Thailand Saw More Cannabis Poisonings and Child Exposures After Legalization
A Thai poison center recorded 1,695 cannabis cases from 2018-2022, with hospitalization rates rising from 69% to 97% and child/adolescent exposures increasing after recreational legalization.
Quick Facts
What This Study Found
Hospitalization rates increased significantly after each policy change: from 68.7% during the illegal period to 82% (medical), 91.5% (decriminalized), and 96.8% (recreational). The proportion of children and adolescents exposed to cannabis increased significantly during the recreational period. Cannabis oil (41.4%) and smoking products (26.7%) were the most common products involved.
Key Numbers
1,695 cases. Median age 38 (IQR 24-53). 67.2% male. Products: cannabis oil 41.4%, smoking 26.7%, sweets 12.5%. Reasons: health belief 29.7%, recreational 29.6%, curiosity 22.5%. Hospitalization rates: illegal 68.7%, medical 82%, decriminalized 91.5%, recreational 96.8%. Lab confirmation in only 20% of cases.
How They Did This
Retrospective analysis of 1,695 cannabis cases reported to the Ramathibodi Poison Center in Thailand from January 2018 to December 2022, compared across four regulatory periods: illegal, medical, decriminalized, and recreational.
Why This Research Matters
Thailand's rapid progression from prohibition to full legalization provides a natural experiment in how policy changes affect cannabis-related poisonings. The data show that increased availability without adequate education led to more hospitalizations and more child exposures.
The Bigger Picture
Thailand's experience adds to the growing international evidence on legalization outcomes. The rise in child exposures and hospitalizations mirrors patterns seen in U.S. states and Canada after legalization, suggesting these are predictable consequences that policy can address through packaging requirements, education, and access controls.
What This Study Doesn't Tell Us
Retrospective study from a single poison center. Lab confirmation available in only about 20% of cases. Cannot separate whether increased reporting reflects more actual cases or greater awareness and willingness to report. No denominator data to calculate population rates.
Questions This Raises
- ?What specific measures could reduce child exposure to cannabis products in newly legal markets?
- ?Did hospitalization rates increase because of more severe cases or because of increased healthcare-seeking behavior?
- ?How does Thailand's experience compare to other recently legalized markets?
Trust & Context
- Key Stat:
- Hospitalization rate rose from 69% to 97% across legalization stages
- Evidence Grade:
- Moderate evidence from a poison center database spanning multiple policy periods, though limited by single-center design and low lab confirmation rates.
- Study Age:
- 2025 study covering Thailand's 2018-2022 legalization transition.
- Original Title:
- Cannabis product exposures reported to Ramathibodi Poison Center, Thailand, during 2018-2022.
- Published In:
- Clinical toxicology (Philadelphia, Pa.), 63(10), 760-769 (2025)
- Authors:
- Paisarnrodjanarat, Bootsakorn, Srisuma, Sahaphume(2), Promrungsri, Puangpak, Tangsuwanaruk, Theerapon, Tongpoo, Achara, Rittilert, Panee, Mayurapong, Manutsanun
- Database ID:
- RTHC-07298
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
What products caused the most poisoning cases?
Cannabis oil was involved in 41.4% of cases, followed by smoking products (26.7%) and cannabis-infused sweets (12.5%). The sweets are particularly concerning for accidental child exposures.
Why did hospitalizations increase?
The study attributes the increase to greater availability and accessibility of cannabis products combined with inadequate public knowledge about effects and safe use. Curiosity alone motivated 22.5% of cases.
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Cite This Study
https://rethinkthc.com/research/RTHC-07298APA
Paisarnrodjanarat, Bootsakorn; Srisuma, Sahaphume; Promrungsri, Puangpak; Tangsuwanaruk, Theerapon; Tongpoo, Achara; Rittilert, Panee; Mayurapong, Manutsanun. (2025). Cannabis product exposures reported to Ramathibodi Poison Center, Thailand, during 2018-2022.. Clinical toxicology (Philadelphia, Pa.), 63(10), 760-769. https://doi.org/10.1080/15563650.2025.2536771
MLA
Paisarnrodjanarat, Bootsakorn, et al. "Cannabis product exposures reported to Ramathibodi Poison Center, Thailand, during 2018-2022.." Clinical toxicology (Philadelphia, 2025. https://doi.org/10.1080/15563650.2025.2536771
RethinkTHC
RethinkTHC Research Database. "Cannabis product exposures reported to Ramathibodi Poison Ce..." RTHC-07298. Retrieved from https://rethinkthc.com/research/paisarnrodjanarat-2025-cannabis-product-exposures-reported
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.