Hawaii Medical Cannabis Qualifying Conditions: Complete 2026 List
See the official list of qualifying conditions for a Hawaii 329 medical cannabis card. Includes specific conditions, symptoms, and important updates on provider discretion for 2026.
To qualify for a Hawaii 329 medical cannabis card, you must have a debilitating medical condition (or symptoms caused by one), or another condition that a licensed Hawaii physician or APRN determines would benefit from medical cannabis. Hawaii law recognizes both specific medical conditions and certain symptoms, and in 2025 the state expanded access under Act 241, giving qualifying providers more flexibility to certify patients. Hawaii recognizes ten named debilitating conditions (including cancer, PTSD, glaucoma, epilepsy, and MS) plus qualifying symptoms such as severe pain, severe nausea, and persistent muscle spasms. Since 2025 (Act 241), a qualifying Primary Treating Medical Provider may also certify other conditions when the benefits are likely to outweigh the risks. Official Specific Qualifying Conditions The Hawaii Department of Health recognizes the following as debilitating medical conditions: Amyotrophic Lateral Sclerosis (ALS) Cancer Glaucoma Lupus Epilepsy Multiple Sclerosis (MS) Rheumatoid Arthritis HIV (positive status for human immunodeficiency virus) AIDS (acquired immune deficiency syndrome) PTSD (Post-Traumatic Stress Disorder) Qualifying Symptoms You may also qualify if you have a chronic or debilitating condition, or are receiving treatment for one, that causes 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 Expanded Access: Provider Discretion (2025 Update) A significant change took effect in 2025 under Act 241. Licensed physicians and Advanced Practice Registered Nurses (APRNs) who qualify as Primary Treating Medical Providers can now certify patients for medical conditions that are not specifically listed above. Your provider may approve you if they determine that: The potential benefits of medical cannabis are likely to outweigh the health risks, and There is a bona fide (genuine, ongoing) provider-patient relationship. This means many patients with conditions not on the original list may now qualify based on their physician's or APRN's clinical judgment and medical documentation. Hospice patients may also be certified by their licensed hospice provider while receiving hospice care. Important Notes The final decision rests with your certifying provider, who must follow Hawaii law and document their reasoning. You do not need to match one of the specific conditions listed above if your provider determines another condition qualifies. A bona fide patient-provider relationship is required for certification. Out-of-state patients applying for a temporary OSP card must also meet Hawaii's qualifying-condition standards. Frequently Asked Questions What conditions qualify for a Hawaii 329 card? Hawaii recognizes specific conditions such as cancer, PTSD, epilepsy, and multiple sclerosis, as well as symptoms like severe pain, severe nausea, and muscle spasms. Providers also have discretion to certify other conditions when they determine medical cannabis would be beneficial. Can my doctor approve me for a condition not on the list? Yes. Since the 2025 law change (Act 241), qualifying Primary Treating Medical Providers can certify patients for other conditions if they believe the benefits outweigh the risks and there is an ongoing patient-provider relationship. Do I need a specific diagnosis to qualify? Not necessarily. Many patients qualify based on symptoms, such as chronic severe pain or nausea, even without one of the named conditions. Is chronic pain a qualifying condition in Hawaii? Yes. Severe or chronic pain is recognized both as a qualifying symptom and through provider discretion. How do I know if I qualify? The best way to find out is to schedule an evaluation with a licensed Hawaii physician or APRN who is authorized to provide medical cannabis certifications. Related Guides Ready to apply? See our step-by-step guide on how to get a Hawaii 329 card . Visiting from another state? See Hawaii medical cannabis reciprocity and the OSP card . Last updated: June 18, 2026 About the Author Dr. James Berg, MD is the founder of Greener Healing Ways. A longtime advocate for Hawaii's medical cannabis patients, he has corresponded directly with the Hawaii Department of Health regarding the state's 329 medical cannabis program. Official Source: Hawaii Department of Health, Qualifying Medical Conditions: health.hawaii.gov/medicalcannabisregistry/providers/debilitating-medical-conditions Disclaimer: This guide provides general information based on current Hawaii Department of Health guidelines. Qualifying for a 329 card depends on evaluation by a licensed Hawaii healthcare provider. This is not medical or legal advice. Always verify the latest information on the official state website and consult with a qualified provider.
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