Medical cannabis is legal in Hawaii, but recreational cannabis use is still illegal. Although recreational marijuana use remains illegal, possession of under 3 ounces of cannabis has been decriminalized.

Hawaii has a rich history regarding medical cannabis. In 2000, the state became the first in the United States to legalize medical marijuana through a legislative process when then-Governor Ben Cayetano signed Act 228 into law. The bill did not establish guidelines for dispensaries, nor did it create any framework for patients to obtain cannabis, but it was nevertheless an essential first step.

The past decade has seen Hawaii’s medical cannabis program expand significantly, with additional legislation allowing for the implementation of medical dispensaries. The state has also updated its list of qualifying conditions since establishing a more comprehensive medical cannabis program.

Medical Marijuana Laws in Hawaii

Patients must receive certification for medical cannabis from a licensed physician. Patients are currently limited to possessing 4 ounces of cannabis products purchased from a dispensary or growing up to 10 plants in their homes.

Recreational cannabis is decriminalized in Hawaii, meaning that, although no form of recreational marijuana is strictly allowed, you could face a fine of up to $130 if caught with 3 grams or less of cannabis. Going beyond the 3-gram limit while staying under an ounce puts you at risk of greater fines (up to $1,000) and a month in jail. Fines and penalties continue to increase, depending on the quantity of cannabis found on your person.

CBD and Delta-8 Laws

The 2018 Farm Bill made hemp products broadly legal, meaning CBD products are legal and readily available on Hawaii’s islands, provided that the products contain less than 0.3% THC.

Cannabis products that are not derived from hemp are not allowed. While you may very well find delta-8 products being sold out of smokeshops around Hawaii, most of these products are illegal because Hawaii no longer allows synthetic cannabis.

What to Know About About Medical Cannabis in Hawaii

Only Certain Conditions Qualify for Medical Cannabis

Hawaii law lists the following conditions as qualifying a patient for participation in the medical cannabis program:

• AIDS/HIV
• Amyotrophic lateral sclerosis (ALS)
• Cancer
• Epilepsy
• Glaucoma
• Lupus
• Multiple sclerosis (MS)
• Post-traumatic stress disorder (PTSD)
• Rheumatoid arthritis
• The treatment of the above conditions or “a chronic or debilitating disease or medical condition or its treatment that produces one or more of the following:”
  • Cachexia or wasting syndrome
  • Severe pain
  • Severe nausea
  • Seizures, including those characteristic of epilepsy
  • Severe and persistent muscle spasms, including those characteristic of multiple sclerosis or Crohn’s disease

Telemedicine Is Allowed

Patients are allowed to receive certification through telemedicine services. Leafwell does not yet operate its medical registration service in Hawaii, but you can join the waiting list.

Hawaii Has Medical Reciprocity

If you’re visiting Hawaii from out of state and you have a valid, state-issued medical marijuana card, you will be able to purchase cannabis from medical dispensaries. In addition to your med card, you will need an ID from the state that issued your med card. This does not mean you can bring cannabis to or from Hawaii, however, as cannabis is still federally illegal, and trafficking a Schedule 1 drug across state lines could get you in serious legal trouble.

Other states with forms of medical cannabis reciprocity include:

• Arizona
• Alaska ^
• Arkansas *
• California ^
• Colorado ^
• Connecticut ^
• Delaware ^
• Guam
• Illinois ^
• Maine
• Maryland ^ (as of July 2023)
• Massachusetts
• Michigan (qualifying state must also have reciprocity with Michigan)
• Missouri ^
• Montana
• Nevada
• New Hampshire
• New Jersey *
• New Mexico *
• New York ^
• Oklahoma *
• Oregon ^
• Pennsylvania (minors only)
• Puerto Rico
• Rhode Island
• U.S. Virgin Islands *
• Utah (max. 45 days, after which the patient must apply for a Utah MMJ card)
• Vermont ^
• Virginia ^
• Washington ^
• Washington D.C.

States marked with * require visitors to complete a visiting patient application for the duration of their stay. States marked with ^ have adult use programs but do not accept out-of-state cards.

Can You Grow Cannabis in Hawaii?

Medical cannabis patients in Hawaii can grow up to 10 plants. While caregivers can currently cultivate cannabis on behalf of the patient in their care, this is primed to change. After December 31, 2023, caregivers will no longer be allowed to grow cannabis, with some exceptions for caregivers of minor patients, patients without the mental capacity to grow cannabis on their own, and caregivers living with patients on an island without medical dispensaries.

The Bottom Line

Medical marijuana is legal in Hawaii. Those who qualify for the program can possess up to 4 ounces of cannabis or grow up to 10 plants in their own home. Recreational cannabis is still against the law in Hawaii, but possession of up to 3 grams will result in fines without the possibility of jail time.