In the wake of new regulations concerning the use of medical cannabis, the Israel Pharmacists’ Association this week published a professional survey on the subject. The report discusses the side effects of cannabis, and the interactions between it and other medications.

The association is publishing this information in the midst of a process whereby the use of cannabis is being regulated, which is expected to be completed in the coming months. The new rules stipulate an increase in the number of doctors authorized to prescribe the drug to patients ranging in age from 20 to 30, and also relate to the composition of medical marijuana and the way it is locally grown, packed and distributed; eventually pharmacies will be responsible for the latter stage.

The purpose of the report, according to the association, is to provide various professional bodies with concise and up-to-date information that will help them to examine the benefits versus the possible damage involved in the use of medical cannabis.

“The effects of cannabis differ from one person to the next," says the document, "and depend on the dosage, the method of delivery, the past experience of the user with the medication, the patients’ surroundings (his expectations of treatment, his attitude toward the effects of the substance, his mood and the social environment), and the amount of use.”

The effects of cannabis, the report continues, can be euphoria or dysphoria, calm, anxiety or even psychosis. Additional phenomena include heightened wakefulness followed by drowsiness, a sharpening of the senses followed by slower comprehension, and increased motor activity followed by problems of coordination. “Many of these side effects of cannabis stems from a high dosage or chronic use,” writes the pharmacists' association.

In bold letters they state that patients suffering from schizophrenia and bipolar disorders should refrain from using medical cannabis. As for older patients who suffer from cardiovascular diseases, use of the drug can lead to increased risks of blood pressure fluctuations, heart attacks, ongoing cardiac distress and even sudden cardiac death, as well as such problems as strokes, damage to peripheral blood vessels, limping and even gangrene in the fingers.

The report also states that older people who suffer from impaired neuro-cognitive functioning and use cannabis could suffer further decline in memory and concentration, and a tendency to fall. The pharmacists also cite potential negative effects among persons with pulmonary disease, mainly when the cannabis is smoked, and write: “Long-term use of cannabis through aspiration increases the risk of inflammation of the jaw and the tonsils, asthma, bronchitis, pneumonia and lung cancer."

The report also warns that the process of growing cannabis at present is not monitored as carefully as development of other medical preparations. The cannabis is liable to contain pollutants such as bacteria, fungi and molds, heavy metals and so on; in addition, the concentration of its active ingredients is not fixed.

In addition to describing the side effects, the association's report also contains a list of possible interactions between cannabis and various medications and substances such as tobacco, alcohol and drugs. For example, there are anti-depressants whose effectiveness is undermined by the use of cannabis.