Dr Bareket Schiff Keren - Drogenberatung Bielefeld eV

Dr Bareket Schiff Keren - Drogenberatung Bielefeld eV

MEDICAL
CANNABIS IN
ISRAEL
Dr Bareket Schiff Keren
Some history
GLOBAL
AND
LOCAL
Gan-zi-gun-nu – the drug that takes away the mind
Azallu
– hand of ghost, poison of all limbs
(neurological diseases?)
Qunnabu
– used in religious rites
For the relief of certain kinds of pain,
I believe, there is no more useful
medicine than Cannabis within our
reach.
J. Russell Reynolds, Archives of Medicine 2, 154 (1859)
1915 – Sir William Osler –
CANABIS INDICA –the best remedy for
migraine
1930 – Federal Bureau of Narcotics
Political campaign – Harry Anslinger
Associated with immoral behaviour and
psychosis
(fibers industry, cotton industry , paper
industry )
1937 Marihuanna Tax Act
1938 a medical review – Cannabis for
Migraine
1941 cannabis taken off the US
pharmacopiea
1970 – Dr Roger O Egeberg
Assistant Secretary of Health:
Marijuana classified as Schedule 1
substance
Controlled substance act of 1970
DEA – Drug Enforcement
Agency
N0
accepted
medical
Marinol
(Drunabinol)
anduse
Nabilone =
synthetic THC
1968- GLAUCOMA
1990 – MIGRAINE
2013 –Dr Sanjay Gupta CNN Chief Medical
Correspondant
23 states – legal medical cannabis
Patients experience with
Cannabis:
Pain disappears – wears off
Pain persists – but can be put aside
Periodic pain – less frequent short
attacks
Sleep – uninterrupted & refreshing
Appetite
CH3
CH 3
OH
OH
HO
C5H11
cannabidiol (CBD)
Mechoulam and Shvo:
Tetrahedron 19,2073 (1963)
O
Δ9-tetrahydrocannabinol (Δ9-THC)
Gaoni and Mechoulam:
J.Amer.Chem.Soc. 86, 1646 (1964)
CH3
OH
O
Δ9-tetrahydrocannabinol
(Δ9-THC)
O
OH
C
O
C
O
N
H
anandamide
© LOH 2004
OH
OH
2-arachidonoyl glycerol
(2-AG)
Science (STKE, 23 April, 2002)
THE HISTORY OF CANNABIS IN
USE OF JASHISH WAS COMMON
ISRAEL
BRITISH MANDATORY LAW
EARLY 90’S – COMPASSIONATE TREATMENT
LICENSE FOR GROWING HOLDING AND CONSUMING
COMPASSIONATE DISPENSARIES
GROWING AND DISTRIBUTING PERMITS
GOVERNMENTAL INVOLVEMENT
Form no 106
Computerized system
Supervision over Good Agricultural Practice
Packing and Distribution Cannabis Products
MINISTERY OF HEALTH
MEDICAL CANNABIS UNIT
INDICATION COMITTEE
SPECIALISTS IN EACH INDICATION
INTEROFFICES COMITTEE
POLICE
MINISTERY OF AGRICULTURE
MINISTERY OF INTERNAL SECURITY
is Cannabis medicine ?
The approved indications
Cancer in active treatment
Neuropatic pain
Crohns & ulcerative colitis
Parkinsons & tourets
Multiple sclerosis
Post trauma
Cancer and cannabis
Nausea & vomiting
Pain
Cachexia
Anxiety and depression
Sleep
Neuropathic Pain
Pain from nerve dammage
Nerve compression
Central pain
Pain clinic without cannabis
Unapproved indication
Glaucoma
HIV
Tinnitus
Asthma
Epilepsy
Fibromyalgia
Rheumatic disease
Other indications
Diabetes
Anorexia nervosa
Disseminated osteoporosis
Menopausal syndrome
Endometriosis
Opioid dependance
Sleep disturbance
All autoimmune diseases
Contraindications
Mental condition
Drug abuse
LICENSE PROCEDURES
AN OFFICIAL FORM
FILLED ONLINE
SENT BY FAX
RECIEVED AND TRANSFORMED
SENT FOR AN APROVAL BY SPECIAL
DOCTORS
A REPLY AFTER 45 WORKING DAYS
Follow up
RE-EVALUTION
RENEW APPLICATION
Change supplier
Raise in the approved amoumt
Continueing the license
Regulators dillema
The source of medical cannabis
Quallity of the strains and which strains
Suppliers and distributers
The funding – the way patients pay
The situation now:
Monopoly
No control on the delivered substance
No education policy
No standardised instructions to the patients
Rigid regulations as for the amount and the preparation
-
MY VISION
RESEARCH -
1 CENTRAL DATA COLLECTION
BETTER OBSERVATIONS AND REPORTS IN THE PRIMARY CARE LEVEL
EDUCATION
1 BASED ON THE KNOWLEDGE AVAILABLE
2 REEVALUATING AND KEEPING TO CONTEMPORARY NEW
INFORMATION
APPLICATION
FLEXIBLE RESPONSE BY THE MEDICAL ESTABLISHMENT
Thank you
‫ﺷﻜﺮﺃأ‬
‫תודה‬
dank
e