Haaretz: Can Israel Lead the World in Weed?

Summary: Haaretz interviews marijuana researcher Dr. Alan Shackelford about the history of medical marijuana research in Israel. Shackelford contrasts the differences between marijuana research in Israel and the United States, highlighting how the field of marijuana science is increasingly gaining momentum in Israel due to reduced restrictions from government entities. "Israel is not against researching cannabis, where the United States, in many regards, is against it," explains Dr. Shackelford. "It’s very, very difficult to get permission to study it because it’s in this category of compounds, substances, that have been deemed to have no medical benefit."

Originally appearing here.

America is slowly coming around to the idea that marijuana isn’t only a recreational drug and that it has legitimated medical uses. Washington and Colorado have legalized the recreational use of marijuana and 23 more others allow it for medical purposes. Around half of the U.S. population now has access to medical cannabis.

Marijuana is medicine but it’s also businesses. Shares of companies such as GrowLife, Nuvilex and Medbox, which are tied in one way or another to the cultivation or study of marijuana, soared in the weeks after Colorado and Washington put their new marijuana laws into effect. But it’s a business that will take time to cultivate. While Nuvilex shares have continued higher over the past year, GrowLife and Medbox have pulled back. It could be a long time before anyone gets rich from buying stock in cannabis.

At least one Israeli company is in the medical marijuana business, One World Cannabis, which merged with the U.S. company Dynamic Applications and now trades on the Nasdaq exchange as OWC Pharmaceutical Research. The company recently raised $2 million for research from private investors in Israel, Singapore and the United States.

‘Dr. Cannabis’

The head of OWC’s scientific team is Dr. Alan Shackelford, an American physician who is a leading expert in the area of medical marijuana. Known as “Dr. Cannabis,” he has helped improve the once-tawdry image of weed among doctors and the public alike.

“There’s definitely a medical benefit, and it’s not highly addictive, and the abuse potential is there. But the abuse potential is there for legal pharmaceuticals, like narcotic pain medicines. And the abuse of narcotics can be dangerous, because people die from overdoses of narcotics. No one has ever died of a cannabis overdose,” Shackelford said in an interview with TheMarker.

What brings an American physician with a world-class reputation to join an Israeli company? Do Israelis have any expertise in cannabis cultivation and research?

“Israel has a long history of studying cannabis, and it goes back to the 1960s, where Raphael Mechoulam, a young chemist, was interested in studying something that hadn’t been studied very much, recently anyway. He wanted to find what components in the plant were effective as medicines or had activity that could be utilized. Others were looking at other plants, and he decided to look at cannabis, because no one had looked at it. He thought he would finish studying cannabis within a couple of years. And that was in the early 1960s — and people are still looking. So Israel has a history that’s more than 50 years of investigation of cannabis. That’s very important because no other country — then certainly, but even in the past few years — has been open enough in its policies to allow for the scientific study of cannabis.”

Is research on medical cannabis in Israel more comprehensive than in the United States? And what about more liberal countries like the Netherlands?

“We have to distinguish uses of cannabis and what kind of studies [are done]. I’ll give you an example of the United States. There was a professor at the University of Massachusetts in Amherst, where the main center of the University of Massachusetts is. His name is Lyle Craker. In 2001, 14 years ago, he applied for a permit from the Drug Enforcement Agency, as a professor of botany, of plant science, to study cannabis, to investigate it as a scientist, and they said ‘No, it’s a controlled substance, it has no medical benefit, you can’t study it.’ He has applied every year since then, and has never been allowed to study it.”

Where does such strong opposition come from?

“The law in the United States says that cannabis is in a category of drugs which have no medical benefit, and they’re addictive, and with high abuse potential. Heroin is there.

Why, in your opinion, is there such great fear of the plant?

“Because there was a concerted, intentional program, started in the 1930s in the United States, to convince people that it was dangerous and needed to be banned. And so they invented propaganda to make their point, to convince people that it has no benefit, was dangerous, created mental illness and caused people to do dangerous things.

“I think it’s very important to differentiate between that campaign of disinformation, lies, propaganda and attempts to convince people that it is dangerous, from the true medical, industrial uses. Cannabis was introduced to Western medicine in the late 1830s in England. It was introduced to Britain by a doctor called William Brooke O’Shaughnessy. He was a physician with the British East India Company, and he saw how the Indian doctors were using cannabis to treat lots of different illnesses — especially muscle spasms and tetanus, which is a disease that causes extreme muscle cramping — and they used it very successfully. He wrote an article about it that was published in an English medical journal, and people were very excited. So they began to use it as an extract in Britain and then throughout the world in the mid-1800s.

The AMA opposed the ban on cannabis

“By the mid-1930s, in the United States … as many as a third of all the prescriptions that doctors wrote and the pharmacists put together had cannabis as a component. So it was widely used, very successfully and very safely. One of the medical textbooks for the period, in the 1920s, had 56 different symptoms and conditions that cannabis was recommended for, everything from muscle cramping to pain to nausea to seizures to anorexia — 56 different conditions. And the American Medical Association was strongly opposed to banning cannabis because it was so useful and so beneficial to patients. So medical usage of cannabis isn’t anything new. It’s just new to us.”

Are you trying to bring back the use of cannabis and the rationale for its use so that physicians will prescribe it for treating disease?

“What’s important is that we should use, in medicine, whatever compound or substance that’s most effective for the patients we are trying to treat. Most effective and safest. Medical science has made tremendous progress in 80 years; it’s almost unrecognizable between the 1930s and today. Cannabis is still stuck in the 1930s. We don’t use many plant medicines now in modern medicine. Many different things we do use come from plants, like digoxin comes from foxglove; certain chemotherapies — Vincristine, Vinblastine — come from vinca plants; there are a lot of different medicines that are plant-based but we don’t use full plant extracts very much.

“The problem with cannabis is two things: We don’t know what the 70 or so compounds that are unique to cannabis actually do. We think we have an idea of some of them: CBD [cannabidiol], for example, and THC [tetrahydrocannabinol], which are two of those 70, are anti-inflammatory, antioxidant, reduce spasming, tend to normalize the nervous system or act on the endocrine system — we now understand something about that — which is a regulatory system in all animals, from humans to hydras. And the cannabinoids, these compounds in the plant, work with the endocannabin
oid system, though we don’t know understand exactly how yet. So cannabis, as a whole plant, is very, very useful. We need to understand it better, understand whether or not some of the compounds by themselves are beneficial or if they all need to work together to be beneficial. It’s not well-understood.

“That’s why Israel is important, because Israel is not against researching cannabis, where the United States, in many regards, is against it. It’s very, very difficult to get permission to study it because it’s in this category of compounds, substances, that have been deemed to have no medical benefit. That’s not true, but someone decided it, and then they put it in the law, and because it’s in the law, even though it’s not true, it’s very difficult to study.”

Do you think that is going to change?

“[The laws] are changing already, rapidly, because in the United States, people themselves, patients, are recognizing that it could be beneficial for them. And a lot of that is being driven by people’s experiences and what they say to each other. It’s an interesting time in history, when you can write an email, or put something on Facebook, and hundreds of millions of people see it. Twenty years ago, it was more difficult to do that, and 30 years ago, it was not in any way similar. So the Internet and Twitter and these things have made instant, worldwide communication possible. So someone like my patient Charlotte, who had 300 seizures a week, suddenly no longer has seizures because we used cannabis extract that has very little THC, so it’s non-psychoactive, and a lot of CBD. The CBD is not psychoactive, and there’s so little THC, she doesn’t get high from this, but it controls her seizures. When we do that, it spreads around the world very quickly, and there’s a huge amount of interest.”

What are other potential applications for cannabis?

“There are many conditions that we don’t have good treatments for — seizures is one, other degenerative neurology diseases like amyotrophic lateral sclerosis — Lou Gehrig’s disease — we don’t have a good treatment for it. And there’s a lot of evidence, just from people using it, that cannabis can slow the progression of multiple sclerosis, possibly ALS, prevent seizures when nothing else works, works extremely well for pain even when narcotics do not. I think there is enough evidence now for basic science research and a lot of anecdotal evidence that it can help in dementia, maybe preventing Alzheimer’s — there’s some research on that — or slowing its progression.”

You become interested in medical marijuana while practicing in Colorado. How did that happen?

“I started very reluctantly — I didn’t think marijuana could be beneficial. When my patients came to me in 2009, I was practicing occupational medicine — workplace injuries, mostly — and most of my patients had pain, and they weren’t doing well with narcotics and nonsteroidal medicines. It was beginning to be talked about, after [Presdent Barack] Obama said that they were not going to prosecute people who were using it for medical purposes. So they said, ‘I’d like to try it because the pills aren’t working.’ And I said, ‘I don’t know, I don’t know how to dose this, I don’t know if it works, I don’t know what to say here,’ so I reluctantly approved a few and they were doing okay, but I still didn’t feel comfortable, because, as a physician, it’s very hard for me to go tell someone to smoke something. That doesn’t make sense. That’s not medical.

Safe and effective

“So I stopped approving and I started to read the medical science, the literature, and I found — though it’s difficult to study — that there still are lots of studies, more than 20,000 at that time, on cannabis as a treatment. Not only was there a lot of current research, but I have discovered that it had been used successfully for 5,000 years as part of general folk medicine, but [also] in Western medicine for a hundred years. I knew it had been used, sort of, but not to the extent that it really was. Then I began to approve it for more conditions and more patients, found that it was really beneficial in so many different things — it really surprised me — from pain to nausea.

“In that five and a half years, I have seen thousands of patients and I’ve seen it work with tremendous safety. Many of my patients are able to stop taking narcotics, go back to work, provide for their families.”

In Israel, about 16,000 patients use medical marijuana, and there are only about 20 physicians who can prescribe it. Is there a correct model for the distribution and sale of medical cannabis?

“Colorado allows any doctor with a medical license to recommend [cannabis]. And that’s okay, but I think [its success] depends on the medical system in the various countries. So in Israel, I think this is something that needs to be worked out with the Ministry of Health, and the physician’s organizations, and their kupot holim [health maintenance organizations]. So there’s a kind of system-specific regulation that needs to be put in place. No matter what the system is, each doctor has to practice medicine properly. So, as happened so much in Colorado, people would come and say, ‘Oh, yeah, my back hurts so much, I need medical marijuana,’ and the doctor would say, ‘Oh, okay, here.’ No examination, no medical records, no medical practice at all. It was a way for people to get [high] — not that I think marijuana is dangerous when used recreationally. It’s not. It’s safer than alcohol, for sure.

“People can do that [sell cannabis they get through physicians]. That’s the same as taking narcotic medicines, or any other prescription medicines, and selling it to somebody else. But that’s something that has to be regulated within Israel.”

Businesswise, this is a new market. What is the growth potential of medical marijuana and a company like OWC?

“As with any new market, [its success] remains to be seen. If we just look at medical cannabis — and there are many other uses, industrial and medical — I think it’s important to look at what the company is doing, not just that they’re dealing with, or interested in, cannabis. There has to be, as with every other market, some sort of innovation, some sort of production, some good. Aside from just idea factories, a business has to based on investigation and doing something. I don’t know about other companies, but I do know that OWC is engaging in research to identify the cannabis profiles that are effective for specific medical conditions, and this is the big difference, I think, in current conditions and what will come soon. Currently, there is no real scientifically supported dosing of cannabis. It’s completely random even though it works; it’s very successful in treating pain and muscle spasms.

“Most of the time, at least in Colorado and most other places I’m familiar with, people smoke it, which is a problem medically. There’s no proof of that scientifically, but it’s still smoke and it’s still irritating and people cough — it’s not a good way to administer a medicine. So people either smoke it or they take drops, which in Israel is much more consistent, usually. There are some companies here that are making consistent products — we hope there’s consistency, anyway.

“But in Colorado, brownies, baklava, candy, drinks — all of it supposedly with the same dose, but most of the time it’s not — it’s very inconsistent. Medical cannabis, in the dosing form, has to be scientifically-based and that’s what OWC is doing. Research on specific conditions, defining what cannabinoid profile is and creating consistent, pharmaceutical-grade, reproducible dosing forms. So there’s a real product here — it isn’t hype. It isn’t wishful thinking. It isn’t like some of those things that are suddenly popular, ‘vaporware.’

“Cannabis itself is not a reason to invest in something. Th
e company has to be actually doing something meaningful, and ultimately producing something meaningful.”