The Ministry of Health in Israel has given oncologists in most of the major hospitals in the country the direct authority to issue medical cannabis licenses. Other doctors are expected to receive similar authority in the future. For all other medical departments, physicians may provide a written recommendation for a medical cannabis license which is sent to the Ministry of Health for approval. All specialist physicians may recommend that a medical cannabis license be issued for one of his/her patients.
· Before consulting with your doctor and requesting a recommendation for a medical cannabis license, we recommend verifying patient eligibility by making sure the patient’s condition falls within the current indication list published by the Ministry of Health.
· The latest medical indications that are eligible for treatment with medical cannabis and the conditions of eligibility are available here.
· After confirming eligibility, please make an appointment to meet with your doctor to discuss the treatment and request a recommendation for a medical cannabis license.
· Note that patients receiving treatment at a hospital pain clinic must prove that they have received opioid treatment for at least 12 months before requesting approval for medical cannabis.
· If the specialist doctor decides that medical cannabis is appropriate for the patient. Both the doctor and the patient are required to fill out an electronic request to the Ministry of Health.
· Patients may request Tikun Olam as their preferred supplier on the electronic form under “supplier name”.
· It is recommended that the patient fax the completed form to the Ministry of Health directly. The fax number for submissions is: +972 2 647 4810. After submission, call +972 8 626 8000 to verify that it was received.
· Approval for a medical cannabis license takes about thirty business days and is subject to the discretion of the Ministry of Health. If the request is denied, the recommending doctor will receive an explanation for the denial. If the request is approved, the license is automatically forwarded to an assigned provider who then contacts the patient and provides the treatment.
· Licenses for medical cannabis for oncology patients are processed independently of the Ministry of Health at the following hospitals: Assaf HaRofeh Medical Center; Haddassah Medical Center; Nahariya Hospital for the Western Galilee; Rambam Health Care Campus; Sheba Medical Center at Tel Hashomer; Sourasky Tel Aviv Medical Center (Ichilov); Ziv Medical Center.
Medical indications recognized by the Ministry of Health today are:
Oncology Field:
- Patients undergoing chemotherapy or those up to six months after treatment for nausea and pain relief related to their treatment.
- For pain relief for patients with metastatic cancers and after conventional treatment methods are exhausted.
Pain Field:
- For patients suffering from neuropathic pain from a clear organic source, after at least one year of treatment at a recognized pain clinic before requesting cannabis, after exhausting conventional treatment options, and with the recommendation of their pain clinic.
Gastroenterological Field:
- Crohn’s Disease- For patients that aren’t responding to conventional treatment options well enough.
- Colitis- In special cases, it will be given to patients with ulcerative colitis that aren’t responding to conventional treatment options.
Infectious Diseases:
- HIV/AIDS- Patients with Cahexia symptoms (defined as a >10% loss in body weight).
Neurological Field:
- Multiple Sclerosis- Patients suffering from spasticity that aren’t responding to conventional treatment options.
- Parkinson’s Disease- Patients undergoing anti-Parkinson’s treatment for at least one year and experiencing chronic pain or pain from stiffness, that aren’t responding to conventional treatment options.
- Tourette’s Syndrome- Adult patients suffering from severe symptoms that impede daily functioning and that aren’t responding to conventional treatment options.
Palliative Care Field:
- Terminally ill patients.
Psychiatric Field:
- Post-Traumatic Stress Disorder (PTSD) – Adult patients that have been diagnosed with PTSD and meet the criteria for at least 21% disability by the Bituah Leumi (National Insurance Institute) (NII), that have been suffering from the disorder for at least two years and exhibiting extreme emotional distress. In addition, patients need to have tried three combinations of conventional medicinal interventions for at least two months each and three commonly accepted psychological interventions.
Counter-indication for treatment – active psychosis or first-degree family history of psychotic diseases.
New indications are being added regularly, see the Ministry of Health website for up-to-date information. A physician is entitled to petition the indications committee of the Ministry of Health to add a new indication to the list. Also, physicians may request individual exceptions for patients with diseases not currently in the list, but which the physician feels warrant cannabis for the patient.