A cancer patient who takes medical cannabis is petitioning the courts over a drastic cut to his prescribed dosage, part of a new reform from the Health Ministry that has angered patients and advocates and forced hundreds of medical cannabis users to cut their usage.
Yehudah Haber, 58, submitted a petition to the Jerusalem District Administrative Court court on Thursday over his medical cannabis prescription, which was slashed from 200 grams to 90 grams per month earlier this year, against the advice of four of his doctors.
Haber was diagnosed with Stage II oligodendrogliomas, a type of brain tumor, when he was 39, one of three cancerous growths he has dealt with since his army service. Haber was a Shayetet 13 naval commando who trained in the polluted water of the Kishon River, and, like many other members of his unit, was diagnosed with cancer linked to his service.
“In the US, they say, ‘Join the Navy and see the world,’ but here, it’s ‘Join the Navy and see the hospital,’” Haber said.
Originally Haber’s doctors gave him a diagnosis of less than a year to live. That was 19 years ago.
But after beating the odds, three years ago his brain tumor became anaplastic, a much more malignant cancer stage that also caused epileptic episodes. Taking approximately 200 grams of medical cannabis per month, in both flower and oil form, stopped the epileptic seizures and halted the growth of the anaplastic brain tumor, said Haber.
The Health Ministry first notified Haber that it was cutting his dosage in June, without consulting his doctors, who strongly opposed the move. For the past three months, Haber has only been able to obtain 90 grams per month. He said the epileptic seizures have returned and the tumor has started growing again. In November, the tumor was classified as Stage III-IV, and Haber was given about a year to live.
Attorney Miriam Brainin is representing Haber. Last month, Brainin won two similar cases, one in which an 82-year-old woman with terminal breast cancer saw her cannabis prescription reduced from 250 grams to 90 grams per month, and another where a cancer survivor’s cannabis prescription was lowered from 140 grams to 90 grams per month.
In both cases, the Jerusalem District Court ordered the Health Ministry’s Medical Cannabis Unit to give the patients the original amount prescribed by their doctors. Brainin says she believes Haber will have the same result, though the hearing could take up to a month.
Haber is one of hundreds of people in a similar situation whose cannabis prescriptions have been reduced, said Dana Bar-On, the CEO of the Medical Cannabis Association. Bar-On herself has had her prescription slashed twice. In 2015, Bar-On, who takes medical cannabis to deal with symptoms of a neuromuscular disease, had her prescription cut from 180 grams per month to 50 grams. Within four months, she had lost 20 kilograms and was forced to start using a wheelchair and oxygen, said Bar-On.
A spokesperson for the Health Ministry said the reductions are due to an increase in the demand for medical cannabis — to ensure that there is enough for all of the patients who require it. The Medical Cannabis Unit received 57,781 requests for new cannabis licenses or changes in 2018, compared with 14,910 requests in 2013, an increase of 387 percent.
“In order to protect the public and patients, the Ministry approves the use of cannabis in dosages and indications [using the correct drug to treat a certain disease] when enough information has accumulated to reasonably conclude that it is helpful and safe,” the spokesperson said. The Ministry refused to comment on reductions in dosage or the process for changing an existing patient’s dosage in the middle of treatment without consulting doctors.
But Bar-On called the Ministry’s reasoning “ridiculous and offensive,” noting that if the Health Ministry was so concerned with the amount of cannabis for Israeli patients, the government should not have approved the export of medical cannabis.
After more than a year of delay, the Knesset approved the export of medical cannabis on December 25, just before dissolving ahead of elections, which will take place on April 9. According to the law, police will be responsible for enforcing export regulations, one of the requests of Public Security Minister Gilad Erdan, who has previously opposed the idea of Israel exporting medical marijuana.
A number of logistics regarding marijuana exports still need to be hammered out with cabinet approval, so it could be a year or two before the first medical cannabis is exported from Ben Gurion Airport. Bar-On noted that multiple times during the hearings about medical marijuana exports, the Medical Cannabis Unit testified that there was sufficient cannabis in Israel for all Israeli patients who required it.
The reduction is part of the Health Ministry’s cannabis reform, which, among other things, will require patients to start paying for medical marijuana based on the size of their dosage, said Bar-On. A patient using 200 grams per month could be required to pay as much as NIS 2,300 ($620) monthly, she said.
Currently, all patients with a license for medical marijuana pay a flat monthly fee of NIS 370, regardless of how much marijuana they obtain through their prescription. The Health Ministry spokesperson declined to comment on future increases in the cost of the medication.
“The state knows that as the prescriptions are higher, they might have to subsidize more [of the cannabis],” said Bar-On. “By reducing the prescription amounts from the get-go, they won’t have to pay as much to subsidize.”
There are about 38,000 patients who have medical marijuana prescriptions in Israel, up from 10,000 in 2012. Currently, cannabis is approved to treat cancer, chronic neuropathic pain, post-traumatic stress disorder, colitis, Parkinson’s, epilepsy, HIV/AIDS, Crohn’s disease, multiple sclerosis, Tourette’s syndrome, and terminal illness. Soon, cannabis is expected to be approved for autism and fibromyalgia.
“If they said the same thing for chemotherapy, that suddenly they’re going to start reducing the chemotherapy for all cancer patients, would it sound logical?” asked Bar-On. “Or what if they said the same thing about insulin for diabetics, that they are cutting in half the amount of insulin diabetics are getting. There would be an immediate investigation.
“This is no different. We’re talking about the sickest people in the country, for whom conventional medicine doesn’t work.”