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Despite its growing acceptance for both medical and recreational use in Israel, cannabis is becoming more difficult for patients to access. Pain clinics, which are the primary dispensers of medical cannabis in the country, claim the system is being flooded by people who simply want a way to legitimize their recreational use of marijuana.

Clinics have started restricting access by making it harder for patients to qualify for medical cannabis and, in some cases, have instructed doctors to consider revoking permits as a way to keep from being overwhelmed by the tide of permit holders. While clinics justify their actions as a necessary capitulation to a logistical strain on their services, some cannabis proponents see the clinics’ stance as a cover for collusion with pharmaceutical companies that stand to lose money as more patients shun their products in favor of cannabis.

As in other countries where patients have legally or illegally sought treatment with cannabis medicine, Israel is full of firsthand accounts from people who have found in cannabis relief from suffering that conventional pharmaceuticals had failed to deliver. With approximately 23,000 permit holders, Israel has one of the highest per capita rates of medical cannabis use in the world. That is why many were surprised when the country’s pain clinics recently started to crack down on what they see as abuse of their services.

Gil Luxenbourg, CEO of the Israel Medical Cannabis Association, finds the pushback from clinics worrisome, saying:

“There is a clear-cut trend at the hospitals to retreat from the use of medical cannabis.”

Luxenbourg sees something sinister in the clinics’ new aggressive stance toward permit holders and permit seekers:

“What we have here is a hidden agenda and silent conspiracy designed to make things difficult for the patients.”

Doctors at the pain clinics reject such accusations as absurd: “All the claims about ties between doctors or the Health Ministry and the pharmaceutical companies are baseless – if not insane – figments of the imagination,” said one senior doctor. “You have to understand that we have no problem with the use of medical cannabis. We have a problem with people who come to the pain clinics to try to get a permit and thereby create a massive workload at the clinics, which then end up handling only requests for permits.” He went on to say that if dedicated cannabis clinics were to be established, the problem for general pain clinics such as his would “improve dramatically.”

Given the recent show of bipartisan support for decriminalized recreational cannabis from members of the Knesset and from Israeli police chief Yohanan Danino, it seems odd that medical cannabis users should be singled out for persecution. It also seems unlikely that any effort on the part of health officials and drug companies to snuff out medical cannabis would be effective given the ready availability of cannabis should efforts to decriminalize recreational marijuana succeed.

More plausible than a conspiracy between the government and pharmaceutical companies is the clinics’ assertion that they simply cannot handle all the permit requests they receive. Why cannabis-specific clinics have not been established to reduce the pressure on general pain clinics is admittedly curious.

It may be that government officials are learning from legalization experiments in the US, such as those in Oregon, where officials are limiting the availability of medical marijuana to those patients who truly need it, while all others who seek cannabis will be shunted toward a regulated retail system.

Whatever the cause for the clinics’ recent move to deny medical cannabis, patients will suffer while a solution to the problem is worked out. One patient captured the essence of the issue facing clinics and their patients, saying:

“The fact that there are thousands of people who are submitting requests and that someone believes they are trying to receive permits fraudulently is not my concern. I’m suffering; and if medical marijuana can help me, then I want to receive a permit to use it.”

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