How Israel became the world leader in medical marijuana

Israel has long been considered a global leader in the research and development of the cannabis industry. The country has become a hub for other countries to conduct research in the medicinal cannabis field due to a history of pioneering studies in the field and less stringent restrictions on initiating clinical trials.  

How did Israel become a hub for medical cannabis research?

Israel's dominance in the medical cannabis sector can be traced back to the early 1960s and the work of Professor Raphael Mechoulam, an Israeli chemist. Mechoulam is credited with "opening the field of cannabis science" after he helped identify "the structure and function of the key compounds of cannabis," The New York Times wrote. 

His "groundbreaking" studies of cannabis began before marijuana and other drugs exploded in popularity around the world, "bringing seismic changes to popular culture while also kicking off decades-long battles about health effects and enforcement," the Times noted. His early discoveries helped earn him the title "the father of cannabis research." His fascination with drugs "was not cultural but scientific," the outlet added, "driven by a fascination with the chemical structures of plants and other natural products." In March 2023, he died at age 92 at his home in Jerusalem. 

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Mechoulam's research is credited with codiscovering the endocannabinoid system, "the largest receptor system in the human body," US News explained. He also found that the human brain makes its own cannabinoids, "compounds that stimulate the body's receptor system." Experts believe these compounds could help alleviate illnesses like "schizophrenia, diabetes, cancer and multiple sclerosis, to name a few," the outlet added, "The revelation of this endogenous cannabinoid system essentially legitimized the study of a substance previously on the margins of scientific research."

That early foothold in cannabis research and development was solidified when Israel became one of the first countries to legalize medical marijuana and one of three countries, alongside Canada and the Netherlands, with a government-sponsored national medical cannabis program. Because of its less stringent policies over cannabis, Israel continues to be a central hub for research and development for other countries as well. 

For instance, cannabis is still classified as an illegal substance by the U.S. federal government, although over half of the country's states have state-sanctioned medical marijuana programs. That status makes initiating clinical trials in the U.S. "difficult to the point of being nearly impossible," Rolling Stone said. Some American companies have begun conducting the first two phases of their clinical trials in Israel and are completing phase 3 in the U.S. to speed up the process of applying for FDA approval, per the magazine.

The reliance on Israel for R&D is relatively new, but the country's impact on America's cannabis industry is not. Without their pioneering research, we "wouldn’t have the scientific interest we have now around the world,” says Paul Armentano, deputy director of the D.C.-based National Organization for the Reform of Marijuana Laws (NORML) told Rolling Stone. 

The Israeli scientific community approaches cannabis research in an "incomparable" way, Charles Pollack, director of the Lambert Center for the Study of Medicinal Cannabis at Thomas Jefferson University, told the magazine. "Israel is a hotbed of quality cannabis research, because they have a much more favorable regulatory climate for doing serious scientific research on medical cannabis."

How have recent regulations attempted to change Israel's medical marijuana industry?

Cannabis legalization is a bipartisan issue for Israeli politicians. Pushes for legalization policies come from both sides, with some of the biggest proponents coming from the right wing. Sharren Haskel, a member of the Israeli Knesset, was one such right wing politician who helped successfully push for the decriminalization of marijuana in 2017. "When you see through your own eyes the impact that only cannabis has on these diseases…within minutes you understand that this is a public health issue, and you have to assist the citizens of your country," Haskel told US News. 

Despite becoming one of the largest exporters of medical marijuana in the world, many of the more than 100,000 medical license holders faced rising costs, "more bureaucracy" and difficulties obtaining their medicinal cannabis, the Jerusalem Post reported. In the face of complaints, Israel's Ministry of Health announced sweeping reforms in August aimed at significantly reducing regulation, improving production supervision, and giving more responsibility to cannabis farmers, 

The regulators also eased restrictions on how patients gain access to medicinal cannabis products. The Ministry of Health additionally approved reforms that would allow physicians to prescribe patients cannabis as a "first-line treatment rather than as an option of last resort," NORML reported. Patients with licenses to consume medicinal cannabis have qualifying illnesses such as cancer, Crohn's, multiple sclerosis, Parkinson's, dementia, epilepsy, autism and post-trauma stress disorder. Previously, doctors had to prove the patient had failed to respond to other conventional treatments, including opioids, before prescribing cannabis products. 

The regulations were reportedly meant to go into effect last December. 

Is the ongoing war affecting the industry?

In the months after the Israel-Hamas conflict began, the Ministry of Health published data showing a "sharp expansion in the reach of the medical marijuana program in that country," Marijuana Moment reported. There was a spike in patient enrollment in the medical cannabis registry, "especially those tied to PTSD and pain," with doctors prescribing "more cannabis by weight than ever before." Enrollments rose by 2,202 people in October, which was "roughly twice the recent monthly average," the outlet noted.  

Medical cannabis enrollments continued to surge the following month, per the Ministry of Health data, rising by 3,254 new patients, "the largest monthly increase since 2021," MJ Biz Daily pointed out. That brought the number of licensed medicinal cannabis patients to an "all-time high" of 135,213, "making it one of the world's largest markets," the outlet added. 

Despite the surge, the new patient might find it challenging to fill their prescriptions, as the regulations meant to ease access face a possible three-month delay due to the ongoing war. While some think the conflict might contribute to the increase in demand, "industry sources say the war is also to blame for the regulatory delay," per MJ Biz Daily.  

Because of the war, "the anticipated implementation of the medical cannabis regulatory reform, originally scheduled for December 29, 2023, has been postponed by three months,” Israeli marijuana producer IM Cannabis Corp. said in a statement.

When the regulation overhaul was announced in August, the company believed "it could change the face of the medical cannabis market in Israel" by easing access for many patients, said Oren Shuster, CEO of IM Cannabis. "We still believe this to be the case," he added. Because the number of new patients enrolling in the medical cannabis program was slowing down, the spike in enrollments in November was "remarkable," he continued. 

"We cannot currently determine if this increase is directly related to the war," Shuster noted. "We anticipate gaining more insights in the coming months."