• Israël: assouplissement des réglementations entourant le cannabis médical
  • Israël: assouplissement des réglementations entourant le cannabis médical

Israel: relaxation of regulations surrounding medical cannabisInternational

Published 14 June 2023 by AQIC

The Knesset’s Health Committee decided on Tuesday that access to medical cannabis will be significantly expanded, with many more patients qualifying – without the need to obtain a special license to use the drug.

The decision is part of a reform led by the Health Ministry in recent months. Within the reform’s framework, patients with a wide range of diseases and medical conditions will no longer be required to obtain a license in order to receive medical cannabis.

According to the approved regulations, patients will receive a prescription similar to those for other prescription medications. The regulations will come into effect within six months, after the necessary preparations by the relevant authorities.

The regulations state that starting now, individuals suffering from the following diseases and medical conditions will be eligible to receive a cannabis prescription: epilepsy, Crohn's disease, dementia, autism (without age restriction), oncological diseases, multiple sclerosis, HIV/AIDS and terminally ill patients with a life expectancy of fewer than six months.

These patients will no longer require a license but will be able to receive a prescription from specific doctors who will receive training relating to cannabis usage.

This represents a change compared to the current health regulations, under which cancer patients with "an active oncological disease or those undergoing active cancer treatment for the relief of symptoms or treating side effects," are eligible to obtain a license for medical cannabis.

However, a delay in training specialized doctors who can prescribe cannabis may slow down the process and push back the expected date when the new legislation will begin operating.

According to the regulations, "some applicants for medical cannabis treatment will be able to receive a prescription from a doctor instead of obtaining a license for possession and use of cannabis."

Until now, treatment with cannabis was only authorized under a license approved by the Health Ministry, causing long waiting times and bureaucratic complexity as patients attempted to get approval.

Opponents of the move claim that it will lead to dependency and addiction to the drug.

Currently, there are about 100,000 patients in Israel with licenses for medical cannabis consumption, the majority of whom suffer from diseases, pain and post-traumatic stress disorder. During discussions on the regulations, patients expressed concern that these particular diseases and conditions aren’t included in the new regulations.

"This is only the first stage; there are additional medical conditions that require attention and treatment,” Knesset member Uriel Busso, the committee’s chairman, said.

“Our focus is on the patient’s wellbeing and the desire to alleviate their pain, increase availability and access to physicians, and lower prices – while taking into account concerns about abuse and harmful use of the drug," he added.

Aharon Shabi, director of the addiction treatment service at the Welfare and Social Services Ministry, said that: "We must ensure that prescriptions don’t increase addiction and lead to a further use of additional psychoactive substances."

However not everyone supports the decision.

"The regulations dramatically expand the number of physicians who can approve cannabis use and the medical conditions that allow for its prescription," said Professor Hagai Levine, chairman of Israel’s Association of Public Health Physicians. "These add an unnecessary risk of addiction."

Meanwhile, the Knesset’s Finance Committee reduced and approved new medical fees as part of the transition from cannabis licenses to prescriptions.

In response to the committee's request, the fee for annual prescription issuance for patients was reduced to 180 shekels instead of the original 220 shekels, and the self-participation fee will stand at 360 shekels.

During the previous discussion on the subject, the Finance Committee criticized the prices required for license issuance and prescriptions under the planned step and demanded that the Health Ministry, Finance Ministry and health maintenance organizations (HMO) to present the committee with lower prices for patients.

In response, the ministries and HMOs argued that the prices were the lowest fees that could be set to allow the program to continue and that cannabis isn’t included in Israel’s health basket. They added that there are additional costs associated with training and recruiting physicians, providing more complex treatment to patients, and adapting computer systems, among others.

At the beginning of Tuesday’s discussion, the committee’s chairman, Knesset member Moshe Gafni, noted that he isn’t willing to approve the proposed fee.

"Some of the services provided are essential, and I don't understand why there’s a need to charge so much money for them. There are many patients in difficult financial situations," he said.

During the discussion, Roee Kahan, head of the budget department at Clalit Health Services, the country's largest HMO, said that: "As part of this new move, we’re required to establish a system with doctors issuing prescriptions, a nursing system, a call center – and we’ll need to establish a digital center as well."

“Since this issue is not included in Israel’s health basket, I can’t impose to get it from a doctor. If the health minister had included the service in the health basket and budgeted it accordingly, things would be different," he added.