Hawaii has one of the oldest medical marijuana programs in the US (since 2000) but remains one of the few states without recreational legalization. The medical program allows patients to possess up to 4 ounces and grow up to 10 plants, with access through licensed dispensaries that opened in 2017. Recreational use remains illegal with very limited decriminalization (only 3 grams or less = $130 fine). The 2025 legislative session again failed to legalize adult use, making Hawaii the oldest medical-only cannabis market in the nation. Out-of-state patients can get temporary cards, and hemp-derived CBD is widely legal. Recent legislative focus has shifted to improving the medical program rather than pursuing recreational legalization.
Registered patients access cannabis through licensed dispensaries located in Hilo, Kona, and Waimea, or by growing their own plants. Dispensaries operate from 8:00 AM to 8:00 PM and require a valid 329 card plus government-issued ID for entry. Patients can also designate caregivers to purchase on their behalf. Out-of-state patients can apply for a temporary 329V card valid for 60 days.
Qualifying conditions include: cancer, HIV/AIDS, glaucoma, PTSD (added 2015), rheumatoid arthritis, lupus, epilepsy, multiple sclerosis, and amyotrophic lateral sclerosis (ALS, added 2017). You can also qualify if you have a chronic or debilitating condition that causes severe pain, cachexia or wasting syndrome, severe nausea, seizures, or severe and persistent muscle spasms. The Department of Health can approve additional conditions through a petition process.
The Hawaii Department of Health's Office of Medical Cannabis Control and Regulation manages both the Medical Cannabis Registry Program and the Medical Cannabis Dispensary Program. The agency oversees patient registration, dispensary licensing, product quality monitoring, and cannabis testing laboratories.
Yes, all patients must register with the Hawaii Medical Cannabis Registry Program to receive a 329 card. The state issues only electronic cards - no physical cards are mailed. You need this card to legally possess, purchase, or cultivate medical cannabis in Hawaii.
Registered patients access cannabis through licensed dispensaries located in Hilo, Kona, and Waimea, or by growing their own plants. Dispensaries operate from 8:00 AM to 8:00 PM and require a valid 329 card plus government-issued ID for entry. Patients can also designate caregivers to purchase on their behalf. Out-of-state patients can apply for a temporary 329V card valid for 60 days.
The initial registration fee is $38.50 for a one-year card or $77 for a two-year card. Cards must be renewed annually (or every two years if you choose the longer option). You can start the renewal process up to 60 days before expiration, and renewal can be done via telemedicine consultations for returning patients.