Medical cannabis use in Thailand after its legalization: a respondent-driven sample survey.
Medical cannabis use in Thailand after its legalization: a respondent-driven sample survey.
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作者：
Assanangkornchai S;Thaikla K;Talek M;Saingam D
许多国家现在允许为医疗目的消费大麻或大麻素，但对允许的产品采取了不同的做法，并对其许可的监管框架采取了不同的做法。2019年2月18日，泰国通过立法，允许将大麻用于医疗目的。本研究旨在研究2019-2020年医用大麻消费的模式和目的，以及消费者对大麻的好处和危害以及相关政策的看法和意见。在泰国的四个地点进行了一项采用应答者驱动抽样（RDS）方法的横断面研究。参与者是485名年龄在18岁及以上的成年人，他们居住在研究区域，在过去12个月内曾为医疗目的使用大麻。使用结构化问卷进行面对面访谈，以收集以下方面的数据：（1）人口统计学特征，（2）消费模式，（3）信息来源和对医用大麻益处和危害的看法，以及（4）对大麻政策的看法。使用RDS Analyst分析数据，并以百分比和平均值以及95%置信区间（CI）表示。大多数参与者（84.7%，95% CI [78.9-90.5]）使用口服形式的原油提取物，而9.2%（95% CI [4.1-14.2]）使用原始形式。最常见的用途是治疗癌症（23.3%，95% CI [16.1-30.4]）、神经精神症状（22.8%，95% CI [17.5-28.0]）和肌肉骨骼疼痛（21.6%，95% CI [16.7-26.6]）。地下商贩等非法来源（54.5%，95% CI [40.8-68.3]），亲友（12.2%，95% CI [6.2-18.3]），非营利提供者组（5.2%，95%CI [0.5-10.9]），地下种植者或生产者（2.9%，95%CI [0.6-5.3]）是主要供应者。大多数人（>80%）认为大麻可以治疗癌症，慢性疼痛，失眠，帕金森病和广泛性焦虑症。不到一半的人认为大麻会导致不良状况，心悸、恐慌、记忆障碍和精神分裂样精神病。大多数答复者同意或非常同意关于允许将大麻用于医疗目的的政策（95.1%，95%CI [92.0-98.2]），用于医用大麻产品的法律的销售（95.9%，95%CI [93.7-98.2]），以及用于人们种植医用大麻（94.2%，95%CI [91.8-96.5]）。然而，只有三分之二的人同意有关大麻销售的政策（65.3%，95% CI [56.9-73.7]）和用于娱乐目的的本土大麻（61.3%，95% CI [52.7-69.9]）。我们的研究报告了医用大麻在泰国合法化后第一年的消费者经历。消费者报告了各种没有科学证据支持的消费模式和迹象，但对消费结果有积极的看法。这些研究结果突显了泰国目前面临的政策挑战，可作为该区域其他国家的经验教训。
Many countries now allow the consumption of cannabis or cannabinoids for medical purposes with varying approaches concerning products allowed and the regulatory frameworks prevailing their endowment. On 18 February 2019 Thailand passed legislation allowing the use of cannabis for medical purposes. This study aimed to examine patterns and purposes for consumption of medical cannabis, and consumers’ perceptions and opinions towards benefits and harms of cannabis and related policies in 2019–2020. A cross-sectional study using a respondent-driven sampling (RDS) method was conducted in four sites across Thailand. Participants were 485 adults aged 18 years and over, living in the study region, who had used cannabis for medical purposes within the past 12 months. Face-to-face interviews using a structured questionnaire were used to collect data on (1) demographic characteristics, (2) pattern of consumption, (3) source of information and perception of benefits and harms of medical cannabis, and (4) opinion towards cannabis policies. Data were analyzed using RDS Analyst and presented as percentage and mean with 95% confidence interval (CI). Most participants (84.7%, 95% CI [78.9–90.5]) used an oral form of crude oil extract while 9.2% (95% CI [4.1–14.2]) used the raw form. The most common uses were for treatment of cancers (23.3%, 95% CI [16.1–30.4]), neuropsychiatric symptoms (22.8%, 95% CI [17.5–28.0]), and musculoskeletal pains (21.6%, 95% CI [16.7–26.6]). Illegal sources such as underground traders (54.5%, 95% CI [40.8–68.3]), friends and relatives (12.2%, 95% CI [6.2–18.3]), not-for-profit provider groups (5.2%, 95% CI [0.5–10.9]), and clandestine growers or producers (2.9%, 95% CI [0.6–5.3]) were the main suppliers. Most (>80%) perceived cannabis could treat cancers, chronic pains, insomnia, Parkinson’s disease and generalized anxiety disorder. Less than half perceived that cannabis could cause adverse conditions e.g., palpitation, panic, memory impairment and schizophrenic-like psychosis. Most respondents agreed or strongly agreed with the policies regarding permission to use cannabis for medical purposes (95.1%, 95% CI [92.0–98.2]), for the legal sale of medical cannabis products (95.9%, 95% CI [93.7–98.2]), and for people to grow cannabis for medical use (94.2%, 95% CI [91.8–96.5]). However, only two-thirds agreed with policies concerning the sales of cannabis (65.3%, 95% CI [56.9–73.7]) and home-grown cannabis for recreational purposes (61.3%, 95% CI [52.7–69.9]). Our study reports the experiences of consumers of medical cannabis in the first year after its legalization in Thailand. Consumers reported various patterns and indications of consumption that were not supported by scientific evidence, but had positive perception of the results of consumption. These findings highlight ongoing policy challenges for Thailand and can be a lesson to be learned for other countries in the region.
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