Hawaii is taking a major step toward expanding access to medical marijuana. Two Senate committees recently approved an amended bill that allows healthcare providers to recommend medical cannabis for any condition they consider “appropriate.” This change would replace the current system where only specific qualifying conditions are approved for cannabis use.

Key Changes in the Bill

1. Flexible Condition Criteria:
   • Under the amended version of House Bill 302 (HB 302), doctors and advanced practice registered nurses (APRNs) can recommend cannabis for any debilitating condition they believe could benefit from treatment with marijuana.
   • This change would allow patients with conditions not previously recognized by the state to access medical cannabis.
2. No In-Person Consultation Requirement:
   • The original version of the bill also proposed removing the requirement for doctors to conduct an “initial in-person consultation” before recommending medical marijuana. This would allow more flexible options for patients to obtain recommendations.
3. Dispensary Changes:
   • Licensed dispensaries would be allowed to sell products, including hemp-based items and cannabis accessories, in waiting rooms.
   • The bill would also allow the transfer of cannabis and related products between licensed dispensaries in specific situations.

Support and Rationale for Expansion

Karen O’Keefe, Director of State Policies for the Marijuana Policy Project, pointed out that doctors frequently prescribe far more dangerous medications for off-label use. She highlighted that 10 other states allow doctors to recommend medical cannabis for conditions beyond an approved list, urging Hawaii to follow suit.

Gov. Josh Green (D) previously expressed support for expanding access to medical marijuana. After recreational cannabis legalization bills failed to pass, he suggested that allowing broader use of medical cannabis could provide patients with more options while maintaining safety measures.

Governor’s Vision for Future Legalization

While supporting this expansion of the medical program, Gov. Green reaffirmed his belief that full recreational marijuana legalization is the ultimate goal. He emphasized that legal cannabis for responsible adult use should be permitted while ensuring safety for children.

“This would make marijuana widely available for those who choose it while keeping kids safe, which remains everyone’s priority,” Green said in an interview.

Legislative Process and Committee Approval

HB 302, introduced by Rep. Gregg Takayama (D), has already passed the Hawaii House of Representatives. The bill was approved by the Senate Committee on Health and Human Services and the Committee on Commerce and Consumer Protection without any opposition in Wednesday’s hearing.

Sen. Joy San Buenaventura (D), chair of the Health and Human Services Committee, explained that the changes reflect input from dispensaries and align with Hawaii’s evolving approach to cannabis regulation.

Other Cannabis-Related Developments in Hawaii

1. Workplace Protections for Medical Marijuana Patients:
   • In January, the House Committee on Labor advanced a bill (HB 325) to protect registered medical marijuana patients from discrimination in the workplace.
   • However, the bill has yet to be taken up by the Senate.
2. Psychedelic-Assisted Therapy Bill:
   • The House Health Committee recently passed a bill to support clinical research on psychedelic-assisted therapies using substances like psilocybin and MDMA.
   • The bill was amended to create a two-year pilot program.
3. Failed Recreational Marijuana Bills:
   • Recent efforts to legalize recreational marijuana through bills SB 1613 and HB 1246 stalled in both the Senate and the House.
   • Advocates believe there is enough support in the Senate, but concerns remain about opposition in the House.
4. Increased Cannabis Possession Limits Proposal Defeated:
   • A separate proposal that would have increased the amount of decriminalized cannabis possession from 3 grams to 15 grams was narrowly defeated in the Senate.

Hawaii’s History with Medical Marijuana

Hawaii made history in 2000 by becoming the first U.S. state to authorize medical marijuana through legislative action. However, advocates have long pushed for broader access and eventual recreational legalization.

Regulators have also been preparing for possible future legalization. Last fall, they requested proposals to assess the state’s current medical marijuana program and estimate demand for recreational sales if legalization moves forward.

What’s Next?

With HB 302 moving through the Senate, healthcare providers in Hawaii may soon have the freedom to recommend cannabis for any condition they deem appropriate. If passed into law, this change would provide more flexibility and accessibility for patients while paving the way for further cannabis reform in the state.