the CCA, is only responsible for concurring with the first’s diagnosis and prescription. All of this needs to be submitted to the Department’s online Compassionate-Use Registry and recorded in the patient’s medical record.
- The patient cannot have more than one prescribing doctor.
- So far, there are only three dispensaries approved to cultivate, process and sell medicinal CBD.
- CBD is not covered by insurance. [4][5]
The full Compassionate Care Act is available for review here.
RELATED: The FDA May Approve CBD-Based Epilepsy Drug
The Science Behind CBD Oil for Seizures
Even if lawmakers in Texas are still working on the logistics of CBD oil in Texas, the science behind CBD oil for seizures is continuing to prove its potential. Part of the reason for the push to explore CBD for epilepsy is based on the adverse side effects of conventional anticonvulsants. The other reason is that 30 to 40 percent of patients find little to no relief through pharmaceuticals.
In a 2017 review of research, Could Cannabidiol be a Treatment Option for Intractable Childhood and Adolescent Epilepsy?, the authors explored the three most relevant clinical studies to date. In a retrospective parent survey of 19 pediatric refractory epilepsy respondents, CBD effectively reduced seizure frequency 80 to 100 percent in eight of the cases, and a 25 to 60 percent reduction in six cases.
In the second study reviewed, which was a 12-month trial for refractory epilepsy in tuberous sclerosis complex, 50 percent of patients had a 50 percent reduction, even after a full year of CBD use.
The third trial explored in the review was the largest by far, with 162 participants. It was a 12-week trial in refractory epilepsy, and more than 50 percent of the patients experienced a 50 percent reduction or more in their seizure frequency. In 11 cases, the patients experienced a 90 percent reduction. [6]
While the authors admit some limitations to these trials, such as study size, side effects, and placebo effect, they concluded that “CBD not only has potential therapeutic effects on epilepsy but may also be effective in treating various other neurological problems.” [7]
Is CBD Oil Legal in Texas?
Yes, but it’s getting access is complicated. The program is just getting started, and there remain significant challenges for the patients with intractable epilepsy. It is not an easy road to meet all the pre-qualifications for a legal prescription for CBD oil for seizures. As the program unfolds, there is hope that some of the barriers to access will fall, and perhaps even leave space for the program to expand. According to Republican House Representative Stephanie Klick, co-author of the act, the legislation will likely go under review in the future. There is also potential to use data collected from the program today, to determine areas for expansion in the future.[8]
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Sources:
[1] https://www.texastribune.org/2018/02/01/six-year-old-texan-first-state-receive-medical-cannabis-oil/
[2] https://www.texascompassionateaccess.org/wp-content/uploads/SB00339F.pdf
[3] http://efcst.org/facts/#1501214309237-53877345-2b67
[4] https://www.texastribune.org/2018/02/05/medical-marijuana-dispensaries-are-opening-will-shortage-doctors-keep-/
[5] https://www.texascompassionateaccess.org/texas-compassionate-use-act/#faq
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540685/table/t1-er-7-1-16/
[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540685/
[8] http://www.fox7austin.com/news/local-news/patient-purchases-first-bottle-of-cbd-oil-from-medical-cannabis-dispensary-in-texas
