Psychiatric Services in the Era of Cannabis Policy Reform in Thailand, 1979–2026
Kamonporn Wannarit, Woraphat Ratta-Apha, Pichet UdomratnAbstract
Background:
Cannabis in Thailand has been reformed several times, ranging from strictly prohibiting the use of cannabis to widespread decriminalization in 2022, and it was subsequently returned to medical use proposes later. The authors intended to highlight how the transition of cannabis policy affects psychiatric services, clinical practice, and patient outcomes in Thailand.
Methods:
The authors did a scoping review to collect information from the relevant literature published between 1979 and 2026. The databases included PubMed, Scopus, ThaiJO, and gray literature. The data were grouped into topics, including policy eras, impacts on clinical outcomes, clinical guidelines, and pharmacological considerations.
Results:
After the shift from cannabis medicalization to decriminalization and then reregulation, Thailand addressed numerous consequences. The increased accessibility of cannabis was related to the usage behavior. As a result, the prevalence of cannabis-related disorders and hospitalization associated with cannabis use was rising, especially in minors. A guideline on cannabis for medical use pointed out that cannabis products are not recommended as the first-line treatment for physical conditions such as chemotherapy-induced nausea and central neuropathic pain. Many Thai patients were taking medications for their underlying medical conditions and were exposed to cannabis products; hence, possible drug–drug interactions through the cytochrome P450 system should be considered.
Conclusion:
Currently, cannabis legalization has a significant impact on health, social, and economic dimensions, causing a gap between patients’ health services and the legal framework. Patients and their guardians should be informed of the potential risks, benefits, and limitations of cannabis use, as well as interactions of cannabis–psychotropic drugs and long-term impacts.