Mar. 19, 2009
David Brinn , THE JERUSALEM POST
On Tel Aviv’s King George Street, nestled between the discount clothing outlets, designer glasses franchises and old-fashioned bubka cake and burekas joints, sits a sliver of a store called The Body Shoppe. There you can buy just about anything related to cannabis smoking aside from marijuana itself.
One wall displays water pipes of every size, color and shape – there’s no chance of confusing these smoking instruments with the Arab hookahs for tobacco so popular with Israeli youths. These are the kind of pipes that Eric Forman and his buddies used on That 70s Show. Turn to the other wall, there’s a display case with a myriad of wooden and ivory one-hit pipes, so called because there’s only room in the bowl for enough grass for one toke on the pipe. Then, there’s the wide selection of pipe screens and canvas and leather pouches, which are especially designed for stashes.
“No, this is all for tobacco,” said the dowdy, middle-aged woman who runs the store. She’s sitting on a chair on the sidewalk, and seems annoyed to be answering questions. And, as if anticipating the next one, she added without prompting, “and, of course, we don’t sell to minors.”
Whether those unlikely claims are true is beside the point. Marijuana, like the small-town hooker who has gained a semblance of begrudged respectability through simple longevity, is evidently here to stay. That illicit drug of choice which emerged in the rebellious counterculture explosion of the 1960s was no passing fad. According to recent studies conducted at the University of Washington, the use of marijuana has retained its popularity with subsequent generations, dropping slightly from a peak in the late 1970s.
ISRAEL MAY have lagged behind the West in introducing cannabis culture, but it’s made up for it in recent years. According to the latest statistics compiled by the government’s Anti-Drug Authority in 2005, at least one in 10 of you reading this have tried marijuana at least once. When you break it down, it’s 11.6 percent of adults 35-49, and 19.3% of adults 21-34.
Don’t blush. That puts you in some pretty good company, like Barack Obama, George W. Bush and Bill Clinton (who didn’t inhale).
Of course, there’s certainly a wide gap between experimenting with pot a few times in one’s youth and continuing to smoke regularly as an adult. But the people who smoke cannabis today aren’t only social deviants, derelicts and jazz musicians.
They cut across various walks of life and social strata. Of course, you may not know it from watching the goofy, outlandish ad campaigns in the recent Knesset elections of the Aleh Yarok (Green Leaf) party showing party head Gil Kopatch smoking pot on the grave of David Ben-Gurion. And forget about trying to understand the party’s even more bizarre offshoot, the Marijuana-Holocaust Survivors party, which was built on an unlikely mutual admiration society between survivors and young, idealistic smokers.
It’s good for a laugh, but for some, it’s a nervous chuckle. Aleh Yarok claims that it’s more like a million Israelis who have tried pot, including 14.3% of high-school seniors. Like its legal counterparts, alcohol and tobacco, the health detriments of pot have been well documented. And as the dismal showing of both parties in the elections attests, the last thing most Israelis want is another legal, semi-addictive substance that will make the nation’s roads even more dangerous than they already are.
However, at the same time, a slow revolution is taking place in the country. Both the legal system and law enforcement agencies are de-facto putting personal marijuana use on the back burner. And perhaps even more significantly, very quietly over the last 10 years or so, the Health Ministry has been cultivating one of the world’s most successful medical marijuana programs which has helped relieve the symptoms of hundreds of people suffering from chronic and acute illnesses.
There’s generally an “elephant in the room” syndrome in society surrounding the marijuana phenomenon. Everyone knows it’s there, but nobody really talks about it. Cannabis only comes out of the closet when a high-profile celebrity like Olympic swimming record-breaker Michael Phelps is “outed.” The reactions in the media and at the water cooler toward last month’s tabloid photograph of the 23-year-old gold medalist with his mouth wrapped deeply around a bong pipe ranged from outrage at Phelps’s “shameful” behavior to “how could he be so dumb as to be photographed” rolling of the eyes to thoughtful treatises on exactly what are the obligations in society of role models.
A look at how the companies who hired Phelps to lucratively endorse their products reacted offered a prescient gauge of the mood toward marijuana today. Cereal giant Kellogg halted his sponsorship, saying his behavior was “not consistent with the image of Kellogg,” and another sponsor, Subway, criticized his behavior but didn’t end their business relationship. In Switzerland, where views about marijuana are less stringent than the public US view, watchmaker Omega didn’t attempt any moral outrage, deeming Phelps’s indiscretion as “a nonissue.”
Attitudes here fall somewhere in between. Everyone across the board agrees that marijuana should be kept away from youth. And even the most avid Aleh Yarok advocates for marijuana legalization admit that it’s only a pipe dream that will never be realized. But in reality, there’s already a certain social acceptance in play. If you’re not a minor, a dealer or flagrantly blowing smoke into a policeman’s face, it’s unlikely that you’re going to be bothered for smoking pot.
Learning about the state of marijuana in Israel 2009 doesn’t necessarily require making a connection on a seedy street corner with a shady underworld figure, although that’s an option. It can also mean visiting suburban backyards in Modi’in, Health Ministry offices in Bat Yam and laboratories in Jerusalem to meet a batch of rather unstereotypical people.
DANNY A. certainly isn’t blowing pot smoke in cops’ faces. Despite smoking since he was about to graduate from high school in 1967, the 58-year-old resident of the center of the country has kept his vice on a low profile. He says he smokes to relax after a long day of pressurized work as an executive in the food service industry.
“It was the beginning of a love affair. I’ve never stopped since then for long periods of time,” says the married father of three. “I would say on the average I smoke three or four times a week, both by myself and in social situations. But I use less quantity now than I did in the old days.”
Danny explains that while he can function normally after smoking, he never indulges while he’s working, preferring instead to treat it as a leisure-time activity.
“For me, it’s more like the cocktail at the end of the day. I also do it before I work out sometimes. I’m a long-distance swimmer and runner, and I find that it keeps me from getting bored,” he says.
However, there’s a price to pay. Possession of up to 15 grams of marijuana is subject to prosecution, a hefty fine and up to three years in prison. And there’s also another price to pay. According to Danny, until about five years ago, it was very easy to purchase pot which was smuggled in from Sinai – saying that a kilo would cost $300-$400 but that the quality wasn’t very good.
“The cannabis you can get now is usually home grown by someone or grown with hydroponics [a method of growing plants using mineral nutrient solutions, without soil], which usually makes it much better but more expensive. On the average, it costs between NIS 60 and NIS 120 a gram. That’s a lot of money,” he says.
Danny deliberately shies away from the stronger, more expensi
ve strains of pot with a high count of THC (tetrahydrocannabinol), the active ingredient in cannabis. “You can’t use heavy stuff for everyday use, like the kind of stuff you can buy in Amsterdam. If I did that, my brain would be mush by now.”
One problem that Danny has encountered through the years is where to find a supply of the drug. He says that he doesn’t use a regular supplier, and generally tries to have a variety of options available, including growing his own.
“I usually find it through word of mouth, and I’m very careful about who I talk to. For a while, there was this one guy I went back to several times. It was kind of low quality but I trusted him. I never asked any questions about where they got it from, I don’t want to know,” says Danny. “There have been brief periods when it’s been dry, but usually I can find some. I schlepp around and try to find it.”
Due to its legal status and the public stigma that he would encounter, Danny’s very careful about which people in his life know about his habit.
“I have some friends who smoke and/or know that I smoke. But there are lots of people who have entered my life at certain stages that I just wouldn’t think of bringing it up, just because of the connotation. Funnily enough, it’s mostly younger people – you can’t trust anyone under 30,” he laughs.
That includes his children, who range from post-army to teen.
“If they’re aware that I smoke, they’ve never mentioned it. I think my daughter probably has tried it. It wouldn’t bother me too much if the ones over 18 try it.
“It’s never bothered me that it wasn’t legal, and I’ve never felt paranoid that I was going to get caught. I was, and am, still pretty smart about when and where to do it, and to not be foolish and overdo it. I’m a mature smoker, you could say, just keeping everything within limits and within reason.”
There are undoubtedly thousands of other Israelis besides Danny who smoke marijuana on a recreational basis – preferring its effects to those of alcohol – and suffering no long-lasting effects, but many others have had their lives ruined by the drug.
“We see people who abuse marijuana develop unmotivational syndrome,” says Dr. Yehuda Baruch, the head of Abarbanel Psychiatric Hospital in Bat Yam and the director of the Health Ministry’s medical marijuana program. “Basically, these people have no motivation to do anything in life besides smoke marijuana.”
WHILE THAT effect can be debilitating but benign, there’s a more serious result of smoking pot, says Prof. Raphael Mechoulam of the Hadassah-University Medical Center School of Pharmacology.
“We know that heavy use of cannabis does have a medical effect – one quite well established. It can induce schizophrenia. Whether it’s in people that are already prone to it or not, it’s difficult to say,” says Mechoulam who cites a study conducted in Sweden where 40,000 army inductees were followed for years.
“It turned out that those that used cannabis in large amounts developed twice as many cases of schizophrenia as those that didn’t. But you could say they were self-medicating since they were already feeling that something wasn’t right with them,” he says.
“Heavy use definitely causes some kind of addiction, not as much as opiates or tobacco, and certainly not as strong as alcohol addiction. And there are withdrawal symptoms. There are bad trips, people who get into some kind of anxiety.”
However, a visit to Mechoulam’s laboratory on the campus of the Hadassah-University Medical Center in Jerusalem would leave a marijuana smoker with his mouth hanging open. Using well-broken-in equipment, a team of white-coated young graduate students are working with Bunsen burners and beakers full of liquids, conjuring up unpleasant experiences from high-school chemistry classes. But the substances the team is working on is cannabis – both in marijuana and hashish form.
Mechoulam isn’t trying to develop an artificial super-high strain of pot – instead, he’s the only scientist in the country who’s synthesizing THC into a liquid to help alleviate the symptoms of cancer patients.
Mechoulam, 78, is kind of an international superstar in marijuana research and its ability to help specific ailments and diseases. In 1964, the soft-spoken scholar was the first researcher in world to isolate THC, and in 1993, he headed an Israeli-Scottish team that succeeded in identifying, isolating and synthesizing a previously unknown substance in the brain that functions much as THC itself. The researchers named it anandamide, from the Sanskrit word ananda, meaning inner joy.
For years, Mechoulam has been researching the health benefits that can be derived from cannabis with a steady supply of marijuana and hashish from the Israel Police.
“I get the OK from the Health Ministry, and with that license I go to the police, and they supply me with kilos of hashish and marijuana which they’ve confiscated. That isn’t a problem,” says the dapper Mechoulam sitting in his office.
In his lab, Mechoulam and his assistants isolate completely pure THC and dissolve it in olive oil. The solution is then dropped under the tongues of cancer patients in the Hadassah oncology ward run by Prof. Reuven Orr. According to Mechoulam, most of the dozen patients receiving the drops are involved at some stage of bone marrow transplants.
“Marrow transplants are nasty things. A person really has to be very sick to qualify for one, no appetite, a lot of pain and a terrible mood. When the patient gets the THC, it enhances the appetite; he starts eating, and starts feeling better,” says Mechoulam, adding that the results have been outstanding. “We can’t keep up with the demand.”
While Mechoulam runs his program independently with the approval of the Health Ministry, he’s left an all-encompassing footprint on the official medical marijuana program run by his colleague Dr. Yehuda Baruch. It was Mechoulam who, 15 years ago as a member of a Knesset committee on marijuana, recommended the development a program to provide suitable patients with marijuana.
WITH THE nonchalance of one who’s been doing it for seven years, Baruch opens up a drawer in his office desk at Abarbanel and pulls out one plastic bag filled with marijuana buds and another containing a dozen neatly rolled marijuana cigarettes.
Director-general of Abarbanel for the last four years, Baruch took over the ministry’s medical marijuana program in 2002 while it was still in its infancy. Even though a committee exists to ostensibly oversee the program, in essence, it’s Baruch alone who decides which of the 60 plus applicants each month receive the license that enables them to receive free marijuana for their medical problems.
“The committee will convene on occasion to discuss whether to allow cannabis use for a new diagnosis, but it doesn’t meet on a regular basis,” says the 51-year-old Baruch, who explains that there are five broad categories that are officially recognized as being helped by marijuana.
“One is cancer or patients with malignant tumors who are in one of two stages – either during chemo to ease nausea and promote appetite, or those with a final-stage tumor, terminal patients who have a prognosis for living for another six months,” he explains.
Other categories are HIV patients, who attend one of the country’s eight HIV centers, chronic pain patients who are being treated at pain clinics or by a known pain physician, patients with Crohn’s disease or ulcerative colitis, who are being treated by gastroenterologists, and multiple sclerosis patients specifically for the spasticity symptoms upon recommendation from an MS center or a neurological specialist.
While not yet an accepted condition, patients with post traumatic stress disorder are being tested with the drug on an experimental basis, Baruch adds.
“We try to work directly with the doctors, and ideally the patient has nothing to do with us. But usually it’s not that way. Often the patient contacts us, he obtains the permission slip fr
om the doctor and he sends it to us,” says Baruch, adding that for some doctors, there’s a stigma in recommending marijuana for their patients.
“A lot of doctors have trepidation – they think they’re being an accessory to illegal drug abuse or something. But it’s really none of their business. We still give Ritalin with prescriptions and we know there is a lot of abuse with it – and we know there’s a black market for it. We know there’s abuse of OTC drugs, but that’s a problem of society. We aren’t the gatekeepers.”
There are currently 372 patients authorized to use marijuana, but the number is rising all the time. The licenses need to be renewed at various intervals ranging from monthly to annually depending on the condition. According to Baruch, once a patient receives approval, he’s given the option to either grow the plants himself or be supplied free of charge by one of the ministry’s five authorized pot growers.
“If they grow their own, it takes about three months until they are able to harvest the crop. One of our suppliers sends someone to provide the seeds and teach them how to take care of the plants. If they’re chronic pain patients or Crohn’s patients, there’s no urgency for them to get the marijuana, since it’s a chronic condition and they’ve had it for years,” he says.
“The other option is for them to get the drug from one of our suppliers. We have five suppliers, one who supplies about 90% of our marijuana and another four who make up the rest. They supply the drug straight to the patient, usually in the form of already rolled cigarettes, as a bag of unrolled marijuana or in cookie form,” says Baruch, pointing to the bags he removed from his drawer.
According to Baruch, the growers work on a philanthropic basis, because the ministry doesn’t have the budget to pay them and because it would be prohibitively expensive for a patient to pay for the drug.
“The problem is for high-grade quality marijuana – and medical cannabis is high grade – it would cost something about near $5 per gram. The average amount a patient uses is 100 grams per month. Which means it would be something like $500 a month, a lot of money for someone to pay each month, especially for a chronic condition,” he says.
While that same lack of funding has prevented extensive research into the benefits the marijuana provides the patients, Baruch says the proof is in the pudding.
“The patients themselves perceive it as being very efficient and beneficial. But that’s just based on talking to them, not specific research. As a doctor, if a patient tells you something helped him very much, I will take it at face value. But as a scientist, I would want more information,” he says.
WHEN YOU walk up the stairs and enter Sylvia Sheinbaum’s tidy downtown Tel Aviv apartment, the striking aspect is how many knickknacks and funky pieces of arts and crafts fill the room, without looking cluttered.
The 61-year-old Sheinbaum has collected a lot of items over the years, including a long list of health ailments.
Seven years ago, she was seriously injured in a traffic accident that resulted in fractures, vision disorders and chronic pain. Despite recovering from her physical ailments, Sheinbaum, originally from New York, who’s lived here for more than 30 years, began experiencing emotional stress, anxiety and depression. No medication she was prescribed seemed to have any effect.
“They gave me all sorts of psychiatric medication – which I was not happy about. I wanted to live a different lifestyle – not going from one pill to the next, with each pill having its own side effects,” says Sheinbaum, sitting in her living room and intermittently picking up, lighting and taking a puff on a marijuana cigarette lying in an ashtray on the coffee table next to her.
When her mother died four years ago, Sheinbaum collapsed, suffering a heart attack and lung problems. After a slow recovery, she decided to look for other options besides conventional medicine to help her regain her health.
“When I came out, a friend suggested, why don’t you apply for medical marijuana instead of taking pills,” she recalls.
Her psychiatrist wrote a letter to Baruch diagnosing her with PTSD and recommending her as a candidate for the medical marijuana program permission. Sheinbaum was accepted on an experimental status, because even though PTSD isn’t officially one of the conditions listed in the program, the ministry is doing research on the subject with a variety of patients, including IDF veterans.
Since then, Sheinbaum has seen a drastic change in both her mental and physical condition.
“I’ve reduced the number of pills I was taking for my heart from three to two. Next month, I’m going to the doctor and I expect that he’ll take me off another one. My lung capacity grew from 30% to 65% over the last three years. The problem with my lungs is that it’s progressive – it should be getting worse. And it’s getting better,” she says. “And my mental and emotional well-being is much better. Cannabis helps me get in touch with my feelings.”
Sheinbaum says that the amount she smokes – or whether she smokes at all – depends on how she feels on a given day.
“There are some days I can’t stand thinking about it, and there are some days when I wake up and I need to have a puff, or three,” she says. “What it does, first gives you an overall good feeling. Sometimes when I have a physical ailment, I also have all these emotions and feelings that are tied up in it. And the marijuana helps me deal with those feelings and not try to run away from them, or panic and have to take a pill. Once you can face the feeling, it slowly dissolves, and that’s part of the healing process.”
Sheinbaum, who’s divorced with two grown sons, says that her children are divided over her use of marijuana.
“One of my sons doesn’t want to know about it. He has his own life and it doesn’t include cannabis. The other one is more open to it,” she says.
Because her license is experimental, she needs get a letter from her doctor every two months to present to Baruch saying that he continues to see progress in Sheinbaum’s condition.
“There’s now a few of us authorized to take it for PTSD,” she says. “Where I go to pick it up at the supplier, sometimes we’ll sit around and talk and compare notes. There are several guys who were POWs in Syria, Lebanon and Egypt and they’re getting cannabis now for post trauma. And the results for them are amazing.”
Sheinbaum, who had occasionally smoked in her younger years, says that medical marijuana is totally different from any pot she had previously tried.
“It’s a lot stronger. The percent of THC in medical cannabis is 23%, where a really good grade hydro pot is between 8% and 15%. It’s almost a different product,” she says.
Since joining the medical marijuana program Sheinbaum has become an advocate for marijuana’s legalization. “We live in such a stressful time and situation, why not?”
BOAZ WACHTEL says it straight out. “Cannabis will never be legalized in Israel. I think the best we can hope for is that it becomes a civil case instead of a criminal one,” says the longtime pro-marijuana rights activist and the founder of the Aleh Yarok party.
“If the government insists on punishing people and creating a deterrence, there would be a small fine according to the quantity the user is caught with. Society maintains a message of disapproval, but people are not criminalized and won’t receive criminal records which could wreak havoc with their lives,” he adds.
Wachtel is one of those pot-smoking stereotype breakers. The 51-year-old Netanya area resident has a BA in Jewish education from Hebrew College in Boston, and a master’s from the University of Maryland. He was the assistant military attache at the Israeli Embassy in Washington for four years in the 1980s, and served on a team of Israeli representatives to former president Ronald Reagan’s space-based anti-missile shield program.
“After that, I lived in New York for a fe
w years, and got involved with some people who said they found a cure for drug addiction using this drug Ibogaine,” says Wachtel. “We flew addicts from the US to Holland for treatment, and it was there that I came across a normal drug policy, quote unquote. They managed to successfully separate between soft cannabis users, which is the vast majority of users in the world, and hard drugs. And I came to realize that some of the harm is caused by bad drug laws themselves.”
When Wachtel returned to Israel, he helped establish in 1994 the forerunner of Aleh Yarok, the Israeli Drug Reform Foundation, and was involved in the Knesset committee that Mechoulam participated in. Wachtel calls himself a recreational marijuana user.
“I don’t like alcohol. A joint once in a while relaxes me and lets me sleep very well, by the way,” he says, adding that research has shown that cannabis is the most benign of all illegal drugs.
“If you classify it by its addictiveness and damage to organs, increasing violent behavior, or its ability to break up families, it’s similar to coffee,” he says. “I’ve had a regular dialogue with the Anti-Drug Authority over the years, but when it comes to cannabis, the only thing that has changed in the last 15 years is their realization about the exaggeration over the damages caused by cannabis.”
But according to Shamai Golan, the spokesman for the Anti-Drug Authority, established in 1998, the effect of marijuana should not be underestimated.
“Marijuana is a drug, and it should never be legal. It’s a drug, like any other, that can cause addiction, and serious damage to a person. It can impair their ability to function and to drive. There’s no doubt about that. There’s no chance that will ever be legalized here,” he says.
According to Mechoulam, the status quo here today is one of the most liberal in the world, in terms of both law enforcement and medical marijuana development, but he thinks that’s as far as it should go.
“I would not recommend legalization,” he says. “Possibly a solution will be decriminalization of a sort, which is more or less what’s happening at the moment. Not officially, but in practice, which is the way many things happen in Israel.
“Israel is a conservative country, legalization wouldn’t be accepted. Things like that in a democratic state have to be supported by the public. I don’t believe that in Israel there’s enough social agreement for that. If tobacco was introduced today, there would be many laws against it. But you can’t say no tobacco tomorrow because the country wouldn’t accept it, it wouldn’t be socially acceptable.”
WHILE THE Knesset committee that Mechoulam was a member of 15 years ago recommended against legalizing marijuana usage, it did suggest that police not open a file on first-time users, even minors, and that prison time should be eliminated as a punishment.
“I understand that the police are going along these lines. They want to keep the law, rightly so, so they can have an instrument for punishing those they want to punish, but they won’t use it just indiscriminately,” says Mechoulam.
According to guidelines issued to the police by the Attorney-General’s Office in 2003, “When apprehending a first-time cannabis user who has no criminal record, and when it is clear that it is a first-time private use of the drug, it is permissible to close the file with a warning.”
While repeated queries to the Israel Police did not succeed in providing information on its policy toward marijuana users, one police officer said that users are only interrogated to help locate the suppliers, a claim backed by the experience of Galit Y. a 26-year-old Jerusalem software programmer, who was stopped by a patrol car for a traffic violation and was caught with two grams of marijuana.
“They brought me in for questioning, and seemed mainly concerned with who gave me or sold me the pot. When I convinced them that it was brought into Israel from abroad by a visiting friend, the officer just told me to be more careful and keep it at home,” says Galit.
According to Tel Aviv attorney Ari Shamai, who’s known as an outspoken advocate of more lenient drug laws, the police have basically adopted the attorney-general’s recommendations.
“Although I still occasionally represent a client on cannabis charges, the frequency has gone way down,” he says.
THAT’S GOOD news for Shlomi Sendak, who’s been bucking the marijuana laws ever since spearheading Aleh Yarok’s efforts in the 1990s as a lobby group for the legalization of cannabis and medical marijuana, before the party was founded in 1999. His mid-1990s booklet “Cannabis Medical Medicine in the 20th Century” helped jump-start the burgeoning medical marijuana movement here.
Sendak possesses the gentle personality that someone in his profession – an aura reader – requires. Sitting in the backyard patio of the apartment he shares with his girlfriend and her daughter in suburban Modi’in, the 49-year-old looks like he’s suffered through some pain in his life.
“I have scoliosis and should have had an operation a long time ago. The reason I don’t is that I smoke marijuana most every day. It relieves the pain. I started smoking when I was 17 – for the fun of it… well, actually to be rebellious maybe. Then eventually, I noted that when I smoked, I didn’t have any back pain,” recalls Sendak.
“I was invited on the Gabi Gazit TV show on a Friday night in 1994, and what I said was quite revolutionary – I think it was the first time someone in Israel said that cannabis can be as medicine and not a drug,” he says, adding that he’s both proud and upset over how the medical marijuana program has blossomed.
“Today, we’ve come a long way. It took the Health Ministry 15 years to accept the idea of medical marijuana. It makes me furious when I think of all the people during those 15 years who could have benefited from it but didn’t because people were locked in an outdated mind-set.”
In Sendak’s utopian scenario, marijuana would be readily available to any adult who wanted it with a simple prescription from their doctor.
“If every Israeli could go to his health fund and ask for medical cannabis because it helps him without the need of further documentation, then forget legalization, that’s good enough for me,” he says. “I’d love to be able to apply for spiritual reasons. I would tell the doctor it helps me in my spiritual life, which is true.”
However, spiritual longing is not one of the conditions recognized by the medical marijuana program. Neither is scoliosis, and Sendak doesn’t experience enough chronic pain to apply under that condition. So, he’s left with the choice of continuing to grow or purchase marijuana illegally, or curtailing his use, which he occasionally does for periods of a month. Rather than being angry or bitter, Sendak just laughs.
This article discusses the Israeli medical marijuana production facility and program supported by MAPS.