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Sickle Cell Disease and cannabis in Hawaii

The state currently does not list this condition as qualifying, and the program does not provide open-ended physician discretion to add conditions. Verify with the state regulator, because programs change.

Not on the qualifying list
✗ No
LEGAL
Up to 4 oz over any 15-…
POSSESSION
$38/yr
STATE FEE
7–21 d
TIMELINE
Not on the qualifying list. The state currently does not list this condition as qualifying, and the program does not provide open-ended physician discretion to add conditions. Verify with the state regulator, because programs change.

Hawaii statute and program

The Hawaii Medical Cannabis Program is the operating authority for Hawaii patient certification. The authoritative legal text is: Hawaii Revised Statutes Chapter 329 Part IX: Medical Use of Cannabis. The program portal is at Hawaii Medical Cannabis Program.

What the evidence says about cannabis and Sickle Cell Disease

Sickle cell disease (SCD) is a group of inherited red blood cell disorders caused by mutations in the hemoglobin gene. Red cells assume a rigid sickle shape under low-oxygen conditions, leading to chronic hemolytic anemia, episodic vaso-occlusive pain crises, stroke risk, acute chest syndrome, and progressive end-organ damage. SCD disproportionately affects people of African, Mediterranean, and South Asian descent.

For the full evidence base, including the NASEM tier, randomized trial summaries, and symptom-domain breakdown, read the mmjnow Sickle Cell Disease page.

How to qualify in Hawaii

The Hawaii Medical Cannabis Program requires the following registration steps for a Sickle Cell Disease patient (or any qualifying diagnosis):

  1. Get certified by a Hawaii-licensed physician or APRN. Under HRS §329-121 et seq. (Act 228 of 2000), any Hawaii-licensed physician or advanced practice registered nurse with prescriptive authority may certify a patient. Qualifying debilitating medical conditions include cancer, glaucoma, HIV/AIDS, lupus, epilepsy, MS, rheumatoid arthritis, PTSD, Crohn’s, and any chronic or debilitating disease or medical condition that produces cachexia, severe pain, severe nausea, seizures, or severe and persistent muscle spasms.
  2. Apply through the Hawaii Medical Cannabis Registry Program portal. The patient creates an account in the Hawaii Department of Health Medical Cannabis Registry Program online portal, uploads the practitioner certification, a Hawaii driver license or state ID, and a passport-style photograph. Out-of-state patients may apply for a 60-day "329 V-card" out-of-state patient registration under HRS §329-123(2).
  3. Pay the $38.50 state registration fee. The annual Hawaii medical cannabis 329 registration card fee is $38.50 (one of the lowest in the United States). Out-of-state 60-day registration is $49.50. The fee for caregivers is included with the patient fee. Hawaii does not currently charge reduced or waived fees for indigent or veteran patients.
  4. Receive the digital 329 card and purchase from a dispensary. Hawaii issues digital 329 cards within roughly 10 to 14 business days of complete application (no physical card; the digital card is downloaded from the Medical Cannabis Registry portal). Patients may possess up to 4 ounces of usable cannabis and cultivate up to 10 plants under their 329 card. Hawaii has eight licensed dispensaries across Oahu, Maui, Hawaii Island, and Kauai. Hawaii honors out-of-state medical cards under its 329 V-card reciprocity provision.
State registration fee
$38
Physician visit (typical)
$200–$350
Certification to card
7–21 days
Out-of-state patients
Eligible
Minors
Eligible with caregiver

For full Hawaii registration steps, fees, and reciprocity rules, see the Hawaii cannabis-laws page.

ICD-10 code

A certifying physician documenting Sickle Cell Disease for the Hawaii medical cannabis program will typically record ICD-10 D57.1 or SNOMED-CT 417357006 in the patient's record. The state registry does not itself collect ICD-10 codes in most programs, but the physician's chart is the audit trail if the certification is later reviewed.

Frequently asked questions

Does Hawaii list Sickle Cell Disease as a qualifying condition for medical cannabis?

No. Hawaii's qualifying-condition list does not currently include Sickle Cell Disease, and the state's program does not give physicians open-ended discretion to add conditions outside the list. Patients with Sickle Cell Disease in Hawaii have limited in-state pathways under the medical program as written. Options to verify and pursue include: petitioning the state regulator to add the condition (where the statute permits public petitions); consulting a physician about whether a co-occurring listed condition could support certification; or reviewing whether the state's program is undergoing legislative expansion. Hawaii program rules change, so verify the current list with the regulator before drawing a final conclusion.

How do I get a Hawaii medical marijuana card for Sickle Cell Disease?

Because Hawaii does not currently list Sickle Cell Disease as a qualifying condition, a card for Sickle Cell Disease alone may not be obtainable in-state under the program rules as written. Step one is finding a physician licensed in Hawaii who is registered with Hawaii Medical Cannabis Program and willing to evaluate Sickle Cell Disease cases. Step two is collecting your records (diagnosis documentation, treatment history, and the ICD-10 code your physician will use) and bringing them to the certification visit. Step three is the physician's certification through the state registry, followed by the patient registration application, state fee, and waiting period before the card is issued. Hawaii honors out-of-state medical cards under its reciprocity rules — uncommon, and worth verifying before relying on it. Verify the patient minimum age with the state program before applying. The authoritative source for the current process is the Hawaii Medical Cannabis Program site at https://health.hawaii.gov/medicalcannabis/; the state updates fees, forms, and physician registration rules periodically.

What does the evidence say about cannabis for Sickle Cell Disease?

For Sickle Cell Disease, evidence is described as limited (a small number of supportive studies, often underpowered or focused on narrow symptom domains). The mmjnow condition page for Sickle Cell Disease lays out the current evidence base, including the citations underlying that evidence tier — typically the National Academies of Sciences, Engineering, and Medicine consensus reports, federal agency guidance, and peer-reviewed reviews. Evidence quality is independent of state law: a state can list a condition for which evidence is limited, and a state can decline to list a condition for which evidence is strong. Patients deciding whether to pursue medical cannabis for Sickle Cell Disease should review the underlying evidence (linked on the condition page) and discuss expected benefit, dosing, and risk with a clinician familiar with both Sickle Cell Disease and cannabinoid pharmacology. Cannabis is not a substitute for evidence-based first-line treatments for Sickle Cell Disease; the evidence position above describes whether trial data supports its use, not whether it should replace standard care.

Sources

  1. Hawaii Revised Statutes Chapter 329 Part IX: Medical Use of Cannabisaccessed May 16, 2026
  2. Hawaii Revised Statutes Chapter 329D: Medical Cannabis Dispensary Systemaccessed May 16, 2026
  3. Hawaii Department of Health: Medical Cannabis Programaccessed May 16, 2026
  4. Wikipedia: Cannabis in Hawaiiaccessed May 16, 2026
  5. NIH National Heart, Lung, and Blood Institute: Sickle Cell Diseaseaccessed May 15, 2026
  6. NIH NCCIH: Cannabis (Marijuana) and Cannabinoidsaccessed May 15, 2026