Is Medical-Only Weed Legal in Hawaii?

Medically reviewed by Alexander Tabibi, MD
August 25, 2021
Legal Weed in Hawaii
Legal Weed in Hawaii

As of now, adult-use, recreational cannabis is illegal in Hawaii. Although, it has been decriminalized, so that those who possess up to 3 grams of weed can pay a small fine rather than face criminal charges.  Medical use marijuana is legal, requiring that a patient obtain certification from their doctor and apply for the medical marijuana program through the Paradise state.


History of Weed Laws

Hawaii was, in fact, the first state to legalize medical marijuana through legislation in 2000, through Act 228.  The law effectively allowed for the cultivation, possession and consumption of legal cannabis by medical patients diagnosed with certain qualifying conditions determined by the state.  It also provided legal protection for anyone approved by the state to consume or possess marijuana.


The Department of Public Safety, in response to the passing of the law, became tasked with regulating the medical marijuana program throughout the state.  Eventually, this was transitioned to the state’s Department of Health (DOH), and the law was soon expanded upon to increase possession limits, while also adding to the list of qualifying conditions so that more patients throughout the state could access legal weed.  It also led to the development of licensed dispensaries throughout the state.  No dispensaries were licensed until 2018.


HI also decriminalized possession in 2019, followed by the passing of HB 1383 which allowed any non-violent drug offender who possessed 3 grams or less of marijuana in Hawaii to petition for release to a drug treatment program in exchange for an expungement of their offense on their record.


Where Can a Person Legally Purchase Weed in Hawaii?

Only a medical patient or authorized caregiver may legally purchase marijuana in the state of Hawaii, and those authorized to do so can only purchase from a state-licensed dispensary, of which there are several throughout the state.  Patients and their caregivers may purchase up to 4 ounces every 15 days, and no more than 8 ounces per 30 days.  The cannabis must be sealed when it’s being transported, and it may not be transported between different islands.  Note that delivery of cannabis from dispensaries to patients’ homes is strictly against the law in the state.


Where Can Cannabis Legally Be Used?

Patients are strictly prohibited from consuming cannabis in public throughout the state of Hawaii and must therefore only consume it at home or on other private properties where they are permitted to do so.  They cannot vape or smoke cannabis on private property that has prohibited the use of tobacco products.


Possession Laws

Authorized medical patients and their caregivers may possess a maximum of 4 ounces of cannabis between them.


Can Residents Grow Their Own?

Those who are registered with the state can legally grow up to 10 cannabis plants on their private property, or on the property of their authorized caregiver.  They must have registered their intent to grow through the application process handled by the Department of Health.  The plants must be all grown in one area of the property, with the patient’s medical marijuana card number and expiration date visible. 


Starting on December 31st, 2023, caregivers will no longer be able to grow cannabis for patients except for minors, adults who lack capacity, and on islands that are lacking a dispensary.


Medical Marijuana

Hawaiian residents who have one of the below qualifying conditions, or a debilitating condition for which they can petition for authorization, can apply to the state for a medical marijuana card, which allows them to legally purchase cannabis only at a state-licensed dispensary, requiring that the medical card is shown at the time of purchase.  The card is referred to as a “329 card,” representing Statute 329 that enabled the medical cannabis program the state employs today.  The card also allows patients to grow the designated number of cannabis plants permitted by the state.  Patients who live out of state may apply for a card if they are regular visitors to the state, even though the state does offer reciprocity laws.  It requires that out-of-state patients see a Hawaiian physician to be approved as qualifying.


Qualifying Conditions:

  • Amyotrophic lateral sclerosis (Lou Gehrig’s disease)
  • Cancer
  • Cachexia, or wasting syndrome
  • Epilepsy
  • Glaucoma
  • Lupus
  • Muscle spasms, including those characteristic of multiple sclerosis or Crohn’s disease
  • Multiple sclerosis
  • Post-traumatic stress disorder (PTSD)
  • Rheumatoid Arthritis
  • Seizures
  • Severe nausea
  • Severe pain


Patients can petition the Department of Health to add their condition to the qualifying list.


Patient Qualifications:

For a patient to qualify for medical marijuana, they must have been diagnosed with one of the above conditions by a licensed physician or must petition the DOH for authorization based on the unique nature of their condition.  Patients are required to have certification from their doctor that qualifies them as suitable for marijuana treatment.  Those under 18 can have a parent or guardian apply on their behalf.


How to Register for Medical Marijuana in Hawaii

First, you must have a doctor diagnose you and provide a certification which will be used during the application process.  You can then register for an online account through the Department of Health’s website and fill out the application and submit it along with the certification and a state-issued ID that verifies your residency.  You can also designate a caregiver during the process.  There is a $38.50 application fee.


Qualifying as a Caregiver

To qualify as a caregiver in the state of Hawaii, you can only care for one patient at a time, unless you are caring for minors, and you must be at least 18 years of age.  Further, a caregiver is not permitted to consume cannabis.


Registering as a Caregiver

A patient will apply for a caregiver on their own application and will cover the application fee.  The caregiver must sign the patient’s application and provide a state-issued ID to prove residency.


Reciprocity Laws

Hawaii does have reciprocity laws, which allows out-of-state visitors to Hawaii to purchase cannabis from a state-authorized dispensary, as long as they have their medical card on them at the time of purchase.  However, a patient must have a qualifying condition as determined by Hawaii.  Patients must register and show a valid government-issued medical marijuana card and state ID or driver’s license from their home state to obtain a Hawaii 329 Registration card.



From Honolulu to Kailua-Kona, all cannabis products sold in Hawaii must undergo a third-party testing process that looks for contaminants, impurities, and other undesirable or harmful compounds, while also determining the cannabinoid profile of the product while ensuring that it’s federally compliant.