Marijuana Law, Policy & Reform

Editor: Douglas A. Berman
Moritz College of Law

Tuesday, May 17, 2016

"Medical marijuana, for babies and their desperate parents"

The title of this post is the headline of this notable new CNN article, which discusses Israel's medical marijuana program. Here are excerpts:

Moments of joy are all too brief for Lavie Parush. They have been since the 2-year-old was born. "Gray" was the word his father used to describe his son, born unconscious. That night, Lavie had his first seizure. "Immediately, they took him to the emergency room," said his father, Asaf Parush. "They doped him up and he was basically passed out the first week of his birth."

For six months, Parush and his wife, Noa, held on to the belief that Lavie's condition would improve. But the seizures worsened. He suffered dozens a day. Doctors diagnosed him with epilepsy and cerebral palsy. Lavie was severely brain damaged.

Doctors put the baby on one drug after another to try to stop the seizures. Each drug required another visit to the hospital. And each one led to another disappointment as the seizures continued unabated. Some drugs had severe side effects, Parush said. Steroids, for example, weakened Lavie's immune system and caused him to become incredibly bloated.

Just before Lavie's first birthday, Parush heard about the use of medical marijuana -- commonly called medical cannabis in Israel -- to treat epilepsy. Unlike other medicines, cannabis is not prescribed by a doctor in Israel. Instead, specialist doctors request a license for a patient to use cannabis for treatment of chronic pain, chemotherapy-induced symptoms, epilepsy and other conditions. The license allows medical cannabis patients between 20 and 200 grams per month. The cannabis is sold at a fixed price of approximately $100 per month, regardless of the amount.

The Ministry of Health points out that the efficacy and safety of medical cannabis "have not yet been established," but the ministry also acknowledges cannabis can help patients suffering from certain medical conditions. Israel has approximately 23,000 licensed medical cannabis users, according to Daniel Goldstein, an industry advocate with Israel Cannabis. Recreational cannabis remains illegal in the country....

Lavie's family requested a license for him from the Ministry of Health for the boy to use medical cannabis. He takes a few drops of cannabis oil every day, mixed into his food. "After a few weeks we didn't see any seizures at all," Parush said.

The cannabis oil, extracted from a strain of cannabis called Avidekel, was developed in northern Israel by one of the country's largest cannabis growers, Tikun Olam. The oil is high in cannabidiol -- or CBD - the pharmacological ingredient in cannabis that has been shown to have anti-inflammatory properties. It is low in tetrahydrocannabinol (THC), the psychoactive ingredient that makes marijuana users high and has been shown to relieve pain.

According to Tikun Olam, Avidekel is the strain used for toddlers and babies. Of Tikun Olam's 6,500 medical cannabis users, only 15 are under 3 years old. The Ministry of Health couldn't confirm the number of toddler and baby cannabis patients in Israel, but Tikun Olam's spokeswoman Ma'ayan Weisberg estimates that no more than 25 children under 3 years old are licensed....

A 2015 study by Dr. Orrin Devinsky of the NYU Langone Comprehensive Epilepsy Center showed a 54% reduction in some types of seizures in 137 people suffering from severe epilepsy who took a liquid form of medical marijuana and did not respond to other treatments. But the study's results will need to be replicated, since it did not adhere to the strictest standards of scientific research, including randomized testing and peer review.

A 2013 Stanford University survey of 19 children between the ages of 2 and 16 suffering from epilepsy found 16 of them self-reported or their parents reported a reduction in seizures from using medical cannabis....

Dr. Uri Kramer, head of the Department for the Treatment of Childhood Epilepsy at Tel Aviv's Ichilov Hospital, said medical cannabis shows promising results in children whose epilepsy has not responded to multiple drugs. "If they are not good candidates for surgery, there are almost no options," said Kramer, who requested the medical cannabis license for Lavie.

Kramer said his patients have shown that medical cannabis has a success rate of approximately 20% in reducing seizures by 75% in epileptic children. "That's much higher than any other drug on the market," said Kramer. But acceptance is not universal. "Some of our colleagues are not convinced yet," he added. "I'd say only about half of the pediatric epiloptologists in Israel are using cannabis."

Research is underway regarding CBD use in children with intractable epilepsy, according to Dr. Angus Wilfong, a pediatric neurologist at Texas Children's Hospital, but Wilfong urged caution. "These studies are complex and take time. No drug should be approved for use in children until scientific studies have validated its efficacy, safety, tolerability, and dosage," said Wilfong.

http://lawprofessors.typepad.com/marijuana_law/2016/05/medical-marijuana-for-babies-and-their-desperate-parents.html

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