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News (Media Awareness Project) - Israel: Health Ministry, Drug Dealers Team Up to Help Chronically Ill
Title:Israel: Health Ministry, Drug Dealers Team Up to Help Chronically Ill
Published On:2009-06-20
Source:Ha'aretz (Israel)
Fetched On:2009-06-20 04:34:15
HEALTH MINISTRY, DRUG DEALERS TEAM UP TO HELP CHRONICALLY ILL

"The 90s were the golden age of chemicals. In every forest clearing
there were people taking ecstasy and LSD and dancing themselves
silly. People didn't get married unless pills were promised to the
guests. Thousands protested at Rabin Square urging us to 'give trance
a chance.' There was a feeling that something was about to change.
But in Israel, people love to party, but they don't love paying for
it. I lost millions, I collapsed financially, and that is how I found
myself in California. Very quickly, I became the owner of three grow
houses of medicinal marijuana, until six months ago, when I go a
phone call from my American friend Rick Doblin."

This is how Yohai Golan-Gild describes how he turned from an
organizer of psychedelic drug parties into a provider of medicinal
marijuana in Israel - with the full approval of the Health Ministry.
The path taken by Golan-Gild represents the quiet but fascinating
revolution that Israeli society has undergone over the last decade.
In 1999, the Health Ministry legalized the use of Cannabis, the plant
from which marijuana and hashish are derived, for use by patients
suffering from serious symptoms such as pain, nausea and loss of appetite.

As the cultivation of the Cannabis plant became legal, the number of
patients prescribed medicinal marijuana grew from two in 2000 to more
than 700 today. The number is expected to reach 1,200 within three
months. Cannabis growing is on the verge of becoming an economic
goldmine and entrepreneurs seeking to tap its potential are eyeing
the endeavor. The consumption of cannabis products, which was
completely forbidden up until ten years ago, is now becoming
regulated and may eventually gain the status of any other drug
supplied to the general public.

"I issue 40 new prescriptions every month, with an average
prescription calling for 100 grams per patient per month," boasts Dr.
Yehuda Baruch, the head of the psychiatric hospital "Abarbanel" in
Bat Yam. Baruch is also the Health Ministry's point man for medicinal
marijuana prescriptions.

The aforementioned revolution has not yet been completed, and the use
of medicinal marijuana is currently in a sort of twilight zone. It is
considered a legitimate medical treatment, under the supervision of
the Health Ministry, but is viewed as a "stepson" of sorts. Baruch,
the sole provider of prescriptions, is only employed by the ministry
part time, and many patients find themselves waiting for him to clear
time from his busy Abarbanel schedule to renew their prescriptions.

"Baruch is already causing a bottle neck. What will happen in
September when we reach 1,200 patients with prescriptions?" asks Liat
Benny (37), a Tel Aviv resident, who suffers from a rare genetic
disorder and is prescribed marijuana to ease her symptoms. She has
recently established a non-profit organization to promote the use of
medicinal marijuana like any other prescription medication.

"Our battle is against an institution mired in prejudice," she said.
"The stigma is that patients who smoke are messed up, or high, but
that is not the way we are. The Cannabis, for me, comes in place of
other drugs, and it allows me to function. Don't compare me to a
healthy person who smokes." She added that she has often encountered
doctors and nurses at conferences where she'd lectured who responded
with giggles and asked to take her picture next to the plant.

Just to be clear, Benny's complaints are not directed at Baruch. On
the contrary - patients laud the Health Ministry and Baruch in
particular for smashing the conventional closed-mindedness in regard
to the use of medicinal marijuana. Dr. Itay Gur-Ariyeh, the head of
pain management at Sheba hospital and the chairman of the Israel Pain
Association said that Baruch is on the right track, but that the
issue must be completely regulated.

Up to Ten Plants

The problematic nature of the status of medicinal Cannabis is most
evident in its production. The Health Ministry committee that decided
to permit the use of medicinal marijuana back in 1999 stipulated that
the drug be given only to patients with extreme symptoms, and only in
order to ease pain directly stemming from their disease. But the
committee had trouble defining how the patients were to obtain the
drug, which was not legally grown in Israel at the time.

Thus, until 2005, the prescriptions for medicinal marijuana were
given only to ten patients, among them Benny. The ministry allowed
them to independently cultivate up to ten Cannabis plants, and to
possess up to 200 grams of processed plants (imagine what would
happen if your doctor prescribed you a drug and then asked you to
produce it yourself).

This was not the only problem. The growing of Cannabis requires some
physical work, as well as time. Since the first patients to be
prescribed the drug were all terminally ill, this aspect took on an
ironic twist, even if not intentionally. The backwards result wasn't
far behind - Yossi Bozaglo, of the first patients to be prescribed
marijuana, was tried in 2001 for buying marijuana from a drug dealer.
The incident made it very clear that the ministry must take
responsibility over providing the drug.

Then "angel face" arrived. That is how the patients call the man, who
to this day insists on remaining anonymous, who approached the
ministry and offered to provide the Cannabis to the patients.
Somewhere in the north, he and his family have been growing the
Cannabis with the authorization of the state for the last four years.
The availability of the drug, thanks to angel face, greatly increased
the number of patients who were prescribed the drug. His grow house
holds dozens of plants, all of which bear the names of patients who
were treated with Cannabis and have since died.

In a small apartment in Tel Aviv, patients huddle almost daily to get
their joints or the raw materials from angel face and the volunteers
at the organization he founded, named "Tikkun Olam." The distribution
of these cigarettes, at the improvised "clinic" and with the
government's blessing, is perhaps the most surreal and heartwarming
sight to be seen at any medical facility - light years away from the
atmosphere at oncology wards at hospitals.

Angel face provides relief for Parkinson's patients in wheelchairs
alongside Crohn's disease sufferers and cancer victims, who smoke
together in the yard. Patients over 70 years old suddenly get up from
their chairs and begin to move around. A child suffering from
Tourette Syndrome, who was forced to leave her school due to ridicule
from her peers, stopped cursing thanks to the drug, went back to
school, and is now in a relationship with her first boyfriend. And
everyone has a smile on their face. The Cannabis they receive has a
much higher concentration of the active ingredient than marijuana
sold illegally.

The process of obtaining the authorization to supply marijuana can
testify to the quiet revolution. At first, only angel face was
permitted to handle the drug and prepare joints. Then, due to the
growing demand, Baruch authorized several volunteers to help prepare
the drug. Ultimately, the volunteers were given authorization to
transport the drug all across the country.

Angel face doesn't receive any payment from the state for the
production of the Cannabis, and the patients don't pay for it either.
However, it is clear to everyone that this cannot continue, in light
of the growing demand and the cost of production. "There must be
payment," Dr. Gur-Ariyeh declared. "Who will pay for this - the
state, the HMOs or the patients - that's a different question."
Baruch, as a representative of the Health Ministry, shares
Gur-Ariyeh's opinion and has already begun compiling a financial model.

Medicinal Cannabis - a combination of helpless patients and a drug
with a hint of the wild - has sparked the attention of many
entrepreneurs. The phone call Yohai Golan-Gild received a year ago
was from his American friend, Rick Doblin, the founder of the
Multidisciplinary Association for Psychedelic Studies, which promotes
the use of these substances in medicine and research. When he heard
about the revolution underway in Israel, Doblin quickly contacted his
friend Golan-Gild, who was in California at the time. Last week,
Baruch and other ministry representatives visited the hothouses built
by Golan-Gild and his two partners, with an initial investment of NIS
1 million. (They asked not to make public the location of the
hothouses, for fear of theft.) They will be the second supplier of
medicinal marijuana.

The Health Ministry - which thinks it is impossible to rely on one
supplier for a drug that is grown agriculturally and is susceptible
to disease or other potential damage - plans to increase the number
of authorized medical Cannabis growers to five or six. According to
Baruch, this number would grow and supply enough Cannabis to meet the
expected demand. At first patients would receive the drug for free,
but they will soon be asked to pay for it.

"There are 160 varieties of Cannabis in the world and each one has
its own side effects," said Golan-Gild, adding, with pleasure, "I can
suit each patient with his or her type - one that will cause
exhaustion, one that will turn you into a ball of energy in the
morning and one that will cause a diagonal erection."

Baruch sees "the potential market in Israel reaching tens of
thousands of medicinal Cannabis users, with each one paying NIS 5 or
10 per gram of the drug, or NIS 5,000 to NIS 10,000 per person per year."

However, Golan-Gild claims that growing one gram of Cannabis costs
NIS 15, more than what Baruch expects patients to pay. The
difference, he says, would need to be subsidized by the Health
Ministry or HMOs, in the same way that they do for drugs included in
the public health basket.

The inclusion of Cannabis in the public health basket seems far off,
especially considering most HMOs are developing complementary
insurance programs, which serve as additional source of income for
them and traditionally include more alternative therapies.

In the mean time, Golan-Gild plans to open three "mercy centers," as
he calls them, in Jerusalem, Tel Aviv and Ra'anana. There patients
can not only smoke joints, but also - for an additional fee -
participate in yoga and Pilates classes and receive training on how
to use the Cannabis properly.

Light years away from all these initiatives, in a small simple Tel
Aviv apartment, the "Tikkun Olam" group continues to distribute
Cannabis for free and insist that patients must not pay for it out of
their own pockets.

Munchies

When Cannabis was approved for medicinal purposes in 1999, it was
originally intended for terminal cancer and AIDS patients. Today it
is being used in earlier stages of illness and for a wider array of
diseases, including Parkinson's, Tourette Syndrome, Multiple
Sclerosis, chronic pain and shell shock. The medical establishment is
also increasingly recognizing Cannabis' effectiveness in treating illness.

At the Hadassah Ein Kerem hospital's Bone Marrow Transplantation
department, patients including children and babies are treated using
drops of oil derived from Cannabis. "It has no side effects and is
largely effective in treating patients," said department chief,
Professor Reuven Or. "I would say it is effective in 80 percent of
patients, which is a lot."

Professor Or continued, "It stimulates the appetite and minimizes
nausea and vomiting, which is of great importance in Oncology. It
also has anti-inflammatory properties, which helps in cases of
infection or inflammation caused by radiation. Along with this,
Cannabis eases the coping process for patients - it improves their
morale and lowers depression, and these are important parameters for
patients battling disease."

Half of the patients being treated with Cannabis are Oncology
patients, while about a quarter suffer from chronic pain.

A Multipurpose Medicine

At age 6, Liat Benny began experiencing pains that would over the
years become stronger and spread, until doctors diagnosed her with a
rare autoimmune disorder that harms blood vessels, the eyes and joints.

Benny describes the pain she feels every hour of every day as an
"insane stabbing sensation." Three years ago, Benny's right eye was
surgically removed, and while she still has vision in her left eye,
she says it is limited and blurry. She has undergone dozens of
operations, treatments and hospitalizations, in addition to multiple
morphine treatments, but her disease worsened to the point that Benny
had to stop working.

Ten years ago, Benny's father told her about medicinal Cannabis, and
three years ago she was introduced to "Tikkun Olam." Today she is one
of the patients authorized by the Health Ministry to use medical
marijuana. Benny also lectures on the subject, tries to persuade more
doctors to lose their preconceived notions about the drug and
increase the number of users.

"I live with interminable pain that reaches level eight to nine (ten
is considered the highest pain level)," said Benny.

"Smoking Cannabis allows me to talk to you and sound coherent even if
I haven't slept all night," she continued. "Cannabis is a
multipurpose drug that should be included in the public health
basket. Its use significantly decreases the use of other drugs, which
is cost-effective for the state. Cannabis improves all patients'
functioning, and we are not just talking about relief from symptoms
but also about a certain form of therapy."

Several weeks ago, Benny established an organization to advance the
use of medicinal Cannabis. "I see this as my m
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