Hawaii Medical Cannabis Program Captures Majority of Patient Spending

Report outlines potential impacts of future adult-use legalization on demand, regulation, and public health

Feb. 6, 2026 at 4:39am

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A new independent economic analysis commissioned by the Hawaii Department of Health's Office of Medical Cannabis Control and Regulation finds that the state's medical cannabis program captures the vast majority of patient spending and is effectively serving registered users. The report also outlines how a future adult-use cannabis market could reshape demand, regulation, and public health risks.

Why it matters

The report provides valuable insights into Hawaii's medical cannabis program and the potential implications of legalizing adult-use cannabis. It highlights the program's performance in serving registered patients, while also cautioning that expansion beyond medical use would bring trade-offs that need to be carefully considered, such as increased overall cannabis use, rates of cannabis use disorder, drug-impaired driving, and youth exposure.

The details

According to the analysis, Hawaii's regulated medical cannabis program generates about $5.3 million in monthly sales and captures roughly 86% to 87% of all cannabis spending by registered patients. The report estimates the total cannabis market in Hawaii, including medical, gray, and illicit sources, ranges from about $16.5 million to $32 million per month, with medical dispensaries accounting for roughly one-third of that total. If Hawaii legalizes adult-use cannabis, the report projects that total cannabis sales across all sources could grow to between $59 million and $95 million per month within five years.

  • The report was commissioned by the state Department of Health's Office of Medical Cannabis Control and Regulation and published on December 19, 2025.

The players

Andrew Goff

OMCCR Program Manager, who stated that the findings show the medical program is performing well but cautioned that expansion beyond medical use would bring trade-offs.

Cannabis Public Policy Consulting

The consulting firm that prepared the report for the state of Hawaii.

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What’s next

The state legislature is considering bills like House Bill 1625 and Senate Bill 2421 that would establish an adult-use cannabis system in Hawaii, which could further reshape the state's cannabis landscape.

The takeaway

The report highlights the strength of Hawaii's medical cannabis program in serving registered patients, but also cautions that legalizing adult-use cannabis would require careful consideration of the potential public health and regulatory impacts. Policymakers will need to balance the interests of the medical program, the emerging adult-use market, and the overall well-being of Hawaii's communities.