Overwhelmed Israeli Pain Clinics Turning Away Cannabis Requests

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Doses of medical cannabis in a storeroom at Abarbanel Mental Health Center, Bat Yam.Credit: Ilya Melnikov

The Association for Medical Cannabis Treatment is threatening legal action because public pain clinics are refusing to treat patients interested in medical cannabis. The clinics claim that they are being overwhelmed with new patients seeking medical cannabis and that not all of them want it to treat pain.

Pain clinics refer certain patients suffering from chronic pain to receive medical cannabis in accordance with their condition. This referral is a prerequisite for getting a permit to use medical cannabis from the Health Ministry.

In recent years, however, more and more clinics have been refusing to refer patients for medical cannabis under any circumstances and make this clear from the start. Some clinics have posted large signs to this effect while others make it clear to patients by phone and in writing that they will not be able to obtain cannabis through them.

“The doctors in the pain clinics have had it,” said a source in the health system. “Many people have discovered that a way to get cannabis is through the pain clinics and they’ve started to flood the clinics. Not everyone wants the cannabis for pain. It’s cheap, good quality stuff and the clinics attract people who aren’t necessarily sick.”

According to Health Ministry data cited recently in a Knesset Research and Information Center document, as of May there were more than 22,000 people with permits to use medical cannabis, of whom 7,350 were taking it for chronic pain. According to Health Ministry regulations, those suffering from pain must have been under treatment for at least a year in a recognized pain clinic and exhausted all other standard treatment options, including strong opiate-based painkillers, before they can apply for a cannabis permit.

The fact that pain is a subjective issue that cannot be quantified, combined with the high demand, has led some doctors and hospital administrators to simply stop dealing with cannabis.

“I speak to patients all day,” says Karnit Yedid, who heads the Association for Medical Cannabis Treatment. “Their pain is unbearable and they have no way to get medical cannabis treatment.

“Today the only way for pain sufferers to get a referral to use cannabis is to go to the private clinics of authorized doctors who take between 1,000 and 1,200 shekels ($255-$306) a visit; when you count follow-up and the renewal of the permit once every three months it can come to 4,000 shekels a year.” Nevertheless, she says, even at the private clinics it’s hard to get an appointment.

Last month the association wrote to Health Minister Yaakov Litzman and other ministry officials, demanding the ministry order the clinics to accept medical cannabis patients.

“Refusing cannabis because of pressure on the clinics or by arguing that some patients are lying is like arguing that old people put pressure on emergency rooms and therefore they shouldn’t be treated,” said Dr. Nili Karako-Eyal, who heads the Patients’ Rights Clinic at the College of Management Law School and worded the association’s letter. “If we don’t get a response or the response isn’t in keeping with the law, the next step will be to go to court and petition the High Court of Justice.”

The Health Ministry said that hospital pain clinics are so overwhelmed with patients seeking to renew their cannabis prescriptions that patients who are not yet cannabis users have a hard time getting to see a pain doctor.

“The Health Ministry is examining ways to resolve the distress over cannabis. What’s being examined includes training doctors to dispense cannabis, increasing the number of authorized doctors, distributing it through pharmacies or even setting up dedicated units in hospitals.”

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