Medical cannabis, patient dignity, and regulatory accountability

Utah legalized medical cannabis because patients fought to be treated like patients. We should never allow the system built from that victory to drift backward into treating them like suspects, revenue sources, or problems for regulators to manage.

I was directly involved in drafting Proposition 2 and the Utah Medical Cannabis Act that followed. My position on this issue is grounded not only in principle, but in hands-on experience with how the system was built, how it was changed, and where it is currently failing the people it was supposed to serve.

One year after Utah’s medical cannabis program began, Dragonfly invited our team to tour one of its grow facility in Sanpete County. As a member of the board for TRUCE we helped pass Proposition 2 and shape the Utah Medical Cannabis Act, it was surreal to go from advocating in a state where cannabis was completely prohibited to walking through greenhouses growing legal medicine for Utah patients. It was proof that change is possible: we began with a vision that patients could have safe, lawful access to medicine, and together, we helped make that vision real.

I did this work because medical cannabis is medicine. Patients deserve access to treatment without stigma, artificial barriers, political interference, or punitive regulation. Their medical decisions should be made with qualified professionals, not dictated by politicians or shaped around the convenience of regulatory agencies.

The federal government finally took an important step in April 2026 by moving state-licensed medical cannabis from Schedule I to Schedule III. That change does not resolve every conflict in federal law, and it does not finish the broader national debate over cannabis scheduling. But it is the clearest federal acknowledgment in more than half a century that state-regulated medical cannabis has legitimate medical use.

The ground has shifted beneath everyone who spent years treating patients like criminals. Utah helped demonstrate that a regulated medical program can work. Now we have to make sure the program works for the patients who depend on it.

Medical cannabis is not a culture-war prop, a moral referendum, or a regulatory playground. Utah voters were clear when they approved it. The Legislature has a responsibility to honor both the letter and the spirit of that decision by ensuring the program is accessible, affordable, medically sound, and centered on patient health rather than bureaucratic control.

Right now, Utah’s program remains too restrictive, too expensive, and too heavily shaped by artificial bottlenecks. More than 114,000 active patients depend on a tightly limited statewide pharmacy system. That is an enormous patient population being served through a market the state has deliberately constrained.

Artificial scarcity does not protect patients. It limits competition, restricts access, and helps keep prices high. Patients are the ones who pay for that policy choice.

I support expanding the number and geographic distribution of licensed medical cannabis pharmacies, especially in rural and underserved parts of the state. Access should not depend on a long drive, a narrow appointment window, reliable transportation, or whether someone happens to live near one of a small number of state-approved locations.

Home delivery helps, but it is not a complete substitute for local access. Some patients need in-person guidance. Some cannot wait for delivery. Some live in communities where the current system still creates unreasonable barriers between them and their treatment.

The state should use transparent measures of patient population, geography, travel time, product availability, pricing, and market concentration to determine where additional pharmacies are needed. Licensing should be based on patient access and public need— not on preserving the market position of businesses already inside the system.

When government restricts supply, limits competition, and then acts surprised when prices remain high, that is not patient protection. It is cartel-like market distortion government created.

Regulatory accountability will become even more important as administration of Utah’s medical cannabis program is consolidated under the Utah Department of Agriculture and Food. Duties currently divided between the Department of Health and Human Services and UDAF are scheduled to move fully to UDAF by January 2027, with portions of the transition permitted to begin earlier.

That means one agency will hold substantial authority over licensing, rulemaking, inspections, enforcement, pharmacies, producers, providers, and patient administration. Concentrating that much authority is exactly when the Legislature should strengthen oversight— not simply assume everything will work itself out.

I have serious concerns about an enforcement culture that can become punitive, inconsistent, and disconnected from actual harm. Regulators should not be able to impose devastating fines, threaten licenses, or effectively shut down a business through an enforcement action before the license holder has access to meaningful review.

No agency should be investigator, prosecutor, judge, and financial beneficiary of its own penalties without strong checks on that power.

Regulation must be clear, proportional, transparent, and accountable. License holders should know the rules before they are punished for allegedly violating them. Enforcement standards should be published and applied consistently. Penalties should reflect the seriousness of the violation and the actual harm involved, not simply the maximum amount an agency believes it can collect.

I will support due-process protections that include timely notice of alleged violations, access to the evidence being used, reasonable opportunities to correct non-dangerous deficiencies, neutral administrative review, transparent penalty schedules, and meaningful rights of appeal.

Public safety matters. Product testing matters. Accurate labeling matters. Preventing diversion matters. But oversight exists to protect patients and ensure quality— not to intimidate license holders, manufacture technical violations, or generate revenue through punishment.

The Legislature must also maintain active oversight after the transition. Moving the program into a single department should not mean moving it farther from public accountability. UDAF should be required to report regularly on enforcement actions, fines, appeals, licensing timelines, patient access, pricing, product shortages, market concentration, and complaints from patients and license holders.

Sunlight is not an obstacle to effective regulation. It is how the public knows regulation is being exercised fairly.

Utah should also modernize its cannabis laws to reflect medical reality instead of maintaining restrictions simply because they were written into the original program.

Topical products are one clear example. Topical, full-spectrum cannabis products intended only for localized external use should not require a medical cannabis card when they do not produce systemic intoxication and meet appropriate testing, dosage, and labeling standards.

The relevant question should not be whether a product touches the skin. It should be whether it delivers intoxicating amounts of THC into the bloodstream or otherwise produces systemic effects. A lotion intended for localized relief is not the same as a transdermal product specifically designed to deliver cannabinoids throughout the body.

Card requirements and medical controls should follow actual risk, dosage, and method of delivery— not arbitrary product categories.

Products that are inhaled, ingested, or designed for systemic absorption should remain within an appropriately regulated medical framework. External-use products that do not create intoxication should be treated proportionately. That distinction protects public safety while removing needless barriers to care.

Affordability remains one of the greatest failures of Utah’s program. Many patients use medical cannabis to manage chronic pain, neurological conditions, cancer-related symptoms, seizure disorders, PTSD, and other serious health needs. For too many of them, cost is not merely an inconvenience. It is the wall between them and their treatment.

Insurance generally does not cover medical cannabis. Patients may have to pay for provider visits, card fees, state-imposed charges, products, transportation, and delivery entirely out of pocket. Those costs land hardest on seniors, disabled residents, veterans, low-income families, and people already carrying significant medical expenses.

The 2026 Legislature took a meaningful first step by creating a patient voucher program providing eligible patients with monthly assistance toward purchases at medical cannabis pharmacies. That assistance can make a real difference. But eligibility is limited to active cardholders enrolled in Medicaid or Medicare.

Many low-income patients do not qualify for either program. Some disabled veterans receive federal healthcare or disability benefits but still live on limited incomes. Others fall into the familiar gap where they earn too much to qualify for one program but nowhere near enough to absorb hundreds of dollars in monthly treatment costs.

A first step is not a finish line. I support expanding patient assistance based on income and medical need rather than limiting it exclusively to enrollment in two existing programs. I also support stable funding so patients are not promised help that disappears when donations or appropriations fall short.

At the same time, we should not provide assistance with one hand while raising costs with the other. The state has authorized UDAF to increase the state fee attached to medical cannabis purchases. Any proposed increase should require public justification, legislative review, and a clear demonstration that the additional cost is necessary.

Patients should not be treated as a captive source of agency revenue. I support meaningful price transparency throughout the system so patients and policymakers can understand what is driving costs. That includes transparency in cultivation, processing, testing, distribution, pharmacy markups, state fees, and required professional services.

Where the state has deliberately limited competition, it has a heightened responsibility to prevent abusive pricing. I support targeted limits on state-imposed fees and excessive markups where market concentration leaves patients without meaningful alternatives.

But the long-term answer is not simply ordering prices downward while preserving the same artificial scarcity. We also have to address the structure of the market.

Utah’s licensing system has encouraged consolidation and made it difficult for smaller, independent businesses to participate. I support expanding processing and manufacturing opportunities through a fair, transparent licensing system that allows qualified local businesses to enter the market while maintaining rigorous testing, safety, and quality standards.

Small businesses should not be locked out because they lack the political connections or capital required to navigate an intentionally narrow licensing structure. Competition can improve product quality, encourage innovation, create local jobs, and place downward pressure on prices.

The goal should not be deregulation for its own sake. The goal should be competent regulation that protects patients without protecting a closed market.

That principle also applies to edibles and other manufactured products. Adults deserve to take medicine in forms that are effective, consistent, palatable, and dignified.

We can protect children without treating adult patients like children. Products should not imitate familiar children’s brands, toys, or commercial candy packaging. They should have clear dosage information, child-resistant containers, responsible serving sizes, and strict manufacturing standards. Those are reasonable protections.

But deliberately making medicine unpleasant is not a serious safety strategy. It is paternalism dressed up as regulation. Patients should not be punished for needing a product they can tolerate, particularly when nausea, sensory limitations, swallowing difficulties, or other medical conditions affect how they take medication.

Medical treatment should not feel like a penalty.

Patient dignity also means ensuring that participation in Utah’s medical cannabis program does not become a pretext for stripping away unrelated constitutional rights.

This issue is not theoretical to me. I was involved in the medical cannabis debate from the drafting of Proposition 2 forward, and I personally know legitimate Utah medical cannabis cardholders who attempted to purchase firearms and were denied. When their background checks were processed through the Utah Bureau of Criminal Identification, their status as medical cannabis patients came back as the reason they were restricted from completing the purchase.

These were not people accused of handling firearms while impaired. They were not found to be dangerous. They had not lost their rights through a criminal conviction or an individualized judicial determination. They were patients following Utah law, and their participation in a state-approved medical program became the reason they were denied the opportunity to exercise another constitutional right.

That is unacceptable.

For years, medical cannabis patients have faced an indefensible choice: keep your medicine or protect your Second Amendment rights. Utah told them that their treatment was legal, regulated, and medically legitimate. Another part of government could then treat that same participation as evidence that they were an unlawful drug user and therefore prohibited from purchasing a firearm.

Utah cannot declare someone a legitimate medical patient on one side of government and then treat that same person as a criminal on the other.

Recent federal developments have begun to challenge the legal foundation for those denials. State-licensed medical cannabis has been moved to Schedule III, and in June 2026, the United States Supreme Court rejected the federal government’s attempt to prosecute someone under the unlawful-user firearm prohibition based solely on regular marijuana use without individualized evidence that the person was dangerous.

That is an important decision. But it does not automatically repair every database, rewrite every form, retrain every background-check examiner, reverse every past denial, or create a clear process for patients whose rights have already been restricted.

The Court also made clear that its ruling was narrow. It did not prevent government from addressing firearm possession by someone who is actively intoxicated, addicted, or individually shown to present a genuine danger to themselves or others. Responsible firearm safety laws still matter.

But regular cannabis use alone cannot be treated as an automatic substitute for evidence of dangerousness.

That distinction matters. Constitutional rights should not disappear through administrative assumption. Government should be required to establish actual conduct, actual risk, and actual legal grounds before depriving someone of a protected right.

The law may be changing, but the administrative system has not necessarily caught up. Utah patients remain caught between a state medical program that recognizes their treatment and a background-check system that may still treat evidence of that treatment as a disqualifying flag.

That is why this issue is not resolved.

I will push for a full legislative review of how medical cannabis information has been used in firearm background checks, how many Utah patients have been delayed or denied, what information BCI receives or accesses, how cardholder status is communicated during a purchase, and whether current practices comply with federal law, Utah privacy protections, and the Supreme Court’s ruling.

Patients who have been denied deserve a written explanation of the precise legal basis for that decision. They deserve access to the information used against them. They deserve a timely and meaningful process to challenge an erroneous, outdated, or unconstitutional determination.

Possession of a medical cannabis card should never, by itself, be treated as proof that someone is impaired, addicted, dangerous, or legally disqualified from purchasing or possessing a firearm. Utah should prohibit state agencies from using cardholder status as an automatic disqualifying flag to the fullest extent permitted by federal law, and it should protect confidential patient information from becoming a de facto firearm blacklist.

We also need to examine what happened to the people who were previously denied. A constitutional right is not meaningfully protected if government acknowledges that the standard was wrong but leaves the people harmed by it to navigate an invisible bureaucracy on their own.

There must be a clear pathway for reviewing and correcting prior denials that were based solely on lawful participation in Utah’s medical cannabis program.

This does not mean ignoring responsible firearm safety. The law can and should address people who carry or use firearms while actively impaired, just as it addresses impairment caused by alcohol or other medications. It can respond to individualized evidence that someone poses a genuine danger to themselves or others.

But those decisions must be based on conduct, evidence, due process, and actual risk— not a presumption attached to someone’s medical record.

No patient should have to choose between treating a serious medical condition and exercising a constitutional right. And no Utahn should lose that right through an automated process they cannot see, understand, or meaningfully challenge.

Changing the law on paper is only the beginning. We have to make sure the agencies, databases, forms, and background-check procedures applying that law change with it.

The same principle should guide patient protections more broadly. A medical cannabis card should not become an excuse for discrimination in housing, employment, family court, medical care, education, or access to public services when the patient is using medication lawfully and is not impaired in a setting where impairment creates a legitimate safety concern.

Standards should be based on conduct and capacity— not stigma.

At its core, my medical cannabis policy is about respect. Respect for patients. Respect for voters. Respect for medical evidence. Respect for constitutional rights. And respect for the limits of regulatory power.

Utah can build a program that is safe without being punitive, accountable without being hostile, and regulated without becoming captured by bureaucracy or entrenched market interests.

We helped create this program because patients deserved relief. The work now is to make sure the system remembers who it was built for.

Patients are not the problem.

They are the reason the program exists.