Views and practices on medical cannabis of unlicensed providers in Thailand: a qualitative study

Sawitri Assanangkornchai; Darika Saingam; Kanittha Thaikla; Muhammadfahmee Talek

doi:10.12688/f1000research.110367.3

Views and practices on medical cannabis of unlicensed providers in Thailand: a qualitative study

F1000Res. 2024 Aug 27:11:365. doi: 10.12688/f1000research.110367.3. eCollection 2022.

Authors

Sawitri Assanangkornchai¹, Darika Saingam¹, Kanittha Thaikla², Muhammadfahmee Talek³

Affiliations

¹ Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
² Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand.
³ Faculty of Nursing, Prince of Songkla University, Pattani campus, Pattani, 94000, Thailand.

Abstract

Background: Despite the legalization of cannabis use for medical purposes in Thailand in February 2019, illicit providers are still widespread and accessible. This study aimed to understand why people still chose to receive medical cannabis treatment or products from unlicensed or illegal providers. The practices of unlicensed or illegal providers in provision of medical cannabis products or treatment services were also examined.

Methods: Qualitative in-depth interviews were conducted among medical cannabis providers and users, including 36 unlicensed and 7 licensed providers and 25 users in 2019-2021. Snowball sampling was used to recruit participants until saturation of data was achieved. Interviews included open-ended questions about the providers' practices and attitudes towards medical cannabis. Interviews were recorded and transcribed, and thematic analysis was performed.

Results: Overall, six reasons were identified to answer why unlicensed/illicit providers were still popular, including: 1) easy accessibility; 2) familiarity with the unlicensed providers before the legal scheme became available; 3) favorable characters (kind, supportive, non-judgmental) of unlicensed providers; 4) affordable treatment fees; 5) trust in the quality of the medicines; and 6) lack of knowledge and negative attitudes towards cannabis from healthcare professionals. Most providers started their career as medical cannabis providers by using it themselves or with their relatives and being satisfied with the results. They used cannabis products to treat all diseases, including skin, eyes, HIV/AIDS, non-communicable diseases and all kinds of cancers. Additionally, they believed that it was effective, with no or minimal adverse effects.

Conclusions: This study suggests that some patients will continue receiving medical cannabis treatment and products from unlicensed or illegal providers. More attention should be paid on increasing the capacity of medical cannabis service systems within public health hospitals, and the certification of unlicensed providers, so as to integrate them into a regulated system.

Keywords: Medical cannabis; decriminalization; folk healers; illegal providers; in-depth interview; legalization; prescription practice; thematic analysis.

Grants and funding

This work was supported by the Health System Research Institute through the National Health Foundation [CNB 62001] and the Centre for Addiction Study, Thai Health Promotion Foundation [CADS 62-01619-0044]. The funding sources had no involvement in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.