Israel and Medical Cannabis Research

Guess which country leads the way in cannabis research?

Whilst CBD may be stealing the headlines, behind the scenes the use of cannabis to fight serious illness has been dominating the political and scientific debate. But while Governments have been going back and forth over the pros and cons of legalising medical cannabis, Israel has been quietly turning itself into a powerhouse of global cannabis research.

Described by CNN’s Chief Medical Officer, Dr. Sanjay Gupta as ‘the marijuana research capital of the world’, Israel has been conducting research into marijuana since the 1960s and is home to the world’s largest medical marijuana production, research and development facility.

The Breath of Life Pharma (BOL) grow-house and research centre is a one-million-square-foot facility where each cannabis plant is monitored by software that remotely controls its biochemical parameters.  It’s a facility that’s expected to produce 80 tons – more than 175,000 pounds – of medical marijuana a year.

So how did Israel come to be streets ahead of other countries in this field? Well, for a start, they had the man widely credited as the grandfather of medical marijuana research.

Raphael Mechoulam, a professor at Hebrew University in Jerusalem was the first to isolate, analyse and synthesise the major psychoactive and non-psychoactive compounds in cannabis, and develop a number of marijuana-related treatments. 

After realising that no one had tried to understand cannabis and its psychoactive and non-psychoactive ingredients, Professor Mechoulam started researching cannabis and its effects in 1964.  

According to a report in the Jerusalem Post Mechoulam and his colleagues, using themselves as test subjects, discovered the cannabis plant’s two core substances; tetrahydrocannabinol (THC) the psychoactive ingredient and cannabidiol (CBD) and how to test its medicinal properties. 

He later went on to co-discover the brain’s own Endocannabinoid system, which plays a key role in mood, memory and the sensation of pain. He discovered that cannabinoids bind to receptors in different areas of the brain and vital organs to trigger different reactions. 

It’s an area the scientific world is now studying in detail as it seeks to gain a greater understanding of the relationship between cannabinoids and human physiology.  

Medical Cannabis research - Professor Raphael Mechoulam
Professor Raphael Mechoulam, the first to isolate, analyze and synthesize the major psychoactive and non-psychoactive compounds in cannabis

Controversially, Mechoulam told the Jerusalem Post that he believed that doctors themselves could be the obstacle to wider acceptance of medical marijuana because they’re unfamiliar with a drug that for many years has been classified on the same level as cocaine and morphine. 

He believes that this isn’t fair and that whilst all drugs have side effects, ‘one has to know how to use them’.

Whilst Cannabis-based medicines are already being used to reduce the side effects of cancer treatments such as chemotherapy, another Israeli scientist breaking new ground is Dr David Meiri of the Technion-Israel Institute of Technology, with his research into how different compounds of cannabis can effectively destroy specific cancer cells.

In the Laboratory of Cancer Biology and Cannabinoid Research, Meiri and his team of researchers have been identifying the exact chemical composition of different strains of cannabis and then systematically applying those strains to different cancer cell samples.

Through this research, they have been able to determine which cannabis strains kill which cancer cells. 

Meiri was inspired by the revelation that as well as eliminating the vomiting and nausea caused by chemotherapy, scientists had observed that cannabis was also actively reducing or stopping the spread of the cancer cells themselves. 

Using sophisticated machinery, Meiri managed to identify the exact composition of compounds such as cannabinoids and terpenes in every single strain of cannabis grown in Israel. 

Medical Cannabis Research

The Israeli government’s backing of research into medical marijuana has played a key part in cementing the country’s place as one of the leaders in global research into cannabis for medicinal purposes.

According to the Ministry of Health, in 2017 there were more than 110 clinical trials taking place in Israel, more than any other country and many of the studies are funded by the Israeli government. 

It’s not surprising and a sign of Israel’s important role in global research that other funding comes from countries including America, Canada, Australia and Germany.  

Some American companies are even outsourcing their research to Israel as given the size of the country, it’s quicker and it’s also one of the few countries that use humans in its research. 

In a world where more cannabis-based medicines are likely to develop, Israel is likely to remain the key player in global medical cannabis research for some time yet.

The use of Cannabis as a medicine

Clinical studies showing the effectiveness of what’s usually referred to as ‘medical marijuana’ has led countries around the world, including the UK to review, debate and pass laws to legalise its use as a medicine.

Israel however, has permitted the use of medicinal cannabis since the early 1990s for patients suffering from cancer, Parkinson’s and Crohn’s disease. In 1996, California followed suit and became the first US state to legalise the medical use of cannabis and in the intervening years, 34 states joined the list.

In 2001, Canada granted legal official approval for AIDS patients to use cannabis and since then, more countries have relaxed their laws around the use of cannabis as a medicine.

High-profile cases around the world have helped to bring the use of medical marijuana as a treatment into the spotlight and have led to a growing awareness of its potential benefits amongst the general public.

For example, the outcry around the cases of Alfie Dingley and Billy Caldwell in the UK, led the then Home Secretary, Sajid Javid to commission a review into the evidence available for the medicinal and therapeutic benefits of cannabis-based medicines, which ultimately led to legislation being passed in November 2018. 

Medical Marijuana can be cannabidiol (CBD) or a mix of CBD and THC. It is important to note that the CBD contained in Medical Marijuana products is not the same as the CBD sold as wellness supplements on the High Street.

Unsurprisingly, Cannabis-based medicines are heavily tested before gaining licences and have to be prescribed by a specialist doctor.

In some counties like Canada, cannabis has been legalised for both medicinal and recreational purposes, however, in most countries, it has only been legalised for medicinal reasons and even then it is only prescribed under strict conditions. Here we take a look at the status in the UK and US.

Medical Cannabis Research

The UK

A review by Chief Medical Advisor Dame Sally Davies concluded that there was evidence medical cannabis can have therapeutic benefits. The second part of the review which was held by the Advisory Council on the Misuse of Drugs (ACMD), stated that doctors should be able to prescribe medicinal cannabis provided the products meet safety standards.

The subsequent legislation enabled specialist doctors to prescribe medical cannabis for patients, usually as a last resort when other medicines have not been effective or the side effects are too great. That doesn’t mean that anyone can walk into their doctor’s surgery and ask to be treated with a cannabis-based medicine as there are stringent rules as to what conditions can be treated:

  • Children and adults with rare, sever forms of epilepsy
  • Adults with vomiting or nausea caused by chemotherapy

 The cannabis-based medicines that can legally be prescribed by specialist doctors in the UK are:

Epidiolex

Epidiolex is a treatment for adults and children with epilepsy and contains a highly purified liquid containing CBD (cannabidiol). Although it is not yet licensed in the UK it can still be prescribed for patients with Lennox-Gastaut syndrome and Dravet syndrome which are both rare and severe forms of epilepsy.

Nabilone

Nabilone is a medication for chemotherapy patients to help relieve sickness and nausea. It can only be prescribed when other treatments haven’t helped or aren’t suitable and is taken in capsule form. According to the NHS website, Nabilone has been developed to act in a similar way to THC – the cannabis chemical that makes you high which is described as a ‘man-made form of cannabis.’

Nabiximols (Sativex)

Nabiximols was the first cannabis-based medicine to be licensed in the UK. Sprayed into the mouth, it can be prescribed for the treatment of MS-related spasticity if a patient has shown an inadequate response to other treatments or found their side effects intolerable.

For more information, visit the NHS website.

The United States

In America, the state of medical cannabis or ‘medical marijuana’ is confusing as marijuana is not recognised for its medicinal purposes by the overall Federal Government which makes it illegal under US federal law. However, individual states have the power to legalise its use for medicinal and recreational within their particular state boundaries.

In states where medical marijuana is legal, each has a specific legal framework governing rules, regulations and requirements. Anyone wanting to use medical cannabis must have a qualifying medical condition and is required to obtain a ‘Medical Marijuana Card’ from an approved, licensed doctor.

Whilst the US Food and Drug Administration (FDA) has not recognised or approved the marijuana plant as a medicine, in June 2018 it did approve the first drug that is derived from marijuana for use as an anti-epileptic treatment.

Epidiolex is the first prescription pharmaceutical formulation of highly purified, plant-derived cannabidiol (CBD) available as a prescribed oral solution in all 50 US states and as in the UK, it can be prescribed as a treatment for seizures in patients with the most severe forms of epilepsy: Lennox-Gastaut syndrome and Dravet syndrome.

More information on the United States and medical marijuana.

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