On Monday, March 2, 2020, Utah’s first medical cannabis “pharmacy” opened its doors in Salt Lake City. Two years into legal sales, several improvements have been made to Utah’s medical cannabis program. Patients can now get medical cannabis delivered at home or pick it up via a drive-through, which is particularly important to keeping medically fragile individuals healthy in light of COVID. And in 2022, lawmakers improved employment protections for medical cannabis patients (SB 46), along passing a labeling bill (SB 190), and allowing limited medical cannabis access for acute pain and terminal patients (SB 195).
Medical cannabis program history
On November 6, 2018, 53% of Utah voters approved Proposal 2 — the Medical Cannabis Act — representing a major victory for medical marijuana advocates who fought for years to establish a compassionate program.
MPP is proud to have supported the Utah Patients Coalition (the campaign behind the measure) in a number of important ways, including helping the campaign organize the signature petition drive, draft the initiative, and fundraise.
Prior to the election, leaders from the Utah Patients Coalition, MPP, our allies at the Libertas Institute, the Church of Latter Day Saints, and the Utah Legislature negotiated a medical cannabis compromise proposal to establish a functional medical cannabis program, but with more restrictions than Proposal 2. Before the election, all parties agreed to support the plan, regardless of the outcome of Proposal 2.
Given that Utah law permits the state legislature to amend voter initiatives with a simple majority vote, medical marijuana advocates and leaders of the Prop. 2 campaign believed the best way to ensure the implementation of a medical cannabis law was to support this compromise.
Some revisions have been enacted since then. In 2019, Gov. Gary Herbert (R) signed SB 161 to make a number of modifications to the state’s medical cannabis program, such as prohibiting discrimination against medical cannabis patients in family court matters. On February 28, 2020, Gov. Herbert (R) signed SB 121, which makes more changes, including allowing flower to be dispensed in child-proof bottles, not just blister packs; allowing physicians to recommend to more patients; and removing criminal penalties from registered patients with THC metabolites in their system who are not impaired.
In 2021, the legislature approved SB 170 (spearheaded by the Libertas Institute) so that medical providers can recommend cannabis to up to 15 patients without having to jump through hoops that reduce physician participation. Only those recommending to more than 15 patients will have to pay a fee, do hours of continuing education, and use a computer system to register for the program.
Medical cannabis program summary
Here are some of the details of Utah's medical cannabis law:
Patient licenses: A patient may submit an application to the Utah Department of Health to receive a medical cannabis registration card if he or she has received a recommendation from a registered healthcare provider (MD, DO, APRN, or PA). Utah patients must obtain a recommendation from a healthcare provider in Utah. Patient registration cards are initially valid for one month. Thereafter, the registration card can be renewed continually in six-month intervals.
Qualifying conditions: HIV, Alzheimer's disease, amyotrophic lateral sclerosis, cancer, cachexia, persistent nausea that is not significantly responsive to traditional treatment (except nausea caused by pregnancy, cannabis-induced vomiting syndrome, or cannabinioid hyperemesis syndrome), Crohn's disease, ulcerative colitis, epilepsy, debilitating seizures, multiple sclerosis, debilitating muscle spasms, PTSD (provided certain conditions are met), autism, a terminal illness (with six months or fewer remaining), a condition resulting in an individual receiving hospice care, and chronic pain (provided that certain conditions are met). Patients may also petition the "compassionate use board" to become a qualifying patient for other conditions.
Minor patients: Patients under the age of 18 may register as a qualifying patient if they receive approval from the compassionate use board. A parent or guardian must also obtain a "medical cannabis guardian card." Minor patients are not permitted to enter medical cannabis pharmacies. Patients aged 18, 19, or 20 must petition the compassionate use board in order to receive a patient license.
Visiting patients: Provided that they have been diagnosed with a qualifying condition approved under Utah law, out-of-state patients have legal protections if they aren't a resident, have a card from another state, and possess cannabis in a form allowed under Utah law.
Healthcare providers: Healthcare providers who issue certifications must have authority to prescribe Schedule II drugs and be a state-licensed physician, registered nurse, or physician's assistant. Practitioners who issue 15 or more recommendations in a year must register with the department, pay a fee, and complete cannabis-specific continuing medical education courses. General practice providers are currently limited to 275 patient recommendations. Some specialists, such as oncologists, neurologists, and others, are limited to 600.
Caregivers: Patients may designate up to two caregivers to assist with the access and use of medical cannabis. Caregivers are not permitted to cultivate cannabis.
Possession limits: Patients are allowed to possess the lesser of: a) a one-month supply based on the dosage amount specified by their doctor or state-licensed pharmacist at a medical cannabis pharmacy; or b) four ounces of flower or 20 grams THC. Marijuana may be dispensed in the following forms: flower or bud, tablets, capsules, concentrated oil, liquid suspension, topicals, transdermal patches, sublingual preparations, and lozenges. Patients are not permitted to cultivate their own medical cannabis.
Anti-discrimination protections: Registered healthcare providers and patients are protected from criminal and civil liability, provided they comply with the law. Patients may not be denied access to organ transplants. State employees may not be disciplined or discriminated against on the basis of their status as a registered patient and their use of medical cannabis in compliance with the law. The law prohibits courts from considering the lawful use of medical cannabis in custody hearings.
Medical cannabis access: The Utah Medical Cannabis Act allows patients with a registry ID card to purchase cannabis from medical cannabis pharmacies. The pharmacies must employ at least one state-licensed pharmacist and may dispense cannabis products only in specific dosages based on the patient's medical needs. Fourteen pharmacies have been approved by the state. Pharmacies may not sell an amount greater than a 14-day supply to patients based on their allotted dosage requirements. The state also regulates and licenses cultivation facilities, testing facilities, and processors. State agencies established an electronic monitoring system to track all cannabis products from the point of cultivation to the point of sale to registered patients.
Localities: Municipalities may not prohibit the establishment of medical cannabis facilities but may impose additional regulations consistent with state law. Medical cannabis establishments are not permitted within 1,000 feet of a "community location" (defined as schools, churches, etc.) or within 600 of a residential area unless the municipality permits it.
Paraphernalia: Smoking is prohibited under Utah’s medical marijuana law. The Utah Medical Cannabis Act does not protect individuals from criminal liability for possessing devices that facilitate the combustion of cannabis. The vaporization of cannabis products with use of a heated nail is also prohibited.
Research: The medical cannabis law establishes a cannabinoid product board tasked with researching the effectiveness and appropriate dosage amounts of medical cannabis for specific medical conditions.
Taxes: Medical cannabis products are exempt from taxes, including the state sales tax.
Timeline: On or before January 1, 2020, the Department of Agriculture and Food was required to begin accepting medical cannabis facility applications. On March 1, 2020, the Department of Health began accepting applications for patient registration cards. The department has 15 days to approve or reject patient applications.
Decriminalization and prohibition
Utah is one of only 19 states that still punishes simple possession of marijuana with jail time.
Even for those who don’t end up in jail, the scarlet letter of a criminal conviction often slams closed the door to opportunity — making it far more difficult to get a good job, housing, and an education, and resulting in hundreds of collateral consequences. Meanwhile, polling shows Utah voters want far more substantial reform: over 60% of Utah voters support full adult-use legalization.
The N.H. House of Representatives has voted to legalize cannabis three times since 2019. Sadly, the Senate has killed every attempt so far. Tomorrow, the House will vote on legalization once again, but this time there’s a twist. The bill is sponsored by Rep. Daryl Abbas (R), an opponent of previous legalization bills, and it includes a poison pill: state-run stores.