Physicians recommending medical cannabis must be licensed under Haw. Rev. Stat. § 453, and licensed with authority to prescribe drugs and is registered under Haw. Rev. Stat. § 329-32. Advanced practice registered nurses with prescriptive authority under Haw. Rev. Stat. § 457-8.6 and registered under Haw. Rev. Stat. § 329-32 may certify patients for medical marijuana use. Physician Assistants are not allowed to write recommendations. Physicians and advanced practice registered nurses must demonstrate a bona fide relationship with patients. To establish this relationship, the treating physician, at a minimum shall:

  1. Complete a full assessment of the qualifying patient's medical history and current medical condition, including conducting a review of the qualifying patient's medical records related to the medical condition as medically appropriate and conducting an in-person physical examination;
  2. Provide follow-up care and treatment as medically appropriate to the qualifying patient and assess the qualifying patient's medical condition during the course of the qualifying patient's medical use of marijuana; and
  3. Maintain records of the qualifying patient's treatment and medical condition in accordance with medically accepted standards.

To certify a patient for medical marijuana use, a physician or advanced practice registered nurse must do the following:

  1. Diagnose the patient as having a debilitating medical condition covered under current medical marijuana law (i.e. Haw. Rev. Stat. § 329-121);
  2. Explain the potential risks and benefits of medical marijuana use to the patient or his/her guardian; and
  3. Certify, in writing, that in his/her professional opinion, after having completed a full assessment of the patient's medical history and current medical condition made in the course of a bona fide physician-patient relationship or bona fide advanced practice registered nurse-patient relationship, as applicable, that the potential benefits of the medical use of marijuana would likely outweigh the health risks for the particular qualifying patient.

Eligible Debilitating Medical Conditions include:

  • Amyotrophic Lateral Sclerosis
  • Cancer
  • Glaucoma
  • Lupus
  • Epilepsy
  • Multiple Sclerosis
  • Rheumatoid Arthritis
  • Positive status for human immunodeficiency virus
  • Acquired immune deficiency syndrome
  • Post-Traumatic Stress Disorder (PTSD)

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 (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

More information about Hawaii’s Medical Provider Forms and Patient Applications can be found here.

Medical professionals have a legal right to recommend cannabis as a treatment in any state, as protected by the First Amendment. Established by a 2004 United States Supreme Court decision to uphold earlier federal court rulings that found doctors and their patients have a fundamental Constitutional right to freely discuss treatment options.

More resources for medical professionals can be found here.