Utah Medical Marijuana Oversight Under Fire After Audit Flags 99% Approval Rate

19 November 2025

Utah’s medical cannabis program is under new pressure from state lawmakers after an audit suggested that key oversight steps may not be working as intended. A report from the Office of the Legislative Auditor General found that the state’s licensing advisory board appears to function more like a “rubber stamp” than an independent reviewer.

The audit focused on the Cannabis Production Establishment and Pharmacy Licensing Advisory Board, which reviews licensing issues for cultivators and pharmacies. Auditors examined the board’s work from 2021 through early 2025 and found that the seven members approved 99 percent of the items placed before them. They did not deny a single license request during that time. That pattern, along with meeting observations, led auditors to conclude that the board may not be offering the level of scrutiny the Legislature intended when Utah first structured its medical cannabis oversight.

The report does not accuse any cultivator, processor or pharmacy of specific misconduct. Instead, it raises concerns about the lack of clear decision rules. The audit argues that near-automatic approvals could create uneven treatment across license holders and may weaken Utah’s ability to manage risk in a growing medical cannabis sector.

Utah legalized medical cannabis through Proposition 2 in 2018. The state has since licensed eight cultivators and sixteen processors, some of which hold both license types, along with fourteen medical cannabis pharmacies. A recent report from the Department of Health and Human Services lists 104,686 active medical cannabis patients, and more than 90,000 cards were issued for persistent pain. The size of that patient population, auditors said, appears to make stronger oversight more pressing.

The audit recommends that lawmakers revisit the advisory board’s duties and update its mandate. It also urges regulators to create a formal decision-making framework so that approvals, denials and conditions follow consistent criteria. Another recommendation calls for standardized inspection procedures at cannabis facilities, including a clear way to classify violations by severity. The current system makes it harder to track patterns or compare compliance issues across operators.

Utah Department of Agriculture and Food Commissioner Kelly Pehrson, whose department helps regulate cannabis producers, agreed with the findings. In a written response, he said the state has already begun standardizing inspection protocols, refining violation categories and building rubrics to guide licensing decisions. He also said the department is working with lawmakers to revise cannabis statutes so the advisory board focuses on the issues that matter most, with clearer expectations and more effective responsibilities.

Pehrson emphasized the department’s commitment to providing “safe, regulated access” to medical cannabis while keeping strong oversight in place. The audit did not question the safety of current products. Instead, it suggests that a more structured system would help Utah manage an industry that now serves more than one hundred thousand patients.

Medical cannabis patients will not see immediate changes. They will continue visiting the same pharmacies and purchasing the same brands. Over time, though, a more defined inspection and licensing system may influence which businesses stay in the market and how quickly regulators respond when problems arise.

For cannabis license holders, the message is more direct. The period of routine, unanimous approvals may be ending. A more formal process is likely to bring clearer rules, more documentation and a better sense of how regulators judge violations.

Lawmakers now decide whether to reshape the advisory board’s role. Their choices may determine whether Utah keeps a relatively light-touch model or shifts toward a more structured system that measures compliance more directly. For anyone following Utah medical cannabis news, the audit suggests that another round of regulatory changes may be on the way.