Traditional Thai Cannabis Medicine Matches Lorazepam for Insomnia in Clinical Trial | Research

The takeaway

A traditional Thai cannabis-based multi-herbal formulation proved non-inferior to lorazepam for treating chronic insomnia over 4 weeks, with comparable safety and improvements in sleep quality, quality of life, and stress.

Sleep medicine specialists, integrative medicine practitioners, patients with chronic insomnia seeking alternatives to benzodiazepines, and herbal medicine researchers.

What the researchers found

The traditional Thai cannabis formulation demonstrated non-inferiority to lorazepam: at week 4, mean PSQI scores were 3.44 (experimental) vs. 4.78 (lorazepam), with a mean difference of -1.34 (95% CI: -2.99 to 0.31), meeting the predefined non-inferiority margin of 2.1.

Why it matters

Benzodiazepines like lorazepam carry addiction risk, and finding a cannabis-based alternative that works as well with comparable safety could provide a safer option for the millions with chronic insomnia.

The numbers in context

N=100 randomized (82 completers); 4-week treatment; PSQI: experimental 3.44 vs lorazepam 4.78; difference -1.34 (95% CI: -2.99 to 0.31); non-inferiority margin 2.1; no significant adverse effects

How the study worked

Phase II randomized, double-blind, active-controlled non-inferiority trial with 100 participants (82 completers, 41 per group) receiving either the Anti-Pom-Leung Fever multi-herbal formulation or lorazepam for 4 weeks, assessed by Pittsburgh Sleep Quality Index.

What this study cannot tell us

Active-controlled without placebo arm (cannot rule out both treatments being equally ineffective); small sample (82 completers); 4-week duration only; multi-herbal formulation makes it impossible to isolate cannabis effects; Thai regulatory context limits generalizability.

How to read the evidence

Randomized double-blind active-controlled trial meeting non-inferiority criteria, but small sample, short duration, and lack of placebo arm limit evidence strength.

When this study was published

Published 2026; conducted under Thailand's medicinal cannabis framework.

The bigger picture

Thailand's unique position having legalized both traditional medicine and cannabis creates opportunities for clinical research on herbal cannabis formulations that most countries cannot easily replicate.

Questions still open

Which components of the multi-herbal formulation drive the sleep benefit? Would effects persist beyond 4 weeks? Could this formulation cause dependence with longer use? How does it compare to CBD or THC alone?

Common questions

Can cannabis help with insomnia as well as sleeping pills?

This trial found that a traditional Thai cannabis-based herbal formulation performed as well as lorazepam (a benzodiazepine) for chronic insomnia over 4 weeks, with comparable safety — though it was a multi-herb formula, not cannabis alone.

Is this safer than benzodiazepines for sleep?

Both treatments had comparable safety profiles over 4 weeks, but benzodiazepines carry known risks of dependence with longer use — whether the cannabis formulation offers a safer long-term alternative requires further study.

Read the original research

Phase II randomized controlled trial comparing traditional Thai cannabis-based medicine with lorazepam for insomnia treatment.

Journal of cannabis research

View on PubMed ↗Publisher’s paper ↗

Citation

Kamoltham, Thavatchai; Chokchaisiri, Suwadee; Yongram, Chawalit; Sripan, Panupan; Im-Iam, Surasak; Sanasit, Panupong; Intaravattana, Varanon; Sawasdichai, Chatchai; Udompat, Patpong; Chaiphongpachara, Tanawat; Kummalue, Tanawan. (2026). Phase II randomized controlled trial comparing traditional Thai cannabis-based medicine with lorazepam for insomnia treatment.. Journal of cannabis research. https://doi.org/10.1186/s42238-026-00415-x