Hawaiʻi voters could be asked this November whether to legalize recreational cannabis under a constitutional amendment proposed by state Rep. David Tarnas, a move that would place the question directly before voters rather than moving through the Legislature.
Currently, Hawaiʻi operates under a medical-only cannabis framework, a system some dispensary operators say is increasingly out of step with consumer demand and national trends.
TY Cheng, president of Aloha Green Apothecary on Oʻahu, told Aloha State Daily that placing the issue before voters reflects lawmakers’ continued reluctance to address cannabis policy themselves.
“Legislators are elected to legislate, not to pass their responsibilities on to voters when consensus is difficult,” Cheng said.
Hawaiʻi established its Medical Cannabis Registry Program in 2000 under Act 228, becoming the first state in the nation to recognize medical cannabis. Since then, many states have moved forward with adult-use legalization.
According to information provided to ASD by the Hawaiʻi Department of Health, nine states — Vermont, Illinois, New Jersey, Delaware, Maryland, Minnesota, Missouri, Ohio and Rhode Island — legalized adult-use cannabis through legislative action rather than voter initiatives. Forty states have legalized medical-only marijuana, and 24 have fully legalized marijuana use, according to the National Conference of State Legislatures.
DOH, which oversees the state’s Medical Cannabis Registry Program, said Hawaiʻi remains a medical-only cannabis state, with licensed dispensaries permitted to serve registered patients only. DOH said the program is structured to ensure regulatory oversight, product testing and patient safety.
Cheng said any eventual adult-use market in Hawaiʻi should prioritize existing medical licensees, local growers, patient protections and community reinvestment. He cautioned that a constitutional amendment could oversimplify an issue that requires detailed policymaking.
“Continued hesitation only ensures that when legalization does arrive, Hawaiʻi’s growers will be left playing catch-up,” Cheng said.
Karlyn Laulusa, CEO of Noa Botanicals on Oʻahu, said the medical-only system continues to push some adult consumers into unregulated markets.
“Those who choose to consume cannabis but refuse to join the medical program are driven into the illicit market,” Laulusa told ASD.
She also pointed to delays in patient access, including the requirement to schedule a physician visit before entering the program.
“Cannabis remains the only medication that cannot be obtained the same day it is prescribed,” Laulusa said.
As of July 31, 2025, Hawaiʻi had 29,325 in-state patients with valid medical cannabis registration cards, DOH told ASD. The state has eight licensed medical cannabis dispensaries, each allowed up to four retail locations, with 25 active storefronts statewide.
DOH said licensed dispensaries must comply with state rules governing cultivation, manufacturing, testing and retail sales, and that any changes to the current medical cannabis framework would require legislative action or voter approval.
Cheng said operating under a medical-only model leaves Hawaiʻi dispensaries navigating uncertainty as cannabis policy evolves at the federal level.
“There is always a risk in operating a medical dispensary because medical dispensaries operate outside of the Controlled Substances Act,” Cheng said.
Both Cheng and Laulusa said continued delays in addressing adult-use legalization place Hawaiʻi operators at a disadvantage compared with Mainland markets that have clearer regulatory pathways.
“Without a recreational market, Hawaiʻi continues to delay the inevitable,” Cheng said. “If federal momentum continues while the state remains at a standstill, local operators will face increasing challenges.”
For the latest news of Hawai‘i, sign up here for our free Daily Edition newsletter.
