Texas patients hope access is expanded to medical cannabis: 'I don't do this for fun'

Joshua Raines worried about going to his son’s choir concert in December — not because of his son, but because he himself would be sitting among throngs of people, which was sure to raise his anxieties.

Ultimately, he decided to go. But it wasn’t long before the Army veteran’s hand began shaking — a seizure warning sign. He smoked a cigarette outside, but quickly realized that wasn’t the comfort he sought. So he left the concert early, returned to his Parker County home and turned on his cannabis vape pen.

Raines said he only uses his pen when his tremors become debilitating or when he needs to calm his anxieties. Sometimes he can go days without it, but at his peak, he was using his pen “all day.”

“I try to use as little of it as possible because, you know, it’s illegal,” he said. “I don’t want my kids to know me for that. They know that I’m fighting to make it legal, but at the same time they know me as the soldier daddy. I fought for the laws, I didn’t break the laws.

“I don’t do this for fun. I don’t do this for a party,” he added. “I legitimately treat this as a medication.”

Under state law, it’s illegal for Raines to use his pen — which contains fast-acting drops of THC, the psychoactive element in marijuana, and CBD, a non-euphoric component of marijuana. But some Texas lawmakers are proposing changing that during the legislative session that begins Tuesday, and Raines is pinning his hopes that by the time the Legislature adjourns in May it will have made his medical regimen legal in the state.

Some advocates say Raines has reason to be optimistic, in large part because of what happened in the Texas Capitol four years earlier.

A rocky start

State Rep. Stephanie Klick, R-Fort Worth, was on the floor of the Texas House on May 18, 2015 hoping to succeed where many before her had failed. The former nurse was trying to convince the conservative Texas House to open up the state to medical cannabis in the most narrow way possible.

“It is also not something you can get high on. It has a low risk of abuse,” Klick told her colleagues during the floor debate. “This is not something that can be smoked. It is ingested orally.”

Fellow Republicans expressed concerns that increased access to any component of marijuana would jeopardize public safety and lead to full-blown legalization — a sentiment still echoed by many today. At one point during the debate, state Rep. Mark Keough, R-The Woodlands, yelled, “This is a bad bill.”

After a lengthy floor debate, the bill passed the House 108-38. Gov. Greg Abbottsigned it into law weeks later.

During the signing, Abbott said he’s “convinced that Texas should not legalize marijuana, nor should Texas open the door for conventional marijuana to be used for medicinal purposes.

“As governor, I will not allow it.”

Klick’s bill legalized products containing high levels of CBD and low levels of THC 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. Roughly 160,000 Texans have intractable epilepsy — less than one percent of the state’s total population.

Only 576 people in the Compassionate Use Registry have been issued a prescription as of Dec. 17, according to the Texas Department of Public Safety. Yet with the dispensaries now in place, advocates argue, tens of thousands of others stand to benefit from the product those facilities are now legally producing.

“Why stop there?”

This year will be the first time the Legislature gavels in since the state’s three licensed dispensaries began legally growing marijuana and selling their products. And advocates are hopeful that the narrowly targeted program has opened the minds of dozens of lawmakers who would not have previously been willing to support any relaxation of the state’s drug laws.

“Every state surrounding Texas has passed legislation allowing patients safe and legal access to cannabis,” Heather Fazio, the director for Texans for Responsible Marijuana Policy, said. “There's something wrong with us not having the same freedom that those in surrounding states have.”

But the Sheriff's Association of Texas opposes any further legalization of marijuana. Many law enforcement officials deal with the social costs of the drug, said Jackson County Sheriff A.J. "Andy" Louderback, who is also legislative director of the association.

"It's not good and healthy for Texans — or Americans for that matter," he said.

Louderback was also quick to note that any bills aimed at loosening the state’s restrictions on marijuana will face intense political scrutiny from lawmakers in a largely conservative state.

“The way to open the door to legalization is through medical marijuana,” he said. “Our state leaders are very aware of where we have stood for years on marijuana use and the legalization of marijuana — which we think is the end game on all of these processes that are taking place.”

Ahead of 2019, state Sen. José Menéndez, D-San Antonio, filed a measure that would expand the list of debilitating medical conditions that qualify for medical cannabis under the 2015 Compassionate Use Act to include illnesses such as terminal cancer, autism, Crohn's disease and — to Raines’ delight — PTSD. The bill would allow doctors to treat medical cannabis like any other medicine and also remove the 0.5 percent cap on the amount of the psychoactive element in marijuana known as THC that medical cannabis products sold under the Compassionate Use Act are legally allowed to contain.

Menéndez said that under his bill, “we’ll leave it up to the doctor to decide which patients need that particular medication and which ones don’t.”

“It doesn’t make sense that politicians are picking winners and losers among patients.”

Meanwhile, Texans like Raines who currently don’t qualify say they’re in a no-win situation: Either theyuse cannabis and risk getting caught — to avoid that, Raines said he usually smokes at home as long as his kids aren't around —or take prescription medication that often comes with unpleasant side-effects.

Raines left the Army in 2011 after back-to-back tours — the first in Iraq and the next in Afghanistan where he said he got “blown up quite a bit.” But he left the military with more than a Purple Heart. Since coming home, he’s endured seizures, paranoia and post-traumatic stress disorder. Doctors put him on nearly a dozen different opioids to offset his pain, but Raines said they made him “a real asshole” or “like a zombie.” At one point, he remembers telling his wife to divorce him.

“I just wasn’t a good dad or a good husband,” he said.

Raines had reached his breaking point when he found two activities — using his cannabis pen and exercising — that, together, drastically improved his quality of life. Now he spends most of his days at home, where he’s able to work at as a motion graphics artist.

Dawn Brooks is another Texan who found herself at a similar crossroads after a series of surgeries starting in 2011.

“I was a mess,” she said, laughing at the memory. “It was a real tough time.”

The now 67-year-old from Pflugerville underwent four surgeries in a five-year period — first her right knee, then her left hip, then her left knee and finally her shoulder. She tried the opioids that doctors prescribed for her but they made her feel like she was “in a fog.” That’s when she turned to marijuana.

"As a senior, we can’t stop the aging process, but we can help improve our quality of life," Brooks said.

Under Menéndez’s bill, Brooks would qualify for the medicine if her doctor determined that she had severe debilitating pain.

“We’ve already made a policy decision that this can help people with intractable epilepsy, so why stop there?” Menéndez said. “Why do we not let a doctor help the patient with cancer? Or the patient with Parkinson's? Or the veteran with PTSD?”

Patrick Tidalgo, the general manager for Knox Medical in Schulenburg, one of Texas’ three licensed dispensaries, said his business hasn’t run into any problems with the DPS since it made its first delivery of cannabis oil to a young child in February — one of the many reasons he’s in favor of an expansion bill passing in 2019.

“We believe its patients’ rights that they decide what they put in their body. CBD is non-euphoric so there’s very little to no chance of abuse,” Tidalgo said. “Here’s a plant, a natural drug, that can help treat medical conditions that humans experience. Why not expand that and give more people access to it?”

[caption id="attachment_1105019" align="aligncenter" width="640"]

Joshua Raines (left) and his son go through the combat veteran's medals in their dining room. Raines, a medical marijuana advocate and user, served in Afghanistan and was wounded in 2010 causing severe PTSD and seizures. Photo: Leslie Boorhem-Stephenson[/caption]

“Unfortunately, it’s politics at play.”

Texas is one of several states where marijuana is still illegal, and the state remains reluctant to move forward on legislation that would legalize its recreational use. More than 30 states allow the use of marijuana for medicinal purposes, according to the National Conference of State Legislatures. Texas is one of 13 states that only allow for “low THC, high CBD” products for medical situations in limited circumstances.

According to the latest University of Texas/Texas Tribune poll, 31 percent of the state’s registered voters would legalize marijuana for only medical purposes. Only 16 percent said possession of marijuana should remain illegal under any circumstances.

“People are seeing that this issue is about people. It’s not about politics,” Fazio said. “Texans with debilitating illnesses are deprived access and we’d like to see that change.”

But in previous legislative sessions, marijuana bills were dead on arrival.

Unsuccessful bills in 2017 included one to replace criminal penalties for possession of up to an ounce of marijuana with a civil fine of up to $250 and another that would’ve created a specialty court for certain first-time marijuana possession offenders.

State Rep. Harold Dutton, D-Houston, who has been filing failed marijuana measures in the Texas House since 2003, said one of the reasons these bills never became law is because lawmakers “don’t want to appear soft on crime.”

“In consequence,” he said, “they don’t do what they know they should. Texas needs to finally get the message that we’re destroying too many young people’s lives having these antiquated laws on marijuana.”

Menéndez filed a similar medical cannabis bill during the 2017 session but it never received a hearing from the Senate Health & Human Services Committee. His companion bill in the House, authored by Democratic state Rep. Eddie Lucio III of Brownsville, attracted nearly 80 co-sponsors — including some of the chambers more hardline conservatives — but was never scheduled for a floor vote.

“Unfortunately it’s politics at play and the bill got a hearing late,” said outgoing Republican state Rep. Jason Isaac, one of the co-authors of Menéndez’s companion bill. “I don’t even know that it would’ve made it to the governor.”

Looking ahead, whether any expansion bill moves forward is likely to come down to three men: the governor, lieutenant governor and state Rep. Dennis Bonnen, the presumptive next House speaker — most of whom have not been vocal on a medical cannabis expansion measure since the dispensaries have opened. At a gubernatorial debate in September, Abbott said that after speaking with the parents of children with autism and veterans and about the possible benefits of medical cannabis, he would consider an expansion bill. However, he said he's seen the medicine get abused in states where it's already legal, so he's “still not convinced yet.”

Neither Abbott nor Lt. Gov. Dan Patrick returned requests for comment.

Bonnen, an Angleton Republican, didn’t co-sponsor the expansion bill in 2017 nor did he sign onto the 2015 Compassionate Use Act. Through a spokesperson, he declined to comment on whether he’d support an expansion bill this session. His office said he wouldn’t weigh in on what issues he’d tackle until the 150-member body votes him in as Joe Straus’ successor next week.

A legislative appetite and renewed support

Though marijuana bills haven’t made a splash in sessions past, shifting politics and public opinion is giving lawmakers and advocates reason to believe the 2019 session might be different.

So far Texas legislators have filed more than a dozen cannabis-related measures, including one to eliminate criminal penalties for Texans found with small amounts of all the drug and another allowing farmers to grow and sell hemp as long as they’re in compliance with federal law — which was recently signed into law by President Donald Trump. More pro-marijuana bills are expected to get filed in the coming weeks.

Some Texas Republicans have already signaled their support for such measures. In September 2018, Abbott expressed openness to reducing penalties for low-level possession of marijuana, a sentiment echoed by the Republican Party of Texas in their 2018 platform. The Republican Party of Texas also approved a plank last year asking the Legislature to “improve the 2015 Compassionate Use Act to allow doctors to determine the appropriate use of cannabis to certified patients.”

“There is definitely renewed momentum. I do think there’s an appetite for this,” Isaac said. “It’s costing our law enforcement and our courts on the criminal justice side, but its also costing folks on the medicinal side when you know that you have constituents treating their children with THC nasal spray. Do we really want to treat those parents as criminals?”

And Klick, who authored the 2015 Compassionate Use Act, is also in favor of an expansion measure. While she didn’t sign onto Lucio and Isaac’s bill in 2017, she’s now changing course. The Fort Worth Republican said she plans to file her own bill — one narrower in scope than Menéndez’s — that would give Texans with multiple sclerosis and a short list of other conditions access to the medicine.

“In the interim there’s been more data that has come out which is why I would support some of the other conditions being added,” Klick said. “The opinions on this medicine have changed. There are clearly individuals that have benefited from it.”

Individuals, Raines said, like him. And though he’s cautiously optimistic, the Army veteran is hopeful lawmakers this year will finally pass legislation to give him some relief.

“I’m a paranoid person because of the war and my anxieties now kind of add to it when I’m in public, so I’m stuck here,” Raines said. “If this bill passes, I could actually go out in public with my kids and family. It would allow me to be a member of society again. I don’t want to have to hide.”