After years of research into the question, in July of last year Israeli authorities made post-traumatic stress disorder the only psychiatric condition for which the Health Ministry will approve the use of medical marijuana. The decision, backed by the Israel Psychiatric Association, was a cause for optimism among many Israeli veterans suffering from PTSD.
But a sobering account in Israeli daily Haaretz Dec. 8 finds that actually getting the stuff has proved difficult for sufferers—starting with the problem of getting the necessary doctor’s recommendation, and then bureaucratic obstacles once they do. “We are a very small group of three or four psychiatrists who believe that in some PTSD cases cannabis is helpful,” said psychiatrist Dr. Ilya Reznik, an Israeli executive board member of the International Association for Cannabinoid Medicines. “The pressure on our clinics is impossible. This is partly because people who get a permit and don’t come in every three months for follow-up risk losing their permit.”
The Health Ministry justifies the restrictions by citing studies “indicating significant dangers in giving cannabis in cases of mental illness or addiction.” But Reznik sees a double standard. “The most serious drugs we give—addictive drugs—there’s no problem, but when it comes to cannabis, the Health Ministry feels it has to protect the patients,” he told Haaretz. “Cannabis is the only material where the Health Ministry interferes in the doctor-patient relationship.”
“Israel produces many cases of PTSD,” added psychiatrist Michael Segal, who has treated veterans from the 1973 Yom Kippur War to the 2014 Gaza campaign. More than 300 patients have received cannabis on Segal’s recommendation. He claims an impressive rate of success in his patients being able to find enough peace to hold down a job and lead a normal life—as well as significantly reduce their use of other medications.
Skeptics are also quoted. “Research is not good enough to ascertain the connection between cannabis and reduced symptoms,” said psychiatrist Shauli Lev-Ran, head of the addiction clinic at Sheba Medical Center, who cited a recent study showing that cannabis worsened symptoms.
To receive a cannabis permit, a patient must have at least a “30 percent disability,” and must have tried at least two other medications for at least two months each. Patients are barred if they have any history of psychosis or drug abuse. Patients rejected for not meeting the criteria can file an appeal with a special committee. By official figures, 1,153 of 1,500 applications have been approved. But Reznik said he doubts these figures. “We are under constant persecution and many of the applications are rejected for no good reason, such as a form filled out by hand rather than typed,” he said.
Lawmaker Tamar Zandberg of the left-wing Meretz party, chair of the Knesset Committee on Drug Abuse, also criticized the bureaucratic bottleneck. “The attitude of the medical establishment toward PTSD victims is a delaying factor in the process of these people’s recovery,” she said. “We find many patients and their families who report relief of symptoms, improved sleep and reduced anxiety following cannabis use. And yet the establishment has trouble seeing cannabis as a legitimate and beneficial medication.”
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