Health scan: Israeli physicians slowly warming to medical marijuana

According to a questionnaire results, physicians recommend medical cannabis to some of the patients who asked for a prescription but not to all.

A marijuana leaf (photo credit: REUTERS)
A marijuana leaf
(photo credit: REUTERS)
Israeli physicians seem to be more knowledgeable about medical marijuana than before and more willing to consider its use by selected patients, according to a new pilot study in the Israel Medical Association Journal (IMAJ).
Researchers from Bar-Ilan University, Hillel Yaffe and Sheba Medical Centers and the Israel Defense Forces sent a 32-item questionnaire to 100 physicians of different specialties in the center of the country, and 72 with an average age of 50 responded. Male physicians were more likely to approve of medical cannabis than their female counterparts. Some 90 percent knew of at least one patient who was authorized to take medical marijuana for cancer or chronic pain, nausea, Crohn’s disease, AIDS, multiple sclerosis or other conditions, while 60% had recommended the drug for at least one patient.
According to the questionnaire results, physicians recommended medical cannabis to some of the patients who asked for a prescription but not to all.
Most of the respondents rated their own knowledge in the field of pharmacology and indications as high or medium-high. Most of them knew of the new Health Ministry decision that medical cannabis would be given to authorized patients at regular pharmacies rather than other, harder-to-reach locations.
The researchers did not find significant differences in most attitudes among doctors of different specialties or at various levels of seniority. Along with more acceptance of cannabis for patients, a number of doctors feared that some patients might abuse the system and try to get a license for cannabis despite not being sick.
While the study was the first of its kind in Israel, the researchers said a larger sample of doctors from around the country was needed to assess physicians’ beliefs on this evolving topic.
“We found partial acceptance among Israeli physicians of medical cannabis as a therapeutic agent, in particular for treatment in cancer and terminal diseases.
It is therefore assumed that he number of licensed medical cannabis patients will continue to climb,” they wrote. But “more clinical studies are required to evaluate the safety and efficacy and to instruct evidence- based clinical choices,” they concluded.
VITAMIN D SUPPLEMENTS REDUCE FALLS Every year, about one in three elderly people living at home suffer a fall; one in 10 of the falls result in serious injury. Even if an injury does not occur, the fear of falling can lead to reduced activity and a loss of independence.
Research published in the Journal of the American Geriatrics Society has shown that vitamin D plays a key role in maintaining muscle integrity and strength, and some studies suggest vitamin D can reduce the risk of falls.
Homebound elderly, a generally vulnerable population due to poor dietary intake and nutrition-related health conditions as well as decreased exposure to sunlight, are at increased risk for low vitamin D levels, possibly leading to more falls.
Researchers at Wake Forest Baptist Medical Center in North Carolina set out to evaluate the feasibility of delivering a vitamin D supplement through a mealson- wheels program to improve the people’s vitamin D levels and reduce falls.
“Falls in homebound older people often lead to disability and placement in a nursing home,” said gerontology Prof. Denise Houston, the lead author of the study. “One or our aging center’s goals is to help people maintain their independence and live safely at home for as long as possible.”
Participants were recruited to take part in a fivemonth, single-blind randomized trial. Sixty-eight study participants received either a monthly vitamin D supplement of 100,000 international units or placebo delivered with their meal. The study included the participants’ history of falls and their fear of falling, blood tests at the beginning and at end of the trial to measure 25-hydroxyvitamin D (the biomarker for vitamin D in blood), and a monthly diary recording falls during the trial period.
At the beginning of this pilot study, the research team found that more than half of the participants had insufficient concentrations of vitamin D in the blood (less than 20 ng/ml), while less than a quarter had concentrations in the optimal range (30 ng/ml or more).
The study showed that the monthly vitamin D supplement was effective in increasing the concentrations of vitamin D in the blood from insufficient to sufficient levels in all but one of the 34 people who received it and to optimal levels in all but five people. In addition, people in the vitamin D group reported approximately half the falls of those in the control group.
JOLIE’S MASTECTOMY IMPROVED PUBLIC AWARENESS OF RECONSTRUCTION Actress Angelina Jolie’s decision to undergo a double mastectomy and subsequent reconstruction increased public awareness of the availability of reconstruction surgery, according to a new study in the journal Cancer.
The peer-reviewed journal of the American Cancer Society said that media coverage can serve as a tipping point for improving the general public’s knowledge about a particular health topic.
In 2013, Jolie’s decision – which she chose because she carries a BRCA1 gene mutation that puts her at increased risk of developing breast cancer – generated considerable media attention. To see if such media coverage had an effect on public awareness, a team led by Dr. David Lumenta, a reconstructive surgeon at the Medical University of Graz, Austria, conducted two online polls with 1,000 women each, one before and the other after the celebrity’s announcement.
Following the announcement, there was an increase from 88.9% to 92.6% in the proportion of women aware that reconstructive breast surgery is possible after the surgical removal of one or both breasts; there were even greater increases in awareness that breast reconstruction can be achieved with the use of one’s own tissue, from 57.6% to 68.9%, and that it can be done during the breast-removal operation. One-fifth of participants of the second poll indicated that the media coverage about Angelia Jolie’s announcement made them “deal more intensively with the topic of breast cancer.”