Hawaii Updates Medical Cannabis Rules With New Patient Options and Dispensary Standards

17 November 2025

Hawaii has updated its medical cannabis rules again. Health officials say the new changes aim to make routine tasks simpler for patients while adding some guardrails to how dispensaries handle and present their products.

The Hawaii Department of Health’s Office of Medical Cannabis Control and Regulation has revised Chapter 11-850 of the Hawaii Administrative Rules, which covers dispensary operations. The updates reflect statutory changes that took effect in July 2024 and 2025. They focus on daily procedures rather than reshaping the program.

One shift for patients involves items they may now buy in dispensaries. Licensed operators may sell supplies such as:

• vaporizers,
• grinders,
• storage containers,
• rolling papers,
• filters and
• cones.

These tools are common for medical cannabis use, and the change may help patients keep their purchases within the same regulated setting as their medicine.

The rules also address inhalable oil extracts and concentrates. Dispensaries may sell them only when they contain no nicotine, tobacco products, hemp, hemp-derived cannabinoids or any other non-cannabis additives. This may suggest a desire to keep medical cannabis separate from tobacco and vaping products that fall under different oversight.

Inside dispensaries, the waiting room still cannot store, display or sell cannabis or manufactured cannabis items. The rules now make clear that a designated caregiver may accompany a patient in that area. This may help patients who rely on another adult for mobility, language support or help with medical decisions.

Advertising standards are now more specific. Dispensaries may not use images that show cannabis use. They also may not use pictures of children, celebrities, influencers or cartoon figures that appear to target young people in ads, menus, signage or waiting room displays. Products may not be presented in a way that resembles common food or candy. These steps appear to set clearer limits around youth-oriented marketing.

Medical certification remains separate from retail settings. Since September 2025, Hawaiian patients have been allowed to complete medical cannabis certifications through telehealth, both for new approvals and renewals. Dispensaries may not host in-person or telehealth appointments for medical cannabis certifications. Regulators say the intent is to keep clinical decisions in a medical office, not in a sales environment.

Other changes affect how dispensaries work with each other. Act 172 of 2024 removed the former 30-day review window for dispensary purchasing plans. Under the updated rules, dispensaries must submit transport manifests before any dispensary-to-dispensary sale and must file completed manifests within one week after the sale. Any changes to a plan or manifest must be reported before transport. Products prepared for retail sale may now go straight to the purchasing dispensary’s retail site.

The state also clarified the 800-ounce limit on sales within a 30-day period and the process for dispensaries that want to request permission to exceed that amount. Each request is handled on a case-by-case basis, but the rules now offer a clearer structure for those petitions.

Officials describe these revisions as small adjustments rather than sweeping policy shifts. Patients may notice modest benefits, such as easier access to basic supplies, clearer rules on caregiver access and more consistent messaging that avoids child-focused or entertainment-style imagery. Dispensaries will face more detailed expectations on documentation, transport and marketing.

The changes come as Hawaii continues to refine its medical system without moving toward recreational legalization in this set of amendments. The updates appear to signal a step-by-step approach that weighs patient needs alongside public health concerns.