Texas should expand its medical marijuana program and improve clinical guidance to better serve patients, especially those with chronic kidney disease and those undergoing dialysis, according to a policy analysis published in Substance Use & Misuse.

The analysis, conducted by a researcher from Our Lady of the Lake University, evaluated the effectiveness, limitations and public health implications of the Texas Compassionate Use Program, with a particular focus on patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD).

Texas established the Compassionate Use Program in 2015 to provide regulated access to low-THC marijuana products for patients with certain qualifying medical conditions. Although lawmakers have expanded the program several times, it remains among the most restrictive medical marijuana systems in the country.

The researcher noted that dialysis patients frequently experience chronic pain, nausea, insomnia, depression and other symptoms that can significantly reduce their quality of life. These patients may also face prolonged exposure to opioids, creating a need for alternative symptom-management options.

Existing evidence suggests medical marijuana may improve quality of life and help some patients reduce their opioid use, according to the analysis. However, restrictive THC limits, limited clinical guidance and the absence of dialysis-specific eligibility provisions continue to create barriers for patients and health care providers.

The analysis also examined how medical marijuana policy could balance expanded patient access with concerns surrounding substance use, misuse and patient safety.

Recommendations include broadening the list of qualifying conditions, increasing access to participating providers, improving medical education and developing clearer clinical guidance for treating medically vulnerable patients. The researcher also called for harm-reduction strategies to be incorporated into the program’s implementation.

“Refining the program may improve outcomes for medically vulnerable populations while balancing patient safety and substance misuse prevention,” the researcher concluded.

The findings represent a policy analysis rather than a clinical trial, meaning additional research is needed to determine the safety and effectiveness of specific marijuana products for dialysis patients.