Israel Seeks to Tighten Medical Marijuana Regulations

Health Ministry includes distribution via pharmacies, authorizing another 10 doctors to prescribe the drug.

Israel's Health Ministry has expressed opposition to granting general practitioners the right to prescribe medical marijuana.

Instead, the ministry will certify 10 doctors during the first half of 2014, allowing them to prescribe medicinal marijuana to the growing number of patients who currently use it. These 10, newly certified doctors will join the 20 doctors currently permitted by the Health Ministry to prescribe the drug.

A bill formulated by the Health Ministry will be brought before the cabinet for discussion next week. The bill also seeks to transform the current distribution process, replacing local marijuana growers with a more regulated supply to pharmacies.

“Marijuana is defined as a ‘dangerous drug,’ though at the same time, the Health Ministry recognizes that there are medical uses for marijuana. Even if it is not an official medication or remedy throughout the world, it can reduce the suffering of many patients,” reads the introduction to the bill. “The Health Ministry believes that marijuana should be treated like every other medical product. It requires proper supervision in order to safeguard public health, while also taking into consideration its special nature − the fact that it is a plant, and not medication produced in a factory or laboratory. Given that marijuana is considered a dangerous drug, any arrangement made to regulate medicinal use of the plant in Israel must closely resemble the regulations for other narcotic medications,” continues the bill.

There are currently about 14,000 individuals in Israel with approved marijuana prescriptions from the 20 doctors presently allowed to prescribe the drug. The doctors are mostly pain management and oncology specialists, and the use of marijuana is meant to combat chronic pain or other symptoms that affect patients’ day-to-day life in significant ways. Use of marijuana is common among cancer patients, AIDS patients and those suffering from multiple sclerosis, Crohn’s disease, Tourette syndrome and other terminal illnesses. Recently, marijuana has also been prescribed to patients suffering from Post-Traumatic Stress Disorder. The number of patients holding legal marijuana prescriptions rises every year, and it is expected to reach some 40,000 Israelis with prescriptions by 2018.

Patients in Israel receive their medical marijuana from distribution centers, which are supplied by growers. The marijuana is consumed in various ways, including smoking, steaming and through oil drops infused with concentrated levels of the plant used for cooking. The Health Ministry’s bill also seeks to put an end to these distribution centers, instead concentrating distribution of the plant at pharmacies only. The ministry will publish a public tender for forming the closed list of pharmacies that will receive licenses to distribute the drug, while the Israel Police will set guidelines for transferring and storing the drug.

The Health Ministry’s bill was formulated following a meeting on Monday between Health Minister Yael German and well-known doctors including psychiatrists, pain management specialists, addiction specialists, clinical pharmacologists and gastroenterologists. The meeting dealt with various topics related to the bill, including the idea of general practitioners being able to prescribe the drug.

Under a bill proposed by MK Moshe Feiglin, general practitioners would be allowed to prescribe marijuana, a notion that was met with opposition from German as well as many general practitioners. Many doctors felt that they did not have the necessary tools or knowledge needed to prescribe the drug, a plant that has no recommended dose and many unknown factors, including how the drug interacts with other medications in the body. Many doctors also feared that giving them the ability to prescribe such a sought-after drug would put them in a rather difficult situation.

During the meeting it was agreed that marijuana has a great deal to offer many patients, but at the same time it must be closely regulated as there are no clear standards regarding minimum or maximum doses, types of treatment, side effects and possible negative effects from combining marijuana with other types of medication.

“We’re currently in an intermediate phase. Until sufficient studies are conducted, the drug must be regulated, while reducing the pressure on the doctors,” German said during the meeting.

Daniel Tchetchik