Jerusalem — Dina Stein, a 24-year-old American-Israeli with a spunky demeanor and streaked blue hair, hopes recently revised regulations to Israel’s medical marijuana program will put her on the fast track for a license to use the drug.
Those reforms, which will make medical marijuana available to licensed patients at local pharmacies, and permit specialists — and not the notoriously slow and short-staffed Medical Cannabis Board —to prescribe the drug — was announced by Deputy Health Minister Yaakov Litzman in late July.
“Today, pharmacies give all kinds of other drugs, like morphine; there’s order [for] that and we’ll make order [for] this, too,” Litzman told reporters at the time. “It will be standard, like a drug.”
Nearly 23,000 Israelis are permitted to use medical marijuana via a program launched by the ministry in 2007. Seven local growers provide more than 50 strains of the drug, which are distributed at a handful of high-security dispensaries.
Pharmacists say implementation could take up to a year. For Stein, the changes can’t come soon enough.
Diagnosed with neurofibromatosis, a disease that causes tumors to grow along her nerves, Stein said she experienced “tremendous” pain relief when she sampled medical marijuana in her native California.
“I have massive tumors everywhere in my body, especially on my spine and pelvic area, but they’re not protruding through my skin so no one knows the pain I’m in; I look perfectly healthy but I’m not,” she said with a sigh.
Not long after she immigrated to Israel three years ago, Stein asked her new doctors to prescribe the drug — whose use in Israel is illegal for non-medicinal purposes — but has encountered bureaucracy ever since.
She discovered, to her dismay, that the Ministry of Health currently permits only 36 physicians nationwide to prescribe the drug, once a patient’s specialist has put in a formal request, and that many of the requests are denied weeks or months later.
Her hospital pain clinic physician has refused to write her a prescription.
“He’s a great doctor and has only the best of intentions but is afraid I’ll abuse the cannabis,” she said, using the Israeli term for marijuana. “I get it,” she said, referring to her doctor’s concerns. “I’m young, I have blue hair and work in a heavy-metal bar, but I wouldn’t abuse a prescription.”
Stein just learned that her oncologist has requested she receive a patient’s medical marijuana license, and she’s hopeful it will be approved in the coming days.
Stein’s experience reflects the ambivalence over the medicinal use of the drug in Israel, a world leader in medical marijuana research on the one hand, and a country with a notoriously conservative medical establishment on the other.
Litzman, the deputy health minister and an ultra-Orthodox Jew, represents the conservatives on the other hand.
“I tried to stay away from dealing with the issue,” he told the Jerusalem Post, referring to his previous four-year stint as deputy health minister. It was only after the High Court required him to examine the issue that he learned about the long waiting period and frequent rejections many patients endure.
Now, he said, “I am aware of the need to create order in the matter and to change the ministry’s policy to make it easier for patients.”
Saul Kaye, a pharmacist, said the reforms cannot come a moment too soon.
Kaye called the Cannabis Board’s dosing criteria “completely arbitrary. I don’t think the doctors totally understand cannabis’ benefit. As regulators they want to prevent the flow of the drug back to the street, but arbitrarily reducing patients from 100 grams to 50 grams per month doesn’t make sense medically.”
Dr. Eliad Davidson, director of the pain clinic at the Hadassah Medical Center, also expressed concerns with the current system.
“I can’t understand why some of my requests are approved by the Cannibas Board and others are not.”
Davidson said the reforms will also force the Health Ministry to step up its scrutiny and chemical analysis of medical marijuana from the farm to the pharmacy.
“The ministry considers medical cannibas a medication, but when I send a patient to receive 20 grams a month, I don’t necessarily know whether it’s derived from the plant’s flower or the leaf or the stem,” he said, noting that the flower is more potent.
While Davidson is hopeful the reforms will enable more people with legitimate medical problems to receive speedy access to medical marijuana, he is concerned that some of Israel’s estimated 800,000 recreational users (roughly 10 percent of any given country’s population smokes weed, he said) will take advantage of the system to obtain it at a fraction of the price through Israel’s universal health system.
“There are many people who sneak into the system, and to some extent we’ve developed a negative approach to prescribing to the people who really need it,” he acknowledged.
Bruce Weber, who had to wait months to receive a “lower than effective” dose of medical marijuana to relieve crippling spinal pain, accused “most” of the physicians charged with recommending and approving medical marijuana requests of “an anti-cannabis bias.”
“A surgeon refused to perform reconstructive spinal surgery on me because I take medical cannabis,” he recalled. “He told me to leave the hospital.”
Weber, who used to travel five to six hours round-trip via public transportation to pick up his prescription from the closest dispensary in another city, is now getting it delivered.
But he offers a caution for those who might be getting the prescription from a local pharmacy. Make sure, he said, that the dispensary “keeps all the [marijuana] strains in stock all the time.
“Medical cannabis is a medication and medications aren’t interchangeable,” Weber said.