Qualifying Medical Conditions

Hawaii patients can receive medical cannabis certification for a Debilitating Medical Condition, other medical conditions determined as appropriate by a Primary Treating Medical Provider, or by a Hospice Provider while undergoing hospice care.

Debilitating Medical Conditions

As defined in section 121 of HRS-329, a qualifying debilitating medical condition includes:

  1. Amyotrophic Lateral Sclerosis (added effective Dec. 19, 2017 per petition process)
  2. Cancer
  3. Glaucoma
  4. Lupus (added effective June 29, 2017 as per Act 041, SHL 2017)
  5. Epilepsy (added effective June 29, 2017 as per Act 041, SHL 2017)
  6. Multiple Sclerosis (added effective June 29, 2017 as per Act 041, SHL 2017)
  7. Rheumatoid Arthritis (added effective June 29, 2017 as per Act 041, SHL 2017)
  8. Positive status for human immunodeficiency virus
  9. Acquired immune deficiency syndrome
  10. Post-traumatic stress disorder (added effective July 1, 2015 as per Act 241, SLH 2015)

“The treatment of these 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

Changes to the list:

  • Act 241, SHL 2015 – Hawaii’s Dispensary Legislation, added post-traumatic stress disorder (PTSD) as a new condition effective July 1, 2015
  • Act 041, SHL 2017 added lupus, epilepsy, multiple sclerosis, and rheumatoid arthritis effective June 29, 2017
  • Amyotrophic Lateral Sclerosis (ALS) was added in 2017 through the petition process.

Process to add new conditions:

In the DOH Administrative Rules, Chapter 11-160, HAR, a process for department approved conditions has been outlined.  See Petition Process for more information.

Other Medical Conditions

Pursuant to Act 241, SLH 2025, the Hawaiʻi Revised Statutes have been amended to allow licensed physicians and advanced practice registered nurses (APRNs) that qualify as “PRIMARY TREATING MEDICAL PROVIDERS” to certify patients for the medical use of cannabis for conditions that are not explicitly listed as a “debilitating medical condition” under the law, if the following conditions are met:

Primary Medical Provider

 To qualify as a Primary Treating Medical Provider, you must:

  1. Be a physician or an advanced practice registered nurse (APRN);
  2. Hold an active, unrestricted license to practice in the State;
  3. Be physically located in the State;
  4. Be EITHER:
    1. Primary Care Provider (PCP):
      1. The provider who is primarily responsible for the patient’s overall treatment and ongoing care; and
      2. Coordinates and manages the patient’s general health care needs; OR
    2. Specialist:
      1. A provider practicing within their licensed scope of practice and individual competency;
      2. Serving as the primary provider responsible for treating a specific condition; and
  • The specific condition is the one for which the provider is certifying the medical use of cannabis.

Eligibility Requirements for Certification

A Primary Treating Medical Provider may certify a patient if the following criteria are met:

  1. The patient has been diagnosed with a medical condition (debilitating or otherwise) and the provider is primarily responsible for ongoing care of the patient or patient’s condition.
  2. The provider certifies in writing that in their professional opinion the potential benefits of the medical use of cannabis are likely to outweigh the associated health risks for the patient.
  3. A bona fide provider-patient relationship This means that the physician or APRN has ongoing responsibility for the assessment, care, and treatment of a qualifying patient’s medical condition with respect to the medical use of cannabis.
  4. The provider’s decision is supported by appropriate medical documentation and clinical judgment.

Hospice

Patients may be certified for medical cannabis by their licensed hospice provider while receiving hospice care.