A decade after a government decision regulating cannabis for medical and research purposes, officials are reassessing the Israeli model amid a sharp rise in usage. Data presented to the committee show Israel has become one of the world’s leading consumers of medical cannabis, with licenses increasing from 33,000 to approximately 140,000.

The surge in cannabis use, particularly since the outbreak of the war, prompted the committee’s formation as more Israelis seek relief from pain, anxiety, and trauma. The ministry stressed that broader access must be matched with increased responsibility to ensure treatment effectiveness and minimize harm.

According to the findings, 62% of patients consume more than 30 grams per month, 88% of licenses include high THC concentrations, and most users rely on smoking. Smoking accounts for up to 98% of licensed purchases, raising concerns about health risks and inconsistent dosing.

Under the proposal, new patients would begin treatment with extracts or precision inhalers rather than smokable cannabis. Exceptions may be allowed in limited clinical cases, but only under strict supervision and dosage limits.

A major structural reform would transfer full responsibility for medical cannabis treatment to Israel’s health maintenance organizations. Diagnosis, approval, monitoring, and dispensing would all be managed within the HMO system, integrating cannabis into patients’ medical records and ensuring continuity of care.

Hospitals would still be able to recommend treatment, but final approval and dispensing would require HMO authorization. Health funds are expected to receive about one year to prepare for implementation.

The committee highlighted particular concern regarding cannabis use for post-traumatic stress disorder. While not recommending the removal of this indication, it emphasized that current research does not sufficiently demonstrate long-term benefits and raises concerns about potential functional impairment.

Cannabis may still be considered in severe cases, such as insomnia or acute distress, but only alongside proven treatments like psychotherapy and under close supervision.

The recommendations place strong emphasis on addiction prevention. Physicians would be required to assess patients’ risk factors before initiating treatment and avoid prescribing cannabis where significant addiction risk exists.

Warning signs include escalating doses, frequent doctor changes, insistence on specific treatments, and concurrent use of addictive medications. Monthly prescription renewals would be allowed, but extended treatment beyond six months would require in-person evaluation and reassessment of benefits versus risks.

Additional measures include mandatory training for healthcare professionals, stricter reporting requirements for driving and firearm eligibility, and expanded investment in clinical research. The committee called for collaboration between the ministry, HMOs, and research institutions, including studies on safer delivery methods such as inhalers.

The Health Ministry framed the recommendations as an effort to balance accessibility with patient safety. While not immediately binding, officials said the proposals will serve as the basis for further policy work and could reshape Israel’s medical cannabis landscape in the coming years.

“All medical treatment requires weighing benefit against harm, and this applies to cannabis as well,” the committee concluded.