Alan Flashman

A Tragedy of Terrors

Israel’s Medical Cannabis Sinks to New Lows

Israel Medical Cannabis Authority is the name of a public program that services no one. It’s CEO, one Yuval Landschaft, a pharmacist, has run the program into the ground but has paid no price for it. He simultaneously decreed (on his lonesome, apparently) that medical cannabis patients can longer receive the strains that have proven effective for them and that the major providers can no longer provide anything at all. The result – a complete interruption of continuity of care for some 40,000 patients, including children with epilepsy or severe frustration attacks as part of autism that have achieved substantial succor with whole cannabis of particular strains. Magister (that’s how he refers to himself, it reminds the world he has a master’s degree) Landschaft announced the sudden “reform” in April and in short order led to his own Chief Medical Adviser’s dissenting  resignation.

In a normal country it is clear whose head should be on the block. Not in Israel. The seemingly invulnerable Landschaft and other Health Ministry functionaries have capitulated to some pretty bad press (in which I am proud to have had a hand) and first exempted children with autism from the “reform” for a year. Then all licenses antedating the “reform” were automatically renewed until after the elections (aka end of September) and today the second to CEO of the Ministry extended all licenses preceding the reform until the end of 2019 in order to mitigate the damages of the “reform.” But the manager in chief of the “reform” remains at the helm!

Let me break this down into clinical practice in an absurd environment. Just yesterday I was spending endless phone time explaining to parents of autistic children whose children have been helped enormously with one strain or another of cannabis that I DO NOT want to renew their license now, because I do not trust IMCA to be able to discriminate in the computer of the renewal and I am afraid that the renewal will go into the “reform” even though the IMCA has claimed otherwise. I said, “Get your last supply in September and then call for renewal. Who knows what will happen by September.” Bingo! Today that license is renewed automatically until December! So they should wait until December? And then?

This behavior of IMCA is clear grounds to reorganize IMCA and restructure including replacing the CEO. Why on earth should someone who scared the daylights out of 40,000 patients and then keeps backtracking remain at his desk? And not just scared but damaged a great many by stopping the main suppliers from producing and marketing (for reasons that are shrouded in double talk and for which he claims not to be responsible) thus creating months of agony for PTSD and chronic pain sufferers among others whose complaints are documented daily in every public media! Patients requested that the High Appeals Court (BaGaTz) stay the Reform but were put off to September – 3 more months of suffering. Yesterday these consumers scheduled a mass protest, and anyone with a grain of practical cynicism might guess that the sudden “extension” is meant to weaken the impact of that protest.

How have we come to this? Why should medical cannabis patients have to make use of media, legal and protest means to force a public agency (IMCA) to not harm them? How can the obviously more than justified removal of Magister Landschaft not reach any significant agenda?

Stay tuned. We should know in the coming months. In the meantime, I have posted a Google Doc with a proposed revision of IMCA and dozens of other doctors, nurses, patients and suppliers have added their comments. I hope to have a tentative draft ready by September so that the political change I hope for could adopt a different structure for medical cannabis, one that would be significant even after the legalization that I believe the majority of Israelis are ready for. I will post it in English when it is ready.

Oh, one last note. Perhaps one might say, “The Ministry is responsive to its consumers, Hurray for the Ministry!” Apparently the Ministry is trying to sell this line. But the Ministry has essentially admitted that the Reform is dangerous and harmful, and “being responsive” must include the removal of the person responsible for danger and harm to patients. No other response can make patients secure.

About the Author
Alan Flashman was born in Foxborough, MA, and gained his BA from Columbia, MD from NYU, Pediatrics, Adult and Child Psychiatry specialties at Albert Einstein College of Medicine, The Bronx, NY. He has practiced in Beer Sheba since 1983, and taught mental health at Hebrew University, Tel Aviv University and Ben Gurion University. Alan has edited readers on Therapeutic Communication with Children (2002) and Adolescents (2005) in Hebrew, translated Buber's I and Thou anew into Hebrew, and authored Losing It, an autobiography, and From Protection to Passover. He recently published two summary works of his clinical experience (both 2022) Family Therapies for the 21st Century and Mental Health in Pediatrics.