Thailand's Cannabis Reversal Puts Public Health, Small Businesses and Medical Access in Conflict

Three Years After Decriminalization, the Market Faces a Reckoning

Thailand's government says 7,000 of the country's 18,000 cannabis shops did not apply to renew their licenses at the end of 2025 after tighter rules restricted purchases to people with prescriptions. That is close to two in every five shops, a measure of how sharply the market has changed since cannabis was removed from the narcotics list in June 2022.

As of January 22, 2026, the country that became the first Asian nation to decriminalize cannabis is struggling to reconcile three competing demands: protecting children, preserving access to medical treatment and keeping businesses alive. New requirements for dispensaries to operate as licensed medical facilities with medical practitioners onsite have placed particular pressure on small operators.

The reform originally promised a regional medical cannabis hub, another source of income for farmers and health tourism to help an economy recovering from COVID-19. Instead, recreational sales spread rapidly, health facilities recorded rising cannabis related problems, and political support weakened.

A Thailand Development Research Institute study put recreational use at 1.2 million people in 2020 and 11.1 million in 2022, an increase of more than nine times. Medical use grew much less, from 430,000 to 540,000 people. Those figures capture the central problem: a policy promoted around treatment developed into a much larger recreational market.

Politicians now broadly support limiting cannabis to medical purposes, although they disagree about whether to put the plant back on the narcotics list. Entrepreneurs face another urgent question: whether they can afford to remain in a market whose rules have changed after they invested their savings.

Thailand's experience has become a dispute over economic opportunity, individual freedom and community protection in a country with a traditionally strict approach to drugs.

How a Medical Policy Became a Recreational Market

Anutin Charnvirakul, the public health minister who championed decriminalization and now deputy prime minister, presented cannabis as a way to expand treatment options and give farmers a new cash crop. Removing the plant from the narcotics list eased criminal restrictions, but comprehensive rules for the resulting market were missing.

Entrepreneurs quickly filled that gap. Thousands of dispensaries appeared within months, especially in cities and tourist destinations. Neon signs advertised shops selling prepared joints, fruit flavored gummies and cannabis strains with high levels of THC, the substance responsible for the drug's mind altering effects.

Residents encountered cannabis far beyond medical settings. Its smell became common in some neighborhoods, drawing comparisons with the familiar scent of grilled pork from street food stalls. The visibility of shops and products helped make cannabis an ordinary part of daily life for many people.

Anunchai Assawamakin, a Mahidol University pharmacologist and adviser to the Office of the Narcotics Control Board, described the regulatory gap as:

a vacuum that has dragged on for over two years

Thailand decriminalized first and developed tighter controls afterward. Businesses built around recreational customers were therefore established before authorities moved toward the medical system originally promised.

The main developments unfolded across several years:

• 2020: Recreational cannabis use stood at 1.2 million people, and medical use at 430,000.
• June 2022: Thailand removed cannabis from its narcotics list.
• 2024: A business study documented weak profitability, while a public opinion poll found broad support for restoring narcotics classification.
• January 2025: The Youth Network Against Cannabis submitted a petition with 200,000 signatories seeking reversal of decriminalization.
• 2025: New rules required prescriptions from certified medical professionals for cannabis purchases.
• End of 2025: The government said 7,000 of 18,000 shops had not applied to renew their licenses.
• January 22, 2026: Businesses and political parties faced decisions about the shape of a market restricted to medical use.

Children Become the Center of the Debate

Thai children and teenagers gained easier access to cannabis products as the retail market expanded. Studies recorded recreational use among people aged 18 and 19 rising from 1% to 2% in 2020 to 9.7% in 2022, a rise described as tenfold from the lower starting figure.

Yodsakorn Khunphakdee, coordinator of the Youth Network Against Cannabis, described the effects on younger people, including those under 25 whose brains are still developing:

It got out of control and has had a huge negative impact, especially on children and young people under 25, whose brains are still developing.

The network's petition to the Public Health Ministry in January 2025 carried 200,000 signatures calling for decriminalization to be overturned. Parents and educators were increasingly concerned about shops in residential communities and near schools.

Dr. Patraporn Kinorn, a specialist in child psychiatry and addiction treatment, questioned whether existing protections were sufficient during a seminar on illnesses caused by cannabis:

The law may say that children are already protected, but the question is: is it enough?

Thapanawong Ladkaew, a businessman aged 38 and father of two in a small town in northeastern Thailand, described cannabis being sold openly at flea markets and bongs displayed in coffee shops. Bongs are devices used to smoke cannabis.

Ladkaew explained his concern about his children's curiosity:

My kids were asking about this out of curiosity. I certainly don't want my children to try cannabis.

He favors limiting recreational use to designated tourism zones such as Pattaya, rather than allowing it to become part of everyday community life. His position reflects the dilemma of parents who may accept some adult use while wanting less exposure for children.

A Toddler's Hospitalization Spurs Action on Edibles

A girl aged two was hospitalized after eating a gummy containing cannabis. The incident prompted the Public Health Ministry to begin an urgent nationwide crackdown on foods, drinks and snacks infused with the drug.

Public Health Minister Somsak Thepsutin expressed grave concern about the case. Authorities were already worried about young people encountering cannabis without understanding what they were consuming.

Fruit flavored gummies illustrate why the debate extends beyond smoking. A product sold in a form familiar to children can bring cannabis into settings far removed from a dispensary or a medical consultation.

The crackdown added another area of enforcement to a policy already moving toward prescriptions and medical supervision. Parents were seeking protection in ordinary places, including markets and coffee shops, while officials were trying to restrict products that had become widely available.

Hospitals Record Rising Dependence and Psychosis

Ministry of Public Health hospitalization data analyzed by Dr. Bundit Sornpaisarn, a staff scientist at Canada's Institute for Mental Health Policy Research, showed monthly cannabis dependence cases rising from an average of 162 in the year before decriminalization to 447 in the following year and 837 in the year after that.

The final figure is more than five times the first. Dependence describes a pattern in which using a substance becomes difficult to control. Sornpaisarn's analysis also recorded a fivefold rise in psychosis induced by cannabis over the same period. Psychosis can involve a person losing contact with reality.

Anunchai Assawamakin gave another set of figures: 20,804 cases of psychosis linked to cannabis in the 12 months after decriminalization, compared with 10,619 in the preceding 12 months. His figures show an increase close to twofold, alongside the fivefold rise described in Sornpaisarn's analysis.

Dr. Patraporn said she was seeing more young patients addicted to cannabis who had started using it themselves to treat depression, only to experience worsening symptoms. Their attempts to manage mental health problems without medical guidance added to concerns about easy access.

The Royal College of Physicians of Thailand issued a statement in June acknowledging physical and mental health risks from cannabis, especially for young people and pregnant women.

Some researchers called for further study to understand the effects of legalization more fully. Hospitalization figures and clinical observations nevertheless increased pressure on policymakers to respond to the health problems accompanying the market's expansion.

The Billion Dollar Promise Meets Weak Profits

Thailand's cannabis industry was projected to be worth $1 billion by 2025. Supporters expected it to revive rural incomes and create thousands of jobs, but a study of its economic effects in 2024 found that many businesses were struggling.

Nuttanan Wichitaksorn, a visiting research adviser at the Thailand Development Research Institute, surveyed 177 cannabis companies. Only 25% were profitable, leaving most of the businesses surveyed without a profit.

Wichitaksorn described the outcome in stark terms:

The policy yielded 'no positive economic impact at all,' even though the industry was tipped to be worth $1 billion by 2025.

Small operators often struggled to cover costs. The weak business performance also reduced the appeal of cannabis as a political promise, particularly when parties were looking for policies likely to win votes.

Wichitaksorn explained the change in political attention:

It's not a hot issue anymore. Now they see other things that are more exciting and get more votes,

The economic disappointment has been especially painful for farmers and entrepreneurs who committed savings after government encouragement. A new crop and a rapidly expanding retail market had appeared to offer a route to greater prosperity. Tighter rules now require further spending from businesses already facing weak returns.

Small Operators Struggle to Pay for the Transition

Porlnarong Panor, a home grower producing premium cannabis buds, sold his Harley Davidson and invested his savings in grow lights and a dispensary. He now faces closure because adapting to the new medical requirements is too expensive.

Panor blamed those who promoted the original policy, referring to Anutin Charnvirakul:

The people who unlocked it didn't think things through from the start. They're the government now, and they still don't care,

Registering a dispensary as a clinic and hiring licensed doctors changes both its costs and its business model. A shop established to serve recreational customers must reorganize around medical requirements.

Panor said the new conditions favored businesses with greater financial resources:

They said everyone should be able to grow and sell, but now it's not for everyone. Only those with big capital and certified farms can survive,

Natthakan Punyathanaworakit, an entrepreneur in Bangkok with three cannabis stores, has already closed one because of mounting pressure and compliance costs. She predicts that most registered shops will eventually close, with many businesses likely to move underground.

Cannabis entrepreneur Chokwan Chopaka described the operators she expected to suffer most:

It's the little guys—the mom and pop shops, the family business where the wife is helping trim while the husband is growing—they're the ones that will suffer,

Businesses that remain open must find the money to comply while retaining enough customers to cover their costs. For family operations, the shift involves livelihoods as well as licenses.

Some Businesses See a More Stable Medical Market

Shaggy Buds, a dispensary in one of Bangkok's busiest commercial districts, is taking a different approach. Its owners plan to build a new store designed to meet the regulatory requirements.

Co-owner Nitikrist Attakrist described stricter rules as a chance to establish a stronger business:

I don't think 2026 is the beginning of the end for the industry. It is actually an opportunity. If you could pass all the criteria, you would build a strong foundation for the future,

Operators able to adapt believe closer supervision could remove businesses operating below required standards and produce a more professional, sustainable market. Their confidence contrasts with the closure risks facing smaller firms.

The government's figures on 7,000 shops that did not seek license renewal show the scale of the retreat from the legal market. They also create uncertainty about how the remaining industry will serve patients who use cannabis for medical reasons.

Thailand's retail transition therefore has two distinct effects: it narrows recreational access while raising the cost of staying in business. Companies with sufficient capital may welcome clearer rules, while those without it face closure or the temptation to operate outside the legal system.

Political Support Moves Toward Medical Use Only

More than two thirds of respondents in a 2024 National Institute of Development Administration poll wanted cannabis restored to the narcotics list. Growing public concern has encouraged parties to take stricter positions on drug control.

Anutin, leader of the Bhumjaithai Party and once known as the "Cannabis King," has largely avoided the subject during recent campaigning. The policy that helped define his earlier political career has become harder to defend.

A Bhumjaithai deputy leader said the policy had been "distorted heavily" and had never been intended for recreational use. If the party returns to power after the election, it would pursue legislation allowing medical use only without recriminalizing cannabis.

The People's Party and Pheu Thai Party, both leading in polls, have indicated that they would restore cannabis to the narcotics list while allowing approved medical use. Their positions are stricter than Bhumjaithai's, although cannabis does not feature prominently in their campaign pledges.

Anutin has also grudgingly pledged support for undoing decriminalization. Speaking about the political choices involved, he said:

we can't take a personal attitude towards this,

The parties share a preference for medical use but differ over the legal route. Restoring narcotics classification would bring the plant back under drug law, while regulation without recriminalization would control access through a different framework.

Advocates Seek Regulation Instead of Prohibition

Prasitchai Nunual, head of the advocacy group Writing Thailand's Cannabis Future, expressed disappointment that the party responsible for decriminalization had changed direction:

We're deeply disappointed, because the party that unlocked cannabis and our only political ally has now gone down a different path from ours. There seems to be no future for an equitable cannabis law.

Prasitchai is running for Parliament in support of tighter regulation that would still permit recreational use under controlled conditions. His chances of securing that change appear slim in the increasingly hostile political environment.

Advocates point to the stalled Cannabis and Hemp Act as a possible framework for protecting the public while preserving legal access. Prasitchai argued that agreement on the need for controls had not been matched by sufficient information within government:

Everyone agrees that it needs to be controlled. But government agencies lack the data to make informed decisions regarding cannabis regulation,

Measures discussed include keeping dispensaries away from children through zoning, testing products, requiring licenses, checking buyers' ages and providing public education. Such a system would require investment in enforcement and oversight.

Government spokesperson Jirayu Houngsub has stated the administration's objective:

the policy must return to its original goal of controlling cannabis for medical use only,

The policy debate also includes whether the Public Health Ministry's order restricting cannabis to medical use will be formalized through publication in the Royal Gazette, making it legally enforceable. No publication date was given. Prescription requirements were already introduced in 2025, while the wider legal framework remained contested.

Jobs, Investments and Legal Exposure Are at Stake

Rattapon Sanrak, a cannabis activist and founder of Thailand's first legal dispensary, estimates that at least 60,000 jobs are at stake if the industry is severely restricted. The sector has created tens of thousands of jobs and generated tax revenue in some areas, despite falling short of its broader economic promises.

Small farmers who adopted cannabis instead of traditional crops may face bankruptcy unless they can move to other agriculture or find legitimate export markets. Their investments were made under rules that encouraged cultivation and sales.

More than a million people registered their growing activities. Recriminalization raises the prospect that growers could face criminal liability again. Around 3,000 marijuana offenders were released from prison after decriminalization, and a reversal has also prompted concern about renewed legal jeopardy.

Cultivators and dispensary owners have said they would sue the government for damages if recriminalization destroys their investments. Rattapon described why the dispute is so personal:

Some people have used their entire savings to invest in the business,

The choices extend beyond whether shops may sell cannabis. Authorities must weigh patient access, employment, farming investments, enforcement costs and the treatment of people who entered the industry when the government encouraged it.

What the United States and Canada Offer for Comparison

California legalized medicinal cannabis in 1996. The United States industry subsequently grew into a market worth $40 billion, with recreational cannabis legal in 24 states and medical use permitted in 40.

Most jurisdictions in the United States introduced regulatory frameworks alongside legalization, covering licenses, testing and taxes. Their experience still includes illegal trading, complicated regulations and concerns about whether the benefits of legal markets are distributed fairly.

Canada legalized cannabis nationwide in 2018 with a control system that limited retail outlets, set product quality standards and restricted advertising. Problems continued, but the rules provided a more orderly transition than Thailand's approach of opening access before completing its controls.

Western countries generally have more established public health infrastructure and experience with harm reduction, an approach that seeks to reduce damage associated with substance use. Thailand entered reform with a history of harsh drug policies and limited experience regulating substances that alter mood or perception.

Foreign governments, particularly in Asian countries where cannabis remains strictly prohibited, have complained about increased drug smuggling from Thailand. Prominent arrests of tourists attempting to take Thai cannabis home have added diplomatic friction and negative publicity.

Thailand's next policy choice must account for both domestic access and those international pressures. Tighter medical regulation, controlled recreational use and restoration of narcotics classification remain competing approaches, each with consequences for families, patients and businesses.

The central tension is now visible in the figures: recreational use grew from 1.2 million to 11.1 million, only a quarter of 177 surveyed companies were profitable, and 7,000 shops did not seek license renewal at the end of 2025. The original ambition of a medical hub and a profitable new crop has given way to a struggle over how much access Thailand should allow and who can afford to provide it.

The Bottom Line

• Thailand decriminalized cannabis in June 2022 to support medical treatment, farming and health tourism.
• Recreational use rose from 1.2 million people in 2020 to 11.1 million in 2022; medical use grew from 430,000 to 540,000.
• Use among people aged 18 and 19 reached 9.7% in 2022, compared with 1% to 2% in 2020.
• Hospital data recorded rising dependence and psychosis, while a toddler's hospitalization prompted action against cannabis foods and drinks.
• Only 25% of 177 cannabis companies surveyed were profitable, despite a projection of a $1 billion industry by 2025.
• Rules introduced in 2025 required prescriptions, and dispensaries face requirements to operate as medical facilities.
• The government said 7,000 of 18,000 shops did not apply to renew licenses at the end of 2025.
• Major parties support medical use only but disagree about restoring narcotics classification.
• Advocates seek tighter regulation without prohibition, while Rattapon Sanrak estimates at least 60,000 jobs are at stake.