April 2, 2025
Two more Senate committees in Hawaii have approved a medical marijuana bill that, among other changes, would allow healthcare providers to recommend cannabis to treat any condition they believe it would benefit.
At a joint hearing Tuesday, both the Senate Ways and Means Committee and Judiciary Committee voted to advance HB 302, from Rep. Gregg Takayama (D).
As introduced, the proposal would clarify that under state law, a medical marijuana recommendation would no longer need to be made by a doctor who had conducted “an initial in-person consultation” with a patient.
Last month, however, another pair of Senate committees amended the bill to effectively allow medical marijuana to be recommended for any condition that a doctor or advanced practice registered nurse (APRN) believes it would benefit, instead of only those maladies on a specific list, as is the case under current law.
The provision would redefine “debilitating medical condition” to mean “any condition determined by the certifying physician or advanced practice registered nurse to be appropriate for the medical use of cannabis.”
That change would open the door to wider access for patients who might have conditions that stand to benefit from medical marijuana but whose ailments haven’t been specifically recognized by state officials.
Before advancing the measure Tuesday, lawmakers adopted another handful of changes suggested by the Department of the Attorney General. Those dealt with penalties around marijuana advertising, unlicensed operation of a dispensary and other licensing and enforcement matters.
The panels did not hold any debate on the substance of the measure, although ahead of the vote, Sen. Brenton Awa (R) said he was voting no because the proposal “pretty much shuts down a medical provider in my district in Waialua.” He did not further explain how the business would be affected.
The move to allow healthcare providers to recommend medical cannabis to patients for any condition they see fit is in line with a plan announced last year by Gov. Josh Green (D) to expand access to marijuana in light of the legislature’s failure to pass recreational legalization measures.
“This would make it very available—that’s marijuana—for those who choose it in their lives,” the governor said in an interview, “and it would still keep kids safe, which has been everyone’s priority.”
At the same time, Green reiterated his support for full recreational legalization.
“I think for adults who can responsibly use marijuana, it should be legal,” he said.
The state Department of Health has taken issue with the medical marijuana expansion bill that is now advancing.
“While the Department supports allowing medical providers to use their professional judgment in diagnosing and treating patients,” it said in written testimony, “there is limited scientific evidence supporting the use of cannabis for conditions beyond those currently listed in statute. The Department is particularly concerned about potential risks to patient safety, including adverse drug interactions between cannabis and a patient’s existing treatment plan.”
To remedy those concerns, the department recommended an amendment stating that only a patient’s treating provider be authorized to certify patients for nonspecified conditions. The panels did not appear to adopt that amendment at Tuesday’s hearing, however.
Written testimony from advocates at Marijuana Policy Project (MPP), meanwhile, called the expansion of qualifying conditions “long overdue.”
“Practitioners can prescribe far more dangerous medications off-label, and they should be able to certify patients for medical cannabis when they feel it is appropriate, too,” wrote Karen O’Keefe, MPP’s director of state policies.
“Allowing doctors and APRNs to certify by telehealth and to recommend cannabis for any medical condition will also increase the number of individuals who can access lab-tested, regulated medical cannabis,” the group added, “reducing the number relying on unregulated illicit cannabis and the untested intoxicating hemp market.”
In comments to Marijuana Moment after Tuesday’s vote, O’Keefe said the bill “would significantly expand Hawaii’s medical cannabis law, allowing doctors and APRNs to certify patients for any medical condition they believe can benefit—either in person or by telehealth.”
“Patients with insomnia, anxiety, autism, ALS, and many other conditions are currently shut out from legal medical cannabis in Hawai’i,” she said. “This bill would finally change that.”
Some reform advocates have raised concerns with other parts of the legislation, however. The Hawai’i Alliance for Cannabis Reform (HACR), for example, wrote to oppose what would be a new Class C felony for operating a dispensary without a license.
The group said in general, however, that HB 302 “would make it easier for Hawaiʻi residents who could benefit from medical cannabis to consult with a knowledgeable provider, qualify for and enroll in the state’s medical cannabis program, and purchase lab-tested medicine.”
Separately, Hawaii’s legislature last week sent a bill to the governor that would help speed the expungement process for people hoping to clear their records of past marijuana-related offenses.
That measure, HB 132, from Rep. David Tarnas (D), would expedite expungements happening through a pilot program signed into law last year by Gov. Josh Green (D). Specifically, it would remove the distinction between marijuana and other Schedule V drugs for the purposes of the expungement program.
The bill’s proponents say the current wording of the law forces state officials to comb through thousands of criminal records manually in order to identify which are eligible for expungement under the pilot program.
The governor approved the expungement pilot program legislation—HB 1595, also from Tarnas—last year. Its goal was to expunge non-conviction marijuana arrest records solely in Hawaii County, home to about 14 percent of the state’s population. The county comprises the Big Island and is the state’s second most populous after Honolulu County.
As originally introduced, the measure would have directed state officials to automatically expunge tens of thousands of arrest and conviction records for low-level marijuana possession. But the Senate Judiciary Committee later amended the proposal, replacing the statewide plan with a pilot program in Hawaii County that would apply only to non-conviction arrest records.
Meanwhile this session, the House Health Committee last month amended and passed a Senate-approved bill to support clinical research on psychedelic-assisted therapies using substances such as psilocybin and MDMA. The panel first adopted a handful of changes suggested by the Office of Wellness and Resilience, most notably replacing a special fund with a two-year pilot program.
Separately, in February the Senate narrowly defeated a separate proposal that would have increased fivefold the amount of cannabis that a person could possess without risk of criminal charges. Had the measure become law, it would have increased the amount of cannabis decriminalized in Hawaii from the current 3 grams up to 15 grams. Possession of any amount of marijuana up to that 15-gram limit would have been classified as a civil violation, punishable by a fine of $130.
The House Committee on Labor in January unanimously voted to advance legislation that would protect state-registered medical marijuana patients from discrimination in the workplace. That bill, HB 325, has not yet been taken up in the Senate.
Another Senate bill that would have legalized marijuana for adults recently stalled for the session. That measure, SB 1613, had yet to make it out of its current committee despite a legislative deadline in February.
While advocates feel there’s sufficient support for the legalization proposal in the Senate, it’s widely believed that House lawmakers would ultimately scuttle the measure, as they did with a legalization companion bill, HB 1246.
Last session, a Senate-passed legalization bill also fizzled out in the House.
This past fall, regulators solicited proposals to assess the state’s current medical marijuana program—and also sought to estimate demand for recreational sales if the state eventually moves forward with adult-use legalization. Some read the move as a sign the regulatory agency saw a need to prepare to the potential reform.
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