Abstract
Background and rationale: The Thai medical cannabis (or medical marijuana: MMJ) system was first established in February of 2019. This study aimed to identify the most essential and urgent policy and research and initial policy recommendations regarding the implementation and impacts of the MMJ policy in Thailand. Methodology: A narrative literature review and other qualitative methods; 18 in-depth interviews with key stakeholders, focus group discussions of nine service providers and patients, and a participant observation in the MMJ clinic at the Ministry of Public Health. Results: Our crucial findings showed that: (a) the Thai MMJ system is complex, consisting of three subsystems: modern medicine, Thai traditional medicine, and folk medicine. These subsystems are not harmonized, and have resulted in poor access to legal MMJ products. (b) MMJ is a new entity in Thailand, and a comprehensive monitoring and evaluation system is needed. (c) the MMJ movement in Thailand has “political economy” attribute, meaning that the policies may be driven by benefits beyond a medical rationale. These findings lead to six research questions. (1) What do the governance structure and plans regarding MMJ policy in Thailand look like? (2) How do we improve the complex MMJ system to best serve patients? (3) How much and how to invest in a knowledge-generation system, and a monitoring and evaluation system regarding the MMJ policy? (4) How do we build MMJ consumers’ health literacy? (5) What are the efficacy levels and cost-effectiveness of the Thai medical cannabis products? And (6) What should be the future MMJ policy in Thailand? Conclusion: The newly established and complicated Thai medical cannabis system is novel for Thai society. This system has potentials to produce both positive and negative consequences, with potentially enormous underlying economic benefits. Therefore, the government and all relevant sectors must collaboratively manage the medical cannabis system in a transparent, creative, and considerate way, to provide the best benefits for patients and the whole of Thai society, in both the short- and long-term.
