ENCOD BULLETIN ON DRUG POLICIES IN EUROPE

JANUARY 2012

MEDICAL CANNABIS IN ISRAEL

Israel has a unique national medical cannabis program with 7500 legally authorized patients allowed to purchase 30 grams of Medical Grade Cannabis (MGC) per month from 8 approved suppliers. The program’s evolution from – “Ah, Marijuana for sick people – you are crazy!” to the current theme of “wow – patients lives are being transformed” was, and still is, a teeth-grinding activist’s struggle that has now been shaped into a state wide program. On the way we had to educate the parties involved, formulate an ever evolving modus operandi and protect this fragile program from villains who constantly attacked it. The modern story of Medical Cannabis in Israel spans over 16 years but its roots are planted in ancient local and foreign cultures and pharmacopeias.

During 1995 I participated (with Shlomi Sandak) as a public representative in “The Committee to examine the legal status of Cannabis”. The committee was nominated by the head of Parliament’s Drug Committee, Rafel Eitan, known for his toughness and rigidity. The outcome, as I saw it, was pre-determined by him and the committee was just a farce to appease the growing public pressure we made through demonstrations and media exposure.

The committee had two recommendations:

1) Not to change the legal status of cannabis and continue to criminalize cannabis users, and

2) Allow and regulate access to medical cannabis for severely sick patients.

The second recommendation was of course extremely positive and important. What helped was that there was an FDA-approved synthetic THC pill (Marinol or Dorabinol) available on the market that was studied extensively in the US and that THC was shown to be beneficial for two major indications: Reduction of nausea and vomiting due to chemo therapy and as an appetite enhancer. What was necessary now was to provide access to patients to the raw cannabis flowers and not the pills that the patients hated taking due to cost, delayed onset of effect and high levels of psychoactivity.

On November 1, 1999 the Ministry of Health established an advisory committee with the role to: “Establish standards for the medical use of cannabis”. Initially the Ministry allowed the patients to grow 5-6 plants but it soon became apparent that many were too sick to grow and attend them.

Time moved slowly with the MOH. Each patient who applied had to bring a recommendation from a specialist in his/her field and many doctors declined that recommendation. As more patients approached the ministry and many were refused we almost reached a stand-still. The final decision to approve requests was in the hands of one man – the Deputy Director of the MOH.

The infamous 1961 Drug Convention stipulates that in order to use illegal drugs such as cannabis for medical uses, the signing country had to establish a special monopolistic “Agency” to regulate all aspects of the medical use of an illegal drug – meaning: the manufacturing, distribution, imports and exports etc. Only during 2003 did the Dutch government legally establish the “Agency” and selection of growers as well of export has become possible.

Not until 2007 did the MOH agree to provide (for a healthy grower with no criminal record) a license to grow 50 plants but on the condition that he supplied the Medical Cannabis to patients free of charge. The grower started growing the MC in his parent’s property in the Galilee and his mother – a biology teacher, became the garden’s caretaker. He initially distributed the cannabis from his ground floor apartment in Tel Aviv. The Ministry then provided licenses for a total of 17 other growers. Some never got off the ground due to the investment required, so as of today 8 serious growers remain. The free distribution was possible for a short time but the “no income” model was not a sustainable one as it costs a lot of money to produce organic, standardized MC. Donations were needed to maintain the growers.

After 18 months of “free cannabis to patients” the Ministry allowed the growers to charge about 100 dollars for about 40 grams per month. That quantity was later reduced to 30 grams due to fears that the MC was seeping into the black market. Slowly the number of patients had risen – personal and press stories spread the word on the multiple benefits of MC. In 2009 the MOH allowed us to open a distribution center. A group of volunteers started distributing the MC in a small 16 square meter room. While the MC and training was free, clients bought papers, rolling machines and vaporizers. For the majority of them, smoking cannabis was a completely new experience. We taught them how to roll a joint, how to inhale and exhale, how not to burn the throat and what the side effects are. We provided them with a few different strains so that they could find the one best for their symptoms. Also available were brownies, and oil for under the tongue drops for those for whom smoking was a problem. The patients were so grateful for the change Cannabis brought to their lives.

The state, for its part, tried to move forward with the regulation of the program since it expanded very fast. The Anti-Drug Authority received a mandate from the MOH to issue a tender to set guidelines for grower’s selection, quality and price. That move was blocked by the growers in court on grounds that according to UN drug conventions, the only body that has the authority to regulate the medical use of prohibited drugs is a “special Agency” and that agency had not been established at that time by the government.

A few months ago, in a historic decision, the Israeli Government decided officially to form and budget the creation of this “special multi-ministerial agency”, consisting of representatives from the MOH, the police, Ministry of Agriculture, Anti-Drug authority and the Internal Security Ministry. The monopolistic government agency will regulate all aspects of the MC program including issuing tenders for growers, distribution, imports and exports. It is supposed to start operating late during 2012.

By Boaz Wachtel (with the help of Peter Webster)

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