Israel: A Medical Cannabis Program Successful with 90% of Patients

Fifty years ago Raphael Mechoulam began to research the field of cannabinoids in Israel. Today he is considered the "grandfather of medical cannabis" as the first to isolate THC, back in the 1960s, and a man who asked the government to study the benefits of cannabis, receiving support from a good portion of the populace.

It was in the 90s when the Israeli government agreed to allow the use of the plant to treat certain diseases when there was no other treatment. This achievement was, to a great extent, thanks to Mechoulam's research, and led to Israel standing today as one of the places where cannabis-related research is most advanced.

At this time there are eight companies holding government licenses allowing them to provide medicinal marijuana to Israeli citizens, even though, unlike the situation in the United States, there is no strong cannabis culture in the country. Fortunately, companies did not have a very hard time convincing people that the product was purely medical when they presented it to potential patients.

The system of licenses

In 2007 the Israeli Health Ministry launched a medical cannabis program that today allows close to 20,000 people to medicate themselves using marijuana (a number that is expected to rise to 30,000 in 2016). However, they do need to obtain a license after their doctor's approval.

The government establishes a series of requirements (which are quite restrictive) for the issuance of these permits. These include, among other things, that the patients suffer serious diseases like cancer, Parkinson's or epilepsy (only in the case of children), be receiving a treatment based on chemotherapy, suffer chronic pain, be ill for at least two years, or be taking morphine.

The doctor's opinion is understood as a recommendation, which is later sent to the Health Ministry, the entity that actually issues the license (or refuses to do so). Once this procedure is complete the patients turn to one of the eight companies that provide cannabis. There they are attended to by nursing staff, and, at a specialised clinic, provided with the most appropriate product to meet their needs. People pay a fixed price of around 100 euros per month, regardless of the amount of cannabis prescribed.

Patients consume the product in oil, capsule or flower form, but the monthly amount will depend on what the license specifies. The standard amount is 30 to 40 grams per month, but some need as much as 100. The case with patients beginning treatment is different: they can only access 20 grams, as determined by government guidelines.

Children can also be medicated, but only under certain circumstances. They must be oncology, neurology, epilepsy or rare disease patients. Their ailment must be serious, and they can only enjoy access to medical cannabis in the event all other medications have proven ineffective. If they suffer from cancer, for example, both children and adults are allowed access to cannabis-based medications only when they are in the terminal stage.

In the case of epilepsy, therapeutic marijuana tends to be used on those children who have already tried from seven to ten conventional medicines without their health recovering from its very delicate state. At this time there are more than 100 epileptic minors who benefit from strains featuring high concentrations of CBD in Israel.

Different studies have also been carried out to evaluate the use of cannabis in the treatment of Post-Traumatic Stress Disorder on Israeli combat veterans, and with "promising" results. Today some 500 patients with PTSD are authorised to use medical cannabis in Israel, and that number is rising. The funds for this research come from the Ministry of Health (MINSA), as well as private donors. Researchers, however, must first try several combinations of THC and CBD (and other cannabinoids) on patients, under strict control, before the medicine can be correctly prescribed.

Good research, hampered by government red tape

Israeli research is important in its demonstration of the benefits of medicinal cannabis for the treatment of certain health issues. Some Israeli hospitals have even welcomed patients of other nationalities (those who manage to obtain licenses) who benefit from their advances, thereby boosting "healthcare tourism" in the region.

But, in what is a strange double standard, they do not approve the exportation of cannabis because they do not want Israel to be viewed as a country that, in addition to weapons, sells marijuana. One medical advisor at a cannabis unit of the Israeli Health Ministry reports that the country's agricultural civil servants support the exportation of Israeli medical cannabis. High-ranking police, military and ruling party officials, however, do not, as knowledge would leak outside Israel−knowledge that is worth a great deal of money.

Marijuana in Israel is grown in greenhouses in the mountains of Galilee, and outdoors in places like the Valley of Elah, yielding varieties containing over 13% of CBD and less than 1% of THC, along with a dozen strains standardised by the regulatory body. They also grow strains high in THC, surpassing even 25% (THC is known to prevent nausea in patients with cancer and to restore appetite in people with AIDS, among other benefits).

Several foreing companies are looking forward to seeking alliances with Israel to develop cannabis medications

Competition between farms, as well as the Israeli companies in the sector, has enhanced the market by rewarding the production of a better and better product. This major development of medical cannabis in the country is leading to international renown, as many investors have begun to show interest in the botanical techniques used to produce high-quality therapeutic marijuana in the country, and more than a few foreign companies have begun to seek alliances with the Israelis to develop specific cannabis medications.

A case in point: the Australian company Medical Phytotech has already announced an agreement with Yissum, the technological branch of the Hebrew University of Jerusalem, to develop dosed cannabis tablets for the pharmaceutical market. After the announcement the company secured more than 6 million dollars in funding on the Melbourne stock market.

Perhaps this is because, unlike in the United States, where some states accept cannabis for recreational use, in Israel it is easy to conduct research on medical marijuana because the national cannabis program accepts it. In the USA, meanwhile, few universities have authorisation or adequate financing to carry out related studies, as it is illegal under federal law.

In fact, in Israel it is even possible to conduct clinical research with patients and government consent, in spite of reservations in this regard. Hence, the country is a global leader in the medical use of marijuana, and its hospitals are successful with 90% of their patients, according to their own estimates. The same cannot be said of other medicines. Success comes thanks to collaboration between universities, researchers and hospitals, working together.

The government, despite all this, remains leery. Israeli activists must still struggle for the authorities to see medical cannabis as a positive solution for many health problems, as well as for authorities to stop hindering with red tape those conducting research on the plant and blocking access by those who seek to use it, as currently less than one third of potential patients manage to do so (around 100,000 people under the current requirements).

For example, if a patient's permit expires, the clinic cannot supply him with cannabis, and he is deprived of his medication. In fact, many patients complain about how difficult it is to obtain access to medicinal marijuana, the long wait times for prescriptions, the small doses that they receive, and the arbitrary way in which the system treats each patient. In reality there are still many limitations, because medical marijuana in Israel is not fully regulated.

This is a situation that results in many tough times for patients, and implies that the knowledge of a world-wide leader in the field is underexploited due to a stifling bureaucracy that at times squanders the country's resources, as many political and financial aspects−and even private interests−converge.

Israel has attained a very high level in research and the development on new types of cannabis. It can help the whole world and, above all, the country's economy. It is difficult to believe that there are still people willing to deprive the nation's own citizens from the fruits of this success. After all, good research is worthless if those who are to benefit from it face pointless obstacles that threaten their quality of life.