A surge of recent research questions common beliefs about cannabis as a medicine for pain, insomnia, and mental health symptoms such as paranoia. The findings matter for Thai readers as medical cannabis access expands in Thailand and across Asia.
Cannabis has entered mainstream health discussions since Thailand decriminalized cannabis plants in 2022. The move aimed to spur medical innovation and wellness tourism. Yet as more Thais buy cannabis products online and at street dispensaries, new global research shows that evidence on effectiveness and risks is far from settled. This has clear implications for patients, caregivers, and clinicians in Thailand.
A 2025 review published in JAMA Network Open finds that evidence for chronic pain relief from cannabis remains limited. Some studies report moderate relief for neuropathic pain, fibromyalgia, and certain cancer-related symptoms, but meta-analyses often show only small benefits beyond placebo. For sleep, cannabis may shorten time to sleep for experienced users, but consistent improvements in sleep quality or duration are not established, and there is little to no long-term benefit for insomnia caused by conditions like obstructive sleep apnea.
The mental health landscape is even more nuanced. While cannabinoids can alleviate anxiety or nausea in some patients, there is a real risk of paranoia, psychosis, or disordered thinking in others—especially among adolescents, people with preexisting mental health risks, or users of high-potency cannabis. A Johns Hopkins study highlighted in 2025 notes that certain cannabis components might influence anxiety and paranoia, underscoring the variable effects across individuals. A Thai clinical faculty member cautions that cannabis is complex: relief for some, but potential psychological side effects for younger people or those with certain genetic or mental health predispositions.
Public enthusiasm for cannabis in Thailand has created a thriving market of cafes, wellness centers, and online sellers. However, the science does not yet support broad claims of universal benefits. Research summarized in sources discussing medical cannabis indicates that clinical trials remain limited by legal and regulatory barriers, particularly for oral, edible, and topical forms that are increasingly popular in Thailand. Short-term use can cause dizziness, drowsiness, and other side effects, while long-term risks—such as memory issues or heightened psychiatric disorder risk among youth—require further study.
Notable trials provide context for Thai readers. A 2023 fibromyalgia study found that cannabis added to lower-dose opioids may offer some benefit, but cannabis alone did not significantly reduce pain beyond placebo for most participants. A 2022 trial examining a melatonin-cannabis extract combination for insomnia showed some short-term sleep onset improvements, but benefits were modest and side effects like fatigue were common.
Global health authorities emphasize that cannabis is not a universal remedy. The National Academies of Sciences, Engineering, and Medicine concluded strong evidence only for certain uses—such as reducing chronic pain in adults, chemotherapy-related nausea, and MS-related spasticity. For insomnia, anxiety, PTSD, and other conditions, evidence remains inconclusive or mixed.
In Thailand, a wide range of administration methods—capsules, lozenges, sprays, patches, edibles, vaporized oils, and inhaled products—adds to the complexity. The onset time and risks vary with the method and potency. Edibles, popular in health cafés, have slower onset but longer duration, which can lead to accidental overuse among newcomers.
Thailand’s Buddhist-influenced culture emphasizes moderation and mindful medicine. Historically, cannabis appeared in Thai traditional remedies, often for topical use or in herbal applications rather than recreation. Today’s market, with potent strains and extracts, raises questions about appropriate medical use within Thai cultural values.
Medical professionals note rising cannabis-related emergency visits, often linked to anxiety, paranoia, or hallucinations in teenagers or adults using high-THC products from unregulated sources. A senior Thai psychiatrist urges caution: cannabis can be part of a medical plan for some conditions, but it is not a universal solution. He advises avoiding cannabis for children, teens, pregnant women, or anyone with mental health concerns.
Looking ahead, researchers are exploring lesser-known cannabinoids (like CBG, CBN, and CBDV) and the “entourage effect,” where multiple cannabis compounds interact. Regulators in Thailand are proposing clearer labeling, potency limits, and public health warnings. There is a call for high-quality local clinical trials that reflect Thai populations and cultural contexts.
Key takeaways for Thai readers weighing cannabis for pain or sleep:
- Seek guidance from licensed healthcare professionals experienced in cannabinoid medicine.
- Begin with the lowest effective dose and monitor for side effects.
- Avoid high-potency and inhaled products, especially for vulnerable groups.
- Stay informed through official Thai public health channels.
- Report adverse effects to health authorities to support safety monitoring.
As scientific understanding evolves, Thailand can balance tradition, safety, and innovation by prioritizing education, patient safety, and culturally informed policy.