Medical Cannabis: The Promise of Thai Medical Future

Cannabis or locally known in Thailand as Gunja has been classified as a narcotic under the Narcotics Act of 1979. It has been considered the same class as mushrooms and Kratom. Producing, importing or exporting cannabis result in imprisonment for 2-15 years. And up to 5 years of imprisonment for cannabis possession. However, in the last general election, Bhumjai Thai Party proposed a cannabis legalization policy. Not only the ban of cannabis would be lifted, but also cannabis would be used as medicines. There was an expectation from Thai people that the policy would go as far as allowing them to smoke Gunja as a leisure and plant Gunja at their home. 

Six months after the election, Bhumjai Thai Party became part of the government and the party leader is now working as the minister of Ministry of Public Health. People were calling for cannabis policies that had been campaigned during the rally. However, the furthest progress up to date is that 99%-pure CBD oil made from cannabis or hemp with a mix of very little psychoactive THC is no longer a narcotic. Also, producing, buying, selling or possessing cannabis or smoking a joint is still against the law.

Nonetheless, because of that first step, medical cannabis project has started. As the two main substances in cannabis is no longer a narcotic, CBD and THC extract are now used in medical labs for medicine production.

There are questions about how far the policies would go and they were discussed in a seminar. The seminar was organized by Pharmacy Association in Thailand under the topic “Pharmacists and Medical Cannabis: How to make it safe and correct” on September 25, 2019.

First of all, Thai people have to admit that we still have very little knowledge about cannabis as it has been banned for 50 years. There was no research done about it.  “When I was a pharmacy student, I had no chance to study about Gunja. At that time, it was classified as a narcotic. It is like a person who has been imprisoned for decades. So, nobody knows about his potential. He needs to be studied.” Moreover, as cannabis was illegal, the researcher who studied it was unable to patent the research.

Having little knowledge is the real setback of the cannabis medical development, especially knowledge about the dose quantity. People who take cannabis oil risk themselves of overdose. Cannabis oil is commonly made from CBD extract. CBD is non-psychoactive substance, so it is difficult for the user to know if the cannabis oil is active. The user tends to overdose to satisfy themselves. Regulating the dose quantity is now a concern for medical professionals.

One of the medical professionals who is regulating the dose quantity of medical cannabis is Dr. Phakakrong Kwangkao, researcher from evidence-based research center, Abhaiphubet Chaopraya Hospital. She is working on a cure of Parkinson’s Disease by using cannabis oil. According to Dr. Phakakrong, medical cannabis is now used as an alternative treatment for a patient of diseases that has no cure such as Parkinson’s Disease or used as a tool to improve the life quality of terminally ill patient such as people living with terminal cancer. Medical cannabis can relief the pain and increase the appetite. Please note that cannabis oil is not a direct cure to cancer, it is allowed to be use to improve the life of the patient only. Nevertheless, each person has their own cannabinoid receptor. So, the medical cannabis will affect differently with different person. This makes considering the dose quantity difficult. Now, the patient treated with medical cannabis is studied case-by-case, to collect information as much as possible.

Dr. Phakakrong cited that there are five principles when choosing to use medical cannabis to the patient. 1. the medical cannabis must be in good quality and it must be consistent. 2. It must be safe. 3. It must show effectiveness. 4. It has to be efficient. The production cost of cannabis oil is very high. So, medical cannabis will never be considered as the first option for treatment. 5. It needs good resource management.

According to the lecture of Dr. Phakakrong, the success of medical cannabis in Thailand relies upon a systematic administration in multiple sections ranging from research, production capacity expansion, quality control and legal management.

Dr. Anunchai Assawamakin, lecturer from Department of Pharmacology at Faculty of Science, Mahidol University and the policy advisor of cannabis legalization mentioned that legalizing cannabis in Thailand proves how effective healthcare system of Thailand as a whole. Dr. Anunchai emphasized on two things that need to be improved. They are knowledge management and collaborative works between organizations.

First of all, knowledge management. It is not about research only, but also includes providing information to the public and regulating the access to cannabis. Dr. Anunchai understood the bad effects from giving too much legal freedom to cannabis use that the number of drug addicts would increase. However, he cited that strictly banning cannabis would give even worse effect. Dr. Anunchai said that banning cannabis will lead to the rise of underground drug dealers and underground cannabis oil producers, which would be extremely harmful to the consumer. He suggested that having strict legal regulation is the best way, which means that cannabis must be legal yet restricted.

Also, collaborative research is urgently needed to find the right dose quantity and healing potential of cannabis, as well as the direction to develop cannabis use in the Thai society. Apart from that communicating facts to the public is also important to prevent people from misbelieving that cannabis is a magic medicine that cures all diseases, which has been wrongly advertised by witch doctors, who sell underground cannabis oil illegally on the internet.

To summarize the seminar, Dr. Anunchai Assawamakin saw the bright future of cannabis use in Thailand if the knowledge management and collaborative works are correctly implemented. He contended that “Knowledge management and collaborative works to create the direction for the use of cannabis and the information from new researches will give the cannabis use a sustainable future.”