The standard image of cannabis is twofold. First is the one presented in
the West’s films and pop subculture. Cannabis, also known as marijuana and
“grass,” has been famous for centuries as a psychoactive, dreamy substance
which, at the same time, is illegal in most countries and attracts a penalty if
the user is caught.
Several generations of anti-establishment youth got
off on hiding it and being part of a subversive underclass. Their
non-cannabis-using peers were relegated to the term “squares” and accused of
The second attitude is one of recreational use in places
like the Netherlands, where cannabis is openly ingested in the infamous cafes,
with a denial that it is any more harmful than alcohol.
has taken a third path and put the nefarious weed into its proper place by
recognizing it as medicine. And like all medicine, it has the potential for
misuse. In any case, the use of cannabis derivatives as medicine is causing a
small, silent revolution among hippies, squares and Dutch cafe users
What is apparent, from much of the recent research, is that
Cannabis sativa (the plant) has many properties that, administered correctly,
offer a multitude of remedial benefits. In taking this forward, Israel is
placing itself leaps ahead of worldwide competition, both scientifically now and
commercially in the future.
Israel is one of the first countries to have
permitted the use of medical marijuana. Tel Aviv’s cannabis clinics have been
open for some time on an experimental basis, with government
They offer treatment for cancer, multiple sclerosis, HIV,
colitis and other ailments. Recently too, Israel’s first-ever hospital to offer
cannabis as a treatment, Sheba Medical Center in Tel Hashomer, started its pilot
program. There patients obtain the necessary government permit, according to a
strict protocol that the hospital developed, and then are provided with
Soon smoking will be replaced with machines which vaporize the
marijuana compound so they can inhale it with steam.
Cannabis for medical
purposes is supplied by a Health Ministry approved, charitable company in Safed
called Tikkun Olam, aptly named after the kabbalistic concept of restoring the
world. Bags of neatly wrapped cannabis cigarettes from the company are
distributed to licensed patients from various locations. The process is
carefully controlled and monitored by the government under the watchful eye of
Dr. Yehuda Baruch, director-general of Abarbanel Mental Health
Medical cannabis guru Prof. Raphael Mechoulam of Hebrew
University in Jerusalem famously pioneered research in 1964 to isolate
tetrahydrocannabinol (THC), the main active ingredient in cannabis, which he was
able to synthesize.
In 1993, he and his research team discovered another
compound called anandamide, which occurs naturally in the brain and acts in a
similar way to THC. Recent research has found this to link to neonatal appetite
stimulation in the womb.
Now Mechoulam uses cannabis provided by the
police to create different chemical compounds that may be useful in
The benefits of cannabis as medicine lie in reducing pain,
increasing appetite, modulating mood and various positive effects on the nervous
system, as identified with sufferers of multiple sclerosis.
The uses are
wide and the potential benefit is huge, but what are the risks? THE CASE against
cannabis is wholly based on harm-related research and legality. The first, most
obvious, risk is crime. Security on cannabis clinics is high (no pun intended).
Recently, reports suggested that there was a “cannabis drought” in the Middle
East. When illegal cannabis does arrive in Israel, most of it is courtesy of
Egypt, Lebanon and Jordan. The likely consequence, if there is indeed a drought,
is a growing black market. The potential for sale of medical cannabis in such a
market might prove too tempting for some. Criminal raids on legitimate cannabis
providers may become an issue. Whatever happens, these factors will require
Misuse and addiction are other issues. Usually,
cannabis treatments are given in low doses to those with a significant health
problem where other treatments may no longer be effective.
are over 30 and the expected benefits outweigh any harmful side-effects of the
Clinics may have to monitor increasing trends in demand and
ensure assessment is always rigorous.
Risks from cannabis lie in its mild
hallucinogenic effect and potential to induce psychosis and paranoia in a small
percentage of the population, particularly if ingested in large amounts. Its
dependence potential has been questioned but exists at least psychologically, if
not as a physical addiction.
There are also physical risks in the method
of ingestion. Inhalation gets the active ingredients into the bloodstream
rapidly but doing this using cigarettes can add damage from the other chemicals
present in the smoke, such as various carcinogens and carbon monoxide. There may
be risk to others of passive smoking. It should be noted, however, that most
medicines have some kind of risk.
Israel’s innovation in treatment using
cannabis derivatives really has the potential to be
revolutionary. Clearly, cannabis is a substance that has significant
risks attached to it and will need to be carefully regulated. The risks may
decrease as cannabis derivatives are understood more and are made into safer
formats, such as steam inhalation, tablets or liquids. It would seem further
research is needed in many areas, in relation to benefits and risks, treatment
methodology and outcomes, but then this is true for many new
If the risks are managed, through a solid process of clinical
evolution, then the potential for the economy is significant. Israel could
become not only one of the few countries manufacturing cannabis-based medicines
but also a key world pioneer in this field. So it’s good-bye hippies and
good-bye squares. Welcome to the new world of mature medicine, using plant
derivatives as perhaps nature originally intended.
The writer is a
freelance writer, therapist and former UK National Health Service manager. He
has an MSc in clinical and public health aspects of addiction and a special
interest in social marketing in health. He spends much of his time in Tel Aviv
when he is not working in London.