Hawaii requires controlled-substance prescribers to be physically located in Hawaii and mandates an in-person consult first

Under Hawaii law, all providers prescribing controlled substances must be physically located in Hawaii, which prevents out-of-state telehealth clinicians from prescribing these medications to Hawaii patients. Establishing the relationship for opioids and medical cannabis also requires an initial in-person consultation. These rules limit telehealth-based pain management, addiction treatment, and psychiatric prescribing for Hawaii residents, especially in rural and neighbor-island areas.

Source: Center for Connected Health Policy (CCHP), Hawaii state telehealth page (2026).