[Medical grade cannabis (MGC): regulation mechanisms, the present situation around the world and in Israel].

Over the past several years, there is an increased demand and use of medical grade cannabis (MGC) in Israel and around the world. Regulation of cannabis growth, use and distribution has been a subject for many discussions in the Israeli medical system, parliament and the media. The increased demand for this kind of treatment, which is considered to be safe and effective in various indications, caused increased interest in the MGC approval mechanisms. Some countries have created regulation and control mechanisms for MGC. The United Nation convention of 1961 defines the medical legal use of narcotic substances. The convention demands full governmental control of the stock of narcotic substances, including cannabis and a governmental mechanism which will license, supervise, control, document and report the yield and consumption. In the Netherlands there is full accordance with the United Nations requirements and there is a special office for MGC which approves growth, production and marketing. MGC is prescribed in the Netherlands and supplied by a pharmacist as a regular drug. In Canada, after a long legal struggle, patients pressured the government to begin a federal program of MGC. In the U.S.A there are differences in cannabis authorization policy between some of the states and the federal government, which opposes MGC use and therefore, places numerous obstacles. Currently in Israel, the Director General of the Ministry of Health, appoints a representative to certify MGC and approve marijuana growers. MGC is directly supplied by the marijuana growers. This is a problematic model which lacks separation between the growers and the patients. Another problem is that the United Nations requirements are not fulfilled. In this review we present the advantages and drawbacks of the current model and propositions for future models for control and regulation of MGC.