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Is Medical Marijuana Legal in Hawaii?

Yes. Hawaii's legislature approved marijuana for medical purposes through SB 862, also called the Hawaii Medical Marijuana Act. Governor Ben Cayetano signed the act into law as Act 228 in 2000. The state also runs a medical cannabis patient registry program overseen by the Department of Health. Qualified patients and their caregivers must register with the state's medical cannabis patient registry program before they may use medical cannabis for medicinal purposes. Medical marijuana may be purchased in the form of capsules, tablets, edibles, smokable flowers, vapes, concentrates, topical creams, and gels in Hawaii.

What is Medical Marijuana in Hawaii?

In Hawaii, per the Medical Use of Cannabis law, medical marijuana cardholders can buy, possess, and consume cannabis to treat severely debilitating health conditions. Some examples of debilitating conditions include amyotrophic lateral sclerosis (ALS), cancer, glaucoma, lupus, epilepsy, and multiple sclerosis. The Center for Medical Cannabis Research has shown that cannabis holds health benefits and that patients can use it to reverse damage from complex health problems.

The Hawaii Department of Health registers eligible patients and gives them medical marijuana identification cards through its Medical Cannabis Patient Registry Program. It also licenses and monitors medical cannabis dispensaries in Hawaii through its Medical Cannabis Dispensary Program. Hawaii currently prohibits recreational marijuana although it decriminalized the possession of up to 3 grams of cannabis.

Who Can Get a Medical Marijuana Card For Cannabis In Hawaii?

Hawaiians who wish to use medical marijuana must be diagnosed with one or more of the approved debilitating conditions in the state and obtain medical marijuana cards. The approved debilitating medical conditions include:

• Cancer

• Positive status for human immunodeficiency virus (HIV)

• Acquired immune deficiency syndrome (AIDS)

• Glaucoma

• Amyotrophic lateral sclerosis

• Epilepsy

• Lupus

• Rheumatoid arthritis

• Multiple sclerosis

• Post-Traumatic Stress Disorder (PTSD)

• Cachexia

• Severe nausea

• Severe pain

• Seizures

• Epilepsy

• Persistent and severe muscle spasms

• Crohn's disease

Out-of-state residents in Hawaii may also qualify to use medical marijuana if they apply for medical marijuana cards 60 days prior to their visits.

How to Get a Medical Marijuana Card in Hawaii

Upon obtaining a medical cannabis certification from a physician or an Advanced Practice Registered Nurse (APRNs), you may proceed to create an online account on the Alaska medical marijuana patient registration portal. You must fill out the online application and provide:

• A valid Alaska-issued driver's license, Alaska-issued identification card, or United States passport

• A patient, caregiver, and grow site certification forms, whichever are applicable

• Payment for a one- or two-year registration

Upon paying the required fee, submit your application to your certifying healthcare practitioner. Subsequently, the physician or APRN will certify your condition and submit the application to the Department of Health for review and approval.

For an out-of-state patient (OSP), the applicant may apply for no more than two 60-day terms in a calendar year. Alaska requires an OSP applying for an OSP medical marijuana card to provide:

• Valid medical marijuana card from another state in the United States, territory, or District of Columbia government

• Valid government-issued driver's license or state identification card from the same state in the United States, territory, or District of Columbia. The identification or license must bear the same name as on the medical marijuana card

• A certification from the applicant's home state showing that the applicant suffers from one or more of the qualifying conditions for medical marijuana use in Hawaii

Applications for in-state patients and out-of-state patients are approved in the order received. Once approved, you may access your medical marijuana card online. For more information on obtaining medical marijuana cards in Hawaii, visit the in-state patient and out-of-state application pages of the medical cannabis patient registry website. The medical cannabis program can also be reached via email at medicalcannabis@doh.hawaii.gov or at (808) 733-2177.

How to Get a Medical Marijuana Card in Hawaii Online

Applying for a Hawaii medical marijuana card follows the same process as described above. The applicant must first get certified by a licensed physician or advanced practice registered nurse attesting that their medical condition can benefit from marijuana therapy. Then they can go online and create an account on the DOH website. After submitting all required documents and paying the registration fee, the DOH reviews each application and issues a 329 Registration Card upon approving the application. It usually takes 4 weeks to review, approve, and issue this card.

What Is the Cost of a Hawaii Medical Marijuana Card?

For in-state patients, a Hawaii medical marijuana card costs $38.50 for a one-year registration and $77 for a two-year registration. For an out-of-state patient, the application costs $49.50. Application fees for both in-state and out-of-state patients are non-refundable. Application fees may be paid using credit and debit cards or direct withdrawal from savings and checking accounts. Note that applications fulfilled with direct withdrawals will not be processed until at least 10 business days from their debit dates. A Hawaii medical marijuana card may be renewed for the same amount as the initial application fee.

Who Can Prescribe Medical Marijuana in Hawaii?

Hawaii requires residents who want to use medical marijuana legally to obtain recommendations from licensed and approved healthcare practitioners in the state before they may be included in the Hawaii medical cannabis patient registry program. Certifications may be issued by physicians and Advanced Practice Registered Nurses (APRNs). The State of Hawaii prohibits physician assistants from issuing medical cannabis recommendations.

In addition, a physician or APRN must maintain a bona fide physician-patient relationship with a patient before issuing a medical cannabis recommendation. The state's requirement for patients to see physicians before obtaining access to medical marijuana is to verify that the patient:

• Suffers from an approved debilitating medical condition

• Has been informed of the potential benefits and risks of medical marijuana use

• Obtains a certification in writing attesting to the conditions stated above

The Hawaii medical cannabis registry program provides a list of medical providers that can provide written certifications to persons interested in getting medical marijuana in the state. Note that the roster is not an exhaustive list of medical providers qualified to issue medical marijuana recommendations. Hence, you may be able to find other providers who can issue medical cannabis certifications that are not included on the list.

Can a Minor Get a Medical Marijuana Card in Hawaii?

Yes. Hawaii permits residents under the age of 18 to use medical marijuana through the assistance of designated caregivers. These caregivers, who must be registered with the Department of Health, can help qualified patients procure, grow, and administer medical marijuana. Prior to obtaining a medical marijuana card, a minor must also obtain a medical cannabis certification from an approved physician or Advanced Practice Registered Nurse before initiating an application for a medical marijuana card.

Can You Get a Medical Marijuana Card at 18 in Hawaii?

Yes. Hawaii’s medical marijuana program recognizes applicants under the age of 18 as minors. When they turn 18, they can apply for a 329 card without requiring the consent of their parents or legal guardians and without designating caregivers on their applications.

How to Renew Your Hawaii Medical Marijuana Card

The renewal process for a 329 card (medical marijuana card) in Hawaii is similar to the initial application process for the card. Note that you may qualify for a two-year renewal if:

• You are renewing with the same physician or APRN who issued your initial medical cannabis certification; and

• The certifying physician or APRN attests that your condition is chronic; and

• The certifying medical practitioner recommends that a two-year medical card registration would be in your best interest

You must check with your medical provider to confirm that the healthcare practitioner will award a two-year registration as the renewal fee is non-refundable. You will receive a notification by email from the Hawaii Department of Health 60 days prior to your medical marijuana card expiration. You may renew the card 60 days before its expiration date; however, the card only becomes valid when the current medical marijuana card expires.

Can You Grow Medical Marijuana in Hawaii?

Hawaii's Act 228 allows qualified patients residing in the state to grow their own cannabis or appoint a caregiver to do so on their behalf. Registered patients and caregivers are permitted to grow up to 10 plants if they have registered their intent to cultivate marijuana in Hawaii. Such grow locations must be made known to the Department of Health, and grow operations may only be conducted at the home of the patient or caregiver or any other site controlled by either person. Hawaii laws require that all cultivated plants be in a single location and tagged with the registered patient's medical marijuana card number and expiration date. No more than 4 ounces of marijuana may be found in possession of a registered patient at any time.

Note that from December 31, 2023, the State of Hawaii will prohibit caregivers from growing marijuana for qualified patients, except for minors and incapacitated adults, or on islands with no medical marijuana dispensaries.

Does Hawaii Allow Medical Marijuana Patients to Designate Caregivers?

Yes. Hawaii allows minors and adults who are unable to care for themselves to designate other adult Hawaii residents as caregivers. Medical marijuana caregivers are persons who have consented to help registered patients under the Hawaii medical cannabis patient program to grow, obtain, transport, and use medical marijuana. To be as designated as a caregiver in Hawaii, an individual must:

• Be aged 18 or older

• Reside in the State of Hawaii

• Not be the registered patient's physician

• Have agreed to undertake the responsibility of maintaining the well-being of a registered patient with respect to the use of medical marijuana

• Be a parent, legal guardian, or other person having legal custody of the patient, if the patient is under 18 or an adult lacking legal capacity

Per Section 329-123 of the Hawaii Revised Statutes, a registered patient may not designate more than one primary caregiver at any given time. However, the DOH permits minors to register up to two caregivers, provided that the primary caregivers are the parents, guardians, or persons with legal custody of the minor patients.

Primary caregivers must be designated by the qualifying patients on their application forms and registered with the Department of Public Health to obtain caregiver cards. Caregivers do not have to register separately from the patients represented.

What Do You Need When Visiting a Medical Marijuana Dispensary in Hawaii?

To purchase medical marijuana from approved medical cannabis dispensaries in Hawaii, you must visit the location with your valid Alaska in-state or out-of-state patient registry card (329 card) and valid State of Alaska-issued identification, valid State of Alaska-issued driver's licenses, or valid passport to gain entry.

Is it Possible to Overdose on Cannabis in Hawaii?

A person overdoses on cannabis when they consume a dosage higher than their body's processing ability. While overdosing on other drugs can prove fatal, medical cannabis patients cannot die simply from a cannabis overdose. Patients are more likely to experience more intense variations of cannabis' typical effects. Some of the symptoms are:

• Hallucinations: Cannabis creates hallucinogenic effects, making people imagine things that are often non-existent. When a person overdoses on cannabis, they may experience intense and terrifying visions.

• Anxiety and panic attacks: Another side effect of a cannabis overdose is anxiety. Anxiety may occur because of the hallucinations or alongside them.

• Increased heart rate and high fever: A physical manifestation of paranoia and hallucinations is usually a faster heart rate. Sweating and fevers usually accompany an increased heart rate.

• Concentration problems: A person that overdoses on cannabis may find it difficult to focus enough to complete simple tasks or hold conversations.

• Nausea and vomiting: Typically, patients use medical cannabis as a treatment for nausea and vomiting. However, when a person overdoses on cannabis, one of the results is extreme nausea and vomiting.

• Fatigue or lethargy: A person that overdoses on cannabis may be extremely lethargic and unable to move.

• Extreme confusion and memory problems: Individuals that use marijuana may sometimes experience short-term memory loss. When they overdose, they may forget entire blocks of time.

If I am Pregnant, Can I Use Cannabis to Relieve Nausea in Hawaii?

Nausea is a common side effect of pregnancy. Also known as Hyperemesis Gravidarum, nausea refers to a sick feeling in the stomach that precedes vomiting. Typically, pregnant women experience bouts of nausea between their first and second trimesters. Depending on the severity, nausea during pregnancy can be mildly uncomfortable or result in cachexia and development complications.

Because medical cannabis is an effective medication for nausea, some pregnant women use it to gain relief. However, the Hawaii Department of Health advises women to pursue alternative means for nausea relief with their healthcare providers. When pregnant women consume cannabis, their infants absorb traces of the drug through their bloodstream. The Department of Health says that although cannabis is natural, it is not necessarily safe for a developing infant. Some of the possible risks to the infant include:

• Smaller size at birth

• Higher chances of stillbirth

• Higher chance of premature birth;

• Secondhand marijuana smoke dangers;

• Attention deficit disorder and behavioral problems in childhood.

Pregnant women also put themselves at risk by using cannabis. The risks include:

• Dizziness and the risk of falling;

• Impaired judgment and the risk of injury;

• Lower levels of oxygen in the body - causing breathing problems;

• Lung damage (if the patient is smoking).