Hemp and cannabis are considered a new economic crop in the nation that can be used for medicinal reasons and to supplement modern medical treatment, but the products and their use must comply with the Health Establishment Act B.E. 2559. The Ministry of Public Health has established the following guidelines for offering integrated medical cannabis clinics for patients with medical cannabis indications:

1. Chemotherapy-induced nausea and vomiting;
2. Intractable epilepsy;
3. Spasticity in multiple sclerosis;
4. Neuropathic pain;
5. Anorexia in underweight patients with AIDS;
6. Improving quality of life in patients receiving palliative care.

     The Care Manager will then evaluate and screen the patients based on the indications and limitations for using medical marijuana extract in order to coordinate between the clinic and the treating physician. If a patient is discovered to have medical cannabis use restrictions, such as severe allergic reactions, preexisting psychotic symptoms, or bipolar disorder, the Care Manager will assess the appropriateness of cannabis use by screening the risk and physical examination, regardless of whether it falls under the category of psychiatric symptoms, congenital diseases, or whether there are drugs used that interact with cannabis.

     Medical cannabis extract can be prescribed to patients prior to diagnosis (each dose not exceeding the 30-day dosage) and guidance on dosage and optimal dosage adjustment can be provided. As a result, patients can achieve excellent therapeutic outcomes while minimizing symptoms and adverse events.

For monitoring and evaluation of all patients

1. Follow up and evaluate side effects after taking the drug within three days via telephone or online system;
2. Follow up and evaluate outcomes and side effects of treatment and F/U within one month at the cannabis clinic and record every evaluation result;
3. If it is discovered that cannabis therapy does not improve symptoms, is ineffective, or does not provide the desired benefit within 4-12 weeks, discontinue it while gradually decreasing the dose.

     In the event of complications or adverse reactions from drug use, decrease or discontinue use of cannabis extract and consult a doctor for treatment, or consider referring the patient to a specialist doctor if required. Complications/side effects from drug use must be reported.

     In the absence of complications and adverse reactions, reduce the dose or discontinue prescribing cannabis extract. If the treatment is no longer effective, inform the Food and Drug Administration (FDA) within 30 days and have the patient’s caregiver return any leftover medical cannabis to the medical facility for consideration of destruction or use for the next patient.

Source : www.mhso.dmh.go.th