The Media Line: With Trauma Cases Climbing, Why Is Israel Questioning Medical Cannabis Now?

With Trauma Cases Climbing, Why Is Israel Questioning Medical Cannabis Now?

The number of people using medical cannabis in Israel is higher than ever, but growing evidence suggests that medical cannabis not only does not necessarily treat PTSD but may actually worsen it

By Maayan Hoffman/The Media Line

The recent report by the Israeli Health Ministry, which aims to halt the smoking of medical cannabis within three years, comes at a critical time. Cases of post-traumatic stress disorder (PTSD) are on the rise in Israel, the number of people using medical cannabis is higher than ever, and growing evidence suggests that medical cannabis not only does not necessarily treat PTSD but may actually worsen it.

On Sunday, a special committee established by the Health Ministry submitted its recommendations on medical cannabis to the ministry’s director-general, with a central proposal to phase out the use of cannabis in smoked form within three years.

The report comes as around 140,000 Israelis now hold medical cannabis licenses, up from just 33,000 a few years ago, according to the report. It also arrives against the backdrop of two separate reports, one by the State Comptroller and another by a private researcher, indicating that roughly a third of Israelis, or about three million people, are struggling with symptoms of PTSD.

According to Dr. Shaul Lev-Ran, co-founder and academic director of the Israel Center on Addiction, the report is not about cannabis legalization, decriminalization, or personal liberty. Nor is it about a lack of compassion for the tens of thousands of Israelis who were either attacked on October 7, 2023, or have been involved in a war for nearly three years. Rather, he argues, it is about ensuring that if cannabis distribution remains in the hands of the Health Ministry, it is evaluated like any other medical treatment — including who prescribes it, for which indications, what evidence-based follow-up is required, and how to properly weigh the risks against the benefits.

Lev-Ran said that the medical cannabis industry in Israel “has become a much larger operation than originally intended,” and that for the first time, the Health Ministry is seeking to introduce better tools to identify populations at risk of developing addiction to cannabis or suffering from its effects.

For instance, smoking, he noted, is inherently tied to cardiovascular and pulmonary disease.

The report showed that 98% of licensed purchases are currently for smoked cannabis, and 88% of licenses are for high-THC products, meaning those that are more addictive.

“Early signs of problematic use kind of define what the red flags are and establish criteria for either tapering or discontinuing your treatment,” Lev-Ran said.

Moreover, he said the medical system’s job is to balance short-term relief against long-term effects. He cited a study published in JAMA Psychiatry within the last year that showed that medical cannabis not only did not alleviate PTSD but actually aggravated long-term outcomes.

“We definitely want to be compassionate, but I think what the report is trying to do is balance compassion and concern,” he said. “So, compassion for the short-term effects and to alleviate them, but concern that people may get stuck with medical cannabis, and they may actually be worse off in the long term, which is obviously opposed to what we intended.”

But that is not necessarily how those who smoke cannabis are reacting to the report.

M., a 50-year-old from the Tel Aviv area who asked that his full name not be used, said he was “jolted to hear of the recommendation by the committee.”

For starters, he said that if such a report was going to be released, those who use medical cannabis should have been contacted by their psychiatrists to help alleviate any immediate shock. Overreacting and anxiety are often symptoms of PTSD.

“Many of us who have PTSD have been smoking cannabis to assist us for many years,” M. explained. “It’s something we’ve been used to relying on.”

1. said that he tried alternative options to smoking cannabis, such as oil and capsules, but those options were not as helpful for him. He also questioned why the ministry would release such a report now, when so many more people in the country are struggling with PTSD symptoms and feel that sufficient treatment options are often not available.

But Lev-Ran noted that the United States Veterans Association has been recommending against prescribing medical cannabis for veterans with PTSD because of its long-term detrimental effects.

The largest review of medicinal cannabis was published in The Lancet earlier this year and showed that cannabis does not effectively treat anxiety, depression, or PTSD, despite claims from those who use it. The study, based on a systematic review and meta-analysis of 54 randomized controlled trials over a 45-year period from 1980 to 2025, found that it could even raise risks such as psychosis and addiction and delay the effectiveness of other proven treatments.

A 2025 report by the Centers for Disease Control found that 19% of Americans, around 52.5 million people, used illegal cannabis at least once in 2021. Medical cannabis, however, is legal in 47 states, three United States territories, and the District of Columbia. A study published in 2021 in the peer-reviewed journal Policy, Politics, & Nursing Practice found that around three million Americans were using cannabis medicinally.

That number has likely increased in the last five years. An article about the aforementioned Lancet study published on ScienceDirect showed that as of this year, around 27% of Americans and Canadians between the ages of 16 and 65 reported using cannabis medically. Half of them said it was to help manage mental health symptoms. The American Medical Association has raised concerns about these figures, citing issues similar to those raised by the Israeli Health Ministry, including limited regulation and ongoing uncertainty about its effectiveness.

Under the committee’s recommendation, the prescribing of medical cannabis will be moved to the four Israeli health funds within the year, which will then work with a study group to track and evaluate the outcomes of cannabis use.

Another development, according to Lev-Ran, is that new technologies will be evaluated, promoted, and supported.

For example, Israel’s SyqeAir inhaler and medical cannabis cartridge might be on that list. According to the SyqeAir website, it is “the most innovative and safest route of administration of medical cannabis, compared to” smoking, vaping, or oil. It is the world’s first metered-dose inhaler for medical cannabis, designed to make treatment more consistent, reduce the risk of overdose, and minimize side effects.

The report does not mention SyqeAir specifically, but it does state that new treatments will begin with extracts and precise inhalers, and that smoked forms will be gradually replaced by alternative methods.

“I think when you look at cannabis, a lot of countries are realizing the limitations of medical cannabis, realizing the burden that it poses on the medical system, which honestly doesn’t know how to steer itself through this as a medicinal product because the medical system relies on research and the research isn’t there,” Lev-Ran added. “It also relies on relatively precise dosing, which is pretty impossible to do with smoked cannabis.”

Lev-Ran compared cannabis use to other alternative treatments, such as forest therapy, where there are some studies pointing to benefits, and “it’s really hard to think about severe risks. So the risk-benefit ratio leans a lot towards the benefits.”

In contrast to cannabis, he said that with treatments like psychedelic-assisted psychotherapy or even ketamine, patients are not given prescriptions to take those medications home.

“Let’s say I’m receiving ketamine in a ketamine clinic,” Lev-Ran said. “I’m not getting doses to take home, so that, for example, substantially reduces the risk of addiction. Or if I’m receiving MDMA treatment for post-trauma in Israel, it is part of an MDMA-assisted psychotherapy protocol. So I have three MDMA trips and 16 sessions. So it’s not giving an individual MDMA and wishing him luck, but rather saying, let’s facilitate a psychotherapeutic process, and that reduces the risk of abuse substantially and increases the chances of benefits.”

At the same time, he said he is confident that if future data support cannabis use, including smoking cannabis, the Health Ministry would be willing to reconvene and revise its recommendations.

Photo credit: Rami Zeringer