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Regulatory Changes In Israel Will Expand Patients’ Medical Cannabis Access

Israel is home to arguably the best cannabis research community on earth, serving as the longtime base for legendary cannabis researcher (and International Cannabis Business Conference alumni) Raphael Mechoulam.

Mechoulam first isolated tetrahydrocannabinol (THC) while conducting his research in Israel in the mid-1960s, and the nation’s scientists built on that research ever since. Unfortunately, Israel’s medical cannabis policies have not always kept up with the nation’s research.

Thankfully, new regulatory changes should help improve the level of safe access for suffering patients in Israel. Below is more information about it via a news release from NORML:

Jerusalem, Israel: Regulators are further easing restrictions on patients’ access to medical cannabis products.

Regulatory reforms approved by the Ministry of Health will allow physicians to prescribe cannabis to patients as a first-line treatment rather than as an option of last resort. (Under current law, doctors must attest that their patients have been unresponsive to other conventional treatments, including opioids, prior to granting them access to medical cannabis products.)

About 100,000 Israelis are currently authorized to use medical cannabis.

Another regulatory change eases legal restrictions on patients’ access to hemp-derived CBD products.

Regulators are also seeking to further facilitate clinical trial research involving cannabis products.

The regulatory changes are anticipated to go into effect this December.

Medical Cannabis Safe Access To Expand In Israel

When it comes to medical cannabis research, Israel has long served as an international leader. After all, it is where International Cannabis Business Conference speaker alumni Raphael Mechoulam became the first person in history to isolate tetrahydrocannabinol (THC), in addition to numerous other cannabis research breakthroughs.

Unfortunately, general medical cannabis policy and safe access for domestic patients have never seemed to receive the same level of embrace and consideration in Israel for some reason, with many patients reporting gaps in being able to acquire their medicine.

Israel currently serves as the top importer of medical cannabis products, which doesn’t make a lot of sense since the country obviously knows how to harness the cannabis plant and maximize its potential. The only logical explanation is that the nation’s laws are holding the domestic medical cannabis sector back.

Thankfully, there appear to be meaningful changes on the way, with it being reported that Israeli medical cannabis patients will soon no longer be required to obtain a special license for medical cannabis, per a recently approved reform measure. Per YNetNews:

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.

The reduced hurdles for obtaining medical cannabis are surely welcomed. With that being said, medical cannabis patients in Israel still are at the mercy of whatever supply they can access. As more patients presumably enter the medical cannabis sector as a result of the change, it will need to be met with boosts in domestic supply.

As is the case with any country, the only real way to ensure that every patient has safe access to medical cannabis is to legalize it for adult use, in addition to medical cannabis policies, and to afford every patient the right to cultivate their own medicine and/or join a noncommercial cannabis club.

Cannabis Associated With Sustained Benefits In Tourette Syndrome Patients

International health experts estimate that roughly 0.5-1% of the world’s population is diagnosed with some level of Tourette Syndrome, although the true diagnosis rate of people suffering from the condition could be larger due to gaps in identification and treatment in some parts of the globe.

According to the National Institute of Neurological Disorders and Stroke, “Tourette Syndrome (TS) is a neurological disorder characterized by sudden, repetitive, rapid, and unwanted movements or vocal sounds called tics.” Currently, there is no cure for the condition.

Various treatments for Tourette Syndrome exist, with common ones being dopamine blockers, Botox injections, ADHD medications, anti-depressants, and anti-seizure medications. All of those treatments can yield possible undesirable side effects. Fortunately, a recent study in Israel found that cannabis may help. Below is more information about it via a news release from NORML:

Tel Aviv, Israel: Patients with Tourette syndrome (TS) report that cannabis inhalation is associated with sustained improvements in their symptoms, according to data published in the journal Cannabis and Cannabinoid Research.

Israeli researchers assessed the long-term use of cannabis in 25 patients suffering from Gilles de la Tourette Syndrome. On average, patients in the study consumed cannabis for a period of four years, with some participants having used cannabis for up to nine years.

Patients reported sustained benefits in the management of TS and other comorbidities. Most subjects gradually increased their daily THC intake over time.

“Patients using MC [medical cannabis] reported an average 75 percent tic reduction compared with baseline,” authors determined. “A significant effect on comorbid conditions was [also] noted,” with 92 percent of subjects reporting reduced restlessness, 88 percent reporting improved mood, 84 percent reporting better sleep, and 75 percent reporting reduced anxiety.”

Authors concluded: “A subset of people with GTS report long-term significant benefit from continuous MC use with no disturbing side effects; however, they required escalating doses of THC over the years. Additional studies are required to test for objective improvement and for biological reasons that may explain dose escalation.”

Separate data published earlier this year reported that TS patients exhibit short-term improvements in their health-related quality of life as well as reductions in their use of prescription medications following cannabis treatment

Full text of the study, “Licensed medical cannabis use in Gilles de la Tourette syndrome: A retrospective long-term follow-up,” appears in Cannabis and Cannabinoid ResearchAdditional information on cannabinoids and TS is available from NORML’s publicationClinical Applications for Cannabis and Cannabinoids.

Terpenes Enhance THC’s Ability To Interact With Endogenous Receptor

For many years very little was known about cannabis terpenes. Terpenes are the compounds contained in the cannabis plant that gives it its smell. Scientists currently estimate that the cannabis plant contains over 150 different terpenes, with different genetics containing different ratios of terpene levels.

An example of a cannabis terpene is pinene, which is one of the most common terpenes found in cannabis terpene profile testing results. Pinene is known for having a forest-type smell, and can also be found in pine nuts, rosemary, and sage.

Researchers in Israel recently examined cannabis terpenes and how they interact with the endogenous CB1 receptor, and what they found regarding THC’s interaction with the receptor and terpenes could change the way cannabis products and treatments are developed going forward. Below is more information about it via a news release from NORML:

Jerusalem, Israel: Terpenes in the cannabis plant enhance the ability of THC to interact with the endogenous CB1 receptor, potentially heightening its effects, according to preclinical data published in the journal Biochemical Pharmacology.

Israeli scientists evaluated the role of terpenes in CB1 receptor-mediated functions. Researchers also assessed the extent to which terpenes acted as direct CB1 receptor agonists and as modulators of THC agonism.

Researchers reported certain terpenes – including borneol, geraniol, limonene, linalool, ocimene, sabinene, and terpineol – amplified THC activity at the CB1 receptor, even at low quantities.

They reported: “The results demonstrate that all terpenes, when tested individually, activate CB1 receptors, at about 10-50 percent of the activation by THC alone. The combination of some of these terpenes with THC significantly increases the activity of the CB1 receptor, compared to THC alone. In some cases, several fold. Importantly, this amplification is evident at terpene to THC ratios similar to those in the cannabis plant, which reflect very low terpene concentrations.”

Authors concluded: “The use of selected terpenes may enable reducing the THC dose in some treatments, and as a result, potentially minimizing the THC-related adverse effects. This would also help in adjusting the treatment to more sensitive populations such as children and elderly. Enrichment with selected terpenes may allow for composition adjustment to personal needs and to changes during chronic use, such as for daytime versus for sleep.”

The findings expand upon those of a 2021 study documenting that certain terpenes activate CB1 and CB2 receptors, and that the combined administration of cannabinoids and terpenes produce additive effects. Authors of that study similarly suggested, “[T]erpenes could be used to enhance the analgesic properties of cannabis/cannabinoid therapy, without worsening the side effects of cannabinoid treatment.”

A study published earlier this year reported that cannabis flowers with elevated levels of the terpenes myrcene and terpinolene are associated with greater perceived symptom relief among patients.

Full text of the study, “Selected cannabis terpenes synergize with THC to produce increased CB1 receptor activation,” appears in Biochemical Pharmacology.

 

Israeli Tourette Syndrome Patients Report Improvements Following Cannabis Therapy

Global statisticians estimate that around 0.5-1% of the planet’s population has been diagnosed with some level of Tourette Syndrome, although the true diagnosis rate of people suffering from the condition could be larger due to gaps in identification and treatment in some parts of the globe.

According to the National Institute of Neurological Disorders and Stroke, “Tourette Syndrome (TS) is a neurological disorder characterized by sudden, repetitive, rapid, and unwanted movements or vocal sounds called tics.” Currently, there is no cure for the condition.

Various treatments for Tourette Syndrome exist, with common ones being dopamine blockers, Botox injections, ADHD medications, anti-depressants, and anti-seizure medications. All of those treatments can yield possible undesirable side effects. Fortunately, a recent study in Israel found that cannabis may help. Below is more information about it via a news release from NORML:

Tel Aviv, Israel: Tourette Syndrome (TS) patients report improvements in their quality of life and reductions in their use of prescription medications following cannabis therapy, according to data published in the journal Cannabis and Cannabinoid Research.

Israeli investigators surveyed patients prior to and six-months following cannabis treatment. Subjects in the study consumed products containing roughly twice as much THC as CBD.

Participants reported statistically significant improvements in their quality of life and employment status following cannabis treatment. Most subjects also reported reduced symptoms of anxiety and obsessive-compulsive tendencies. Patients reduced their use of prescription medicines.

By contrast, subjects did not report statistically significant improvements in their frequency of either vocal or motor tics during the study period.

Authors concluded: “Subjective reports from TS patients suggest that medical cannabis may improve their quality of life and comorbidities. More studies are needed to evaluate the efficacy and safety of medical cannabis.”

A limited number of clinical trials have shown both oral THC and inhaled cannabis to be associated with symptom improvements in TS patients, including decreased tic severity and reductions in obsessive-compulsive behaviors. The results of a randomized, placebo-controlled trial published last month in the journal Psychiatry Research reported that patients with more severe TS symptoms experienced symptomatic improvements following the consumption of a balanced formulation of oral THC and CBD.

Full text of the study, “Using medical cannabis in patients with Gilles de la Tourette’s Syndrome in a real-world setting” appears in Cannabis and Cannabinoid Research. Additional information on cannabinoids and TS is available from NORML’s publicationClinical Applications for Cannabis and Cannabinoids.

Cannabis Use Prior To Bedtime Is Associated With Improved Sleep According To Israeli Study

Consuming cannabis prior to bedtime is associated with improved sleep in patients with treatment-resistant post-traumatic stress (PTS) according to data recently published in the journal Frontiers in Psychiatry.

Researchers in Israel conducted a study involving a cohort of 14 subjects with combat-related traumatic stress. All of the study’s participants previously explored various conventional treatments with those treatments proving to be unsuccessful.

According to the researchers, none of the patients were cannabis consumers prior to enrolling in the study. Study participants consumed cannabis ‘in the evenings’ in an outpatient setting for a period of at least six-months as part of the study parameters.

Investigators reported: “After treatment with cannabis, total sleep score, subjective sleep quality, and sleep duration significantly improved. … Total PTSD symptom score and its subdomains (intrusiveness, avoidance, and alertness) showed [also] improvement.” By contrast, cannabis treatment was not associated with reducing patients’ frequency of nightmares. None of the patients reported any side-effects from cannabis, nor did any elect to cease using cannabis prior to the end of the study period.

“To the best of our knowledge, this is the first published study examining long-term cannabis efficacy in chronic combat treatment-resistant PTSD patients,” authors concluded. “The study’s findings show an overall improvement in sleep quality and duration, as well as a decrease in PTSD symptoms. … Future research should clarify the long-term effects of cannabis on different groups of patients suffering from PTSD.”

Post-traumatic stress has been a qualifying condition for medical cannabis in Israel since 2014. Currently, it is estimated that roughly 10 percent of all Israelis authorized to access medical cannabis use it to treat various symptoms of PTS.

This latest study builds on prior studies, which have similarly reported improvements in sleep duration and in insomnia in patients with and without PTS. The enactment of adult-use cannabis legalization is also correlated with a decrease in the sale of over-the-counter sleep aid medications.

Cannabinoid Combination Possesses Synergistic Anti-Cancer Effects In Cellular Model

The cannabis plant is made up of dozens of cannabinoids. THC and CBD may currently garner the most headlines, however, other cannabinoids are growing in popularity amongst patients and researchers.

A great example of that is cannabichromene (CBC). According to Science Direct, “CBC can be one of the most abundant nonpsychotropic CBs found in strains or varieties of Cannabis,” and “can cause strong anti-inflammatory effects.”

Researchers in Israel recently evaluated a combination of CBD and CBC and its effects in cellular models, and the results are encouraging. Below is more information about it via a news release from NORML:

Jerusalem, Israel: According to preclinical data published in the journal Cancers, plant-derived extracts containing both CBD and CBC (cannabichromene) are highly effective at killing head and neck cancer cells in culture.

Israeli researchers assessed the anti-cancer activity of 24 plant-derived cannabinoids in head and neck cell cultures.

They reported that the administration of CBD and CBC at a ratio of two-to-one “maximizes the cytotoxicity of HNSCC [head and neck squamous cell carcinoma] cells.” Authors also identified a similar “entourage effect” when CBD was combined with THC at a two-to-one ratio, but they suggested that the former combination possessed a more beneficial safety profile.

“Our research found CBC to enhance the cytotoxic effect of CBD, establishing additional support for the phenomenon of the entourage effect in phytocannabinoids,” investigators determined. “Considering the adverse psychotomimetic effects of THC, there is a clear advantage for favoring the CBD-CBC combination over CBD-THC for novel treatments for HNSCC.”

They concluded, “This research suggests using whole cannabis extracts, which are decarboxylated CBD-rich, to induce cancer cell death.”

Although cannabinoids possess well-established anti-cancer activity in preclinical models, scientists have largely been reluctant to try and replicate these results in controlled clinical trials.

According to a 2015 literature review, cannabis smoke exposure is not positively associated with the development of cancers of the head or neck. A 2009 study reported that the moderate long-term use of marijuana was associated with a reduced risk of head and neck cancers.

Full text of the study, “The effect of cannabis plant extracts on head and neck squamous cell carcinoma and the quest for cannabis-based personalized therapy,” appears in Cancers. Additional information on cannabinoids and cancer is available from NORML’s publication, Clinical Applications for Cannabis and Cannabinoids.

Autism Case Study Finds Terpene-Enriched CBD To Be More Effective Than CBD Alone

One thing that I often point out to people is that the cannabis plant is one of the most dynamic plants on earth, and that in many ways humans are just beginning to scrape the surface of understanding and harnessing its full potential.

The cannabis plant, and wellness products derived from it, can be used to successfully treat a number of health conditions according to an ever-increasing list of peer-reviewed studies, as well as a growing body of patient testimonials.

Research dedicated to specific cannabinoids is becoming more common, thankfully, with research focused on cannabidiol (CBD) being particularly popular these days. One area of CBD-based research that is showing a lot of promise is CBD treatments for autism patients.

Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain. Tens of millions of people around the world suffer from ASD, including an estimated 1% of all children worldwide.

Cannabis-based treatments are a fairly new thing when it comes to younger ASD patients largely due to prohibition-induced stigma, however, international researchers are exploring CBD and autism more and more thanks to reform victories in various jurisdictions.

A recent example can be found in Italy where a case study was conducted by researchers in Italy and Israel involving a young ASD patient. The patient was first diagnosed in 2008, and after exploring various conventional treatment regimens the patient eventually started to use CBD.

“On August 2018, after contacting a medical cannabis prescribing physician and consulting a specialized laboratory (THC Lab), G was first prescribed a CBD-rich cannabis extract containing 2.5% CBD. This was later exchanged with pure synthetic CBD oil at the same concentration. CBD oil was first administrated at a daily dose of 15 drops (12 mg CBD), corresponding to 0.34 mg CBD/kg bw (body weight) per day. CBD accompanied the Neuleptil treatment. This was found beneficial, completely eliminating aggression and leaving G happy and calm.” researchers stated in an article published by Frontiers in Pharmacology.

“CBD treatment was efficient for 3 years, until G turned 16 years old. From April 2021, with puberty, G became highly agitated. In order to control his symptoms, the dose of pure CBD was raised, reaching 27 drops (21.6 mg CBD), corresponding to 0.48 mg CBD/kg bw per day. However, the increased dose did not result in improved efficacy. Aggression had increased, reaching more than two major aggressive events per week. Aggressive events were severe (scored eight to nine on a 0–10 subjective aggressive scale, by G’s parents).” researchers stated.

“G’s regular CBD oil (pure synthetic CBD at a concentration of 2.5%) was enriched with one of two proprietary terpene blends, composed of terpenes demonstrated in pre-clinical and clinical trials to produce anxiolytic and calming effects. These included alpha pinene, limonene, linalool, beta caryophyllene and nerolidol. One of these two terpene blends was provided for daily use, and the other – for night use, or for times when G was highly agitated.” researchers also stated.

“Since August 2021, G has completed 9 months of treatment with terpene-enriched CBD oil. As can be seen in Table 1 and in Figure 2, aggression was significantly reduced, from two major aggressive events per week during treatment with synthetic CBD oil, to a complete elimination of aggressive events during treatment with the same synthetic CBD oil enriched with the selected terpene blends.” researchers observed.

“This case demonstrates the benefit of terpene-enriched CBD oil for treating aggression associated with ASD in an agitated adolescent. Enrichment of CBD with selected terpenes increased CBD potency, providing a therapeutic response wherein CBD alone had insufficient effect.” researchers concluded.

Israeli Cannabis Study Finds Improvements In Patients With Treatment-Resistant Fibromyalgia

Fibromyalgia is a condition involving widespread musculoskeletal pain. The condition is accompanied by feelings of fatigue, lack of sleep, memory issues, and mood swings. It is estimated that as many as 1 out of every 20 people on earth suffers from fibromyalgia.

Women are much more likely to be diagnosed with fibromyalgia compared to men, with roughly seven times as many women suffering from the condition compared to men. Women between the ages of 20 and 55 are particularly susceptible to being diagnosed with fibromyalgia.

Pharmaceutical prescriptions, including anti-depressants, are common treatments for fibromyalgia, although most if not all of them can yield very undesirable side effects. Fortunately, cannabis provides a safer alternative to many pharmaceutical drugs, and a recent study in Israel found it to be effective. Below is more information about it via a news release from NORML:

Holon, Israel: Cannabis treatment is associated with quality of life improvements in patients with treatment-resistant fibromyalgia (FM), according to the results of a prospective cohort study published in the journal Pain Practice.

Israeli researchers evaluated cannabis’ efficacy in a cohort of 30 patients diagnosed with fibromyalgia. All of the study’s participants had previously failed to respond to conventional pharmaceutical treatments. Investigators assessed patients’ quality of life, general health, and physical health following 30 days of cannabis treatment.

They determined: “Cannabis treatment … showed a marked improvement in general quality-of-life by 1.97 points out of a 5-point score and enhanced general health by 1.83 scores. Cannabis treatment also improved the physical health domain score by 1.5 points. Further examination of the physical health subdomains showed a reduction of 1.67 points in pain and discomfort, pain and fatigue (1.57), and an improvement of 2.13 points in activities of daily living.”

The authors further acknowledged that cannabis use was also associated with improvements in patients’ self-esteem, mood, memory, and concentration.

“This study suggests that cannabis treatment shows short-term improvement in quality of life through its influence on pain, sleep, and physical and psychological domains,” they concluded. “Further studies are still indicated to understand this potential and its long-term beneficial impact.”

Survey data reports that fibromyalgia patients frequently consume cannabis for therapeutic purposes, and several recent observational trials have affirmed its safety and efficacy in this population. A recent review of the relevant literature, published in 2021, concluded, “[T]he use of cannabinoids and cannabis carries limited side effects in the treatment of FM, and they can also improve some common and debilitating symptoms associated with FM, thus making them an adequate potential treatment option, when other treatment lines have been exhausted.”

Full text of the study, “The role of cannabis in treatment-resistant fibromyalgia women,” appears in Pain Practice. Additional information on cannabis and FM is available from NORML.