Mimi Peleg uses cannabis and MDMA to treat PTSD in herself and others. Credit: Ori Sharon.
The issue of drugs, and psychedelic drugs in particular, generally opens up questions which cannot be ignored by anyone seeking a more just and caring society. Current global policies towards psychedelic drugs range from the cruel to the barbaric. Every country in the world, excluding Portugal, currently prosecutes or otherwise severely penalizes individuals who use psychedelic substances.
Since the 1960s, this prosecution has come under question. This is particularly true in the U.S. To many, the pro-psychedelic movement that emerged out of the anti-war movement seems frivolous and non-essential. To observers with these attitudes, psychedelics are viewed as recreational diversions. People who see psychedelics in this way may be bewildered to know that the Multidisciplinary Association for Psychedelic Studies (MAPS), an organization aimed at studying the medical benefits of MDMA (the pure compound in the illegal drug Ecstasy), cannabis, and other drugs, has chosen Israel as a key location for psychedelic research.
To those who follow the growing body of medical research on psychedelics, this choice is much less surprising. Increasingly, scientists have come to view psychedelics as the most powerful tool we possess in treating PTSD, radically changing the old picture of the drug. According to The Israel Center for the Treatment of Psychotrauma (ICTP), a group that has been active since 1989 to contend with the growing phenomenon of psychotrauma in Israel, an estimated 9% of Israelis suffer from PTSD. While this is in the mid-range of PTSD rates in areas near Israel, it is three times the rate of PTSD in the U.S. and other Western countries. Israel’s high rate could be due to the many wars, presence of first and second generation Holocaust Survivors, and numerous other factors.I am an American/Israeli from Ohio, Virginia, and California. I currently reside in Tel Aviv where I work for the MAPS. As the association’s CRA (Clinical Research Associate), I monitor a clinical trial that studies the effect of MDMA-assisted therapy on Post-Traumatic Stress Disorder (PTSD).
My work for MAPS is not my only job in Israel. I am also the Director of Large Scale Training at the Medical Cannabis Distribution Center (MECHKAR – an acronym meaning “research in Hebrew”), which serves thousands of patients from Abarbanel Hospital, Israel. Every Monday and Wednesday morning for the past five years I have met with licensed medical Marijuana patients like myself, to help them get started successfully using cannabis.
Young marijuana plants grow in a sheltered greenhouse in Tel Aviv. Credit: Mimi Peleg.
I currently focus on patients who are issued licenses to use cannabis for the first time. These patients come in with any of these or other conditions: Chronic Pain due to a proven organic etiology; Orphan diseases (rare enough to affect small percentages only); HIV patients with loss of body weight greater than 10% or CD 4<400; inflammatory bowel disease (as opposed to irritable bowel syndrome); multiple sclerosis; parkinson’s disease; malignant tumor in various stages of the disease; psychotic episodes, panic attacks, generalized anxiety disorder, amotivational syndrome, chrones, fibromyalgia, epilepsy, and PTSD.
Like many of my patients, I too have PTSD. Treating PTSD by way of cannabis and MDMA is up close and personal for me both privately and professionally, and I perceive my contribution to the collective goal of “tikkun,” or repairing the world, to be working on expanding medical research into alternative medications in Israel.
“Posttraumatic Stress Disorder (PTSD) is a widespread and devastating illness for which we urgently need more effective treatments,” states Dr. Allan Frankel of Los Angeles and Tel Aviv. PTSD symptoms include re-experiencing the trauma through nightmares, obsessive thoughts, and flashbacks (feeling as if you are actually in the traumatic situation again). There is an “avoidance” component as well, where the individual avoids situations, people, and/or objects that remind them about the traumatic event (e.g., a person experiencing PTSD after a serious car accident might avoid driving or being a passenger in a car).Finally, PTSD patients also tend to suffer from increased anxiety in general, sometimes with a heightened startle response (e.g., very jumpy, startled easy by noises).
PTSD can be a chronic, devastating illness that severely impacts quality of life. Sufferers often struggle to maintain healthy lives and relationships. It involves changes in the brain, such as decreased activity in areas associated with memory and learning, and increased activity in areas associated with fear.
MAPS is making every effort to recruit Israeli combat soldiers with PTSD to the MAPS study of MDMA and psychotherapy. MAPS is currently conducting five other clinical trials around the world in: Switzerland, Australia, UK, Canada, and the U.S. MAPS is studying whether MDMA-assisted psychotherapy has the potential to heal the psychological and emotional damage caused by sexual assault, war, violent crime, and other traumas.
Medical marijuana joints produced in Tel Aviv. Credit: Mimi Peleg.
In short, MDMA-assisted psychotherapy is a treatment that combines psychotherapy with the administration of MDMA, which catalyzes the therapeutic process. So far results have been eye-opening: Four years after participants went through just a few MDMA-assisted psychotherapy sessions, results show long-lasting, clinically meaningful benefits and absence of harm. This is especially astounding considering that the participants were all resistant to conventional drug treatments (where existing treatments are not always effective). Astoundingly, in fact, a third of all PTSD patients do not respond adequately to established psychotherapies and even after treatment, patients still suffer from symptoms.
In Israel, the first two participants have already been treated. Eight additional subjects will soon be enrolled in a randomized, double-blind active placebo-controlled study, with five subjects receiving 125 mg (high dose) and three subjects receiving 25 mg (active placebo or low dose), with an optional supplemental half-dose available 1.5 to 2.5 hours after the initial dose. Participants will have two experimental sessions of MDMA-assisted psychotherapy scheduled at a three- to five-week interval with pre and post therapy sessions.
MAPS put together a therapy team of six and flew many of them to the U.S. for extensive training to ensure adherence to the strenuous protocol in order to ensure the greatest levels of comprehension and expertise.
I returned to Israel in 2009 partially to help kick start the cannabis movement here along with about 100 other activists. I didn’t know it at the time but I came back at a crucial juncture – directly prior to the start of centralized, state sanctioned distribution and storage. Today this facility, MECHKAR, serves about a third of Israel’s approximately 12,000 patients. For the entire first year of distribution, all patients in Israel received cannabis free of charge. In 2010 the price was set at ~100 USD per patient month. Legally this is a price for the service of receiving cannabis, not the monthly gram allotment that varies from 10 to 100 grams. Most patients start with between 20 and 30 grams per month. Israel’s patients come from all religions, age groups, and ethnicities. Some groups (such as holocaust survivors and people in financial need) are eligible for subsidies for both their cannabis and a vaporizer.
Today, different strains are known for having different active ingredients. Our Ministry of Health guidelines aim for three offerings: a low CBD (under 3%) high THC (20% and above) strain; a low THC (under 14%) high CBD strain (6% and above) and a mid-range THC (14-20%) mid-range CBD (3-6%).
Dr. Frankel treats people primarily with cannabis oils. The reason for using cannabinoid oils is because the oil extracted from the plant is in fact the whole plant medicine. All medicine from cannabis and most other plants is within the plant oils and waxes. When the cannabis oil and waxes are tested and then blended with diluents, such as grape seed oil, it is fairly straightforward to create a dosing scheme for the patients. The oils tested and blended to specific doses can be used to treat many illnesses.
(Credit: Rick Doblin/ MAPS)
I asked Dr. Frankel if cannabis is a cure for PTSD. He chuckled. Through the VA, Dr. Frankel has treated around a dozen recent war veterans with documented PTSD from recent wars. These patients for the most part are living increasingly comfortable lives and beginning to reach out to other veterans to spread the knowledge. Dr. Frankel reports that veterans using cannabis tend to sleep better, memory of atrocities seem to be less painful, and their overall life function is far improved. Frankel’s studies are neither double-blind nor controlled, but the initial results are extremely encouraging and require more research.
Yet, Dr. Frankel asserts:
There is no reason to speak about “cures.” Cures are very rare in medicine. We tend to control or manage disease processes and relieve symptoms. There is evidence that cannabinoids allow a better quality sleep, relieve anxiety/panic and allow bad memories and nightmares to abate to a significant degree in limited studies…
Why are these studies so limited? For an answer we can look to Dr. Sanjay Gupta, (CNN Chief Medical Correspondent). When Wolf Blitzer recently asked “why did you change your mind on cannabis?” Dr. Gupta responded: “when you look at the literature surrounding marijuana, if you do a search through the medical journals, you know, some 20,000 papers will pop up. And I was keeping up steadily on the scientific literature, but what I was realizing was that the vast majority of these studies talked about the harm, the perils, the problems with marijuana. A very small percentage, less than 10 percent, close to 6 percent actually evaluated benefit.” As Gupta highlights, it has been practically impossible to do clinical trials on cannabis in the U.S. that evaluate benefits.
Dr. Allan Frankel seeks to fill this gap. He will be conducting a PTSD study in cannabis in Israel to determine how cannabis might diminish the effects of traumatic memories, alter emotional states, reduce anxiety, and improve general mood. The study that he is conducting along with Principal Investigator Dr. Yehuda Baruch intends to validate the assumption that use of cannabis ameliorates symptoms of PTSD through reduction of nightmares, sleep betterment, anxiety abatement, and general mood improvement.
Dr. Frankel’s study aims to isolate which cannabinoids best help reduce PTSD testing various ratios of THC/CBD and placebos in participants’ blood streams via appropriate lab tests and by administering self-reported questionnaires at specific intervals. There will be baseline, bi-weekly and long term follow-ups and daily phone calls.
Dosing in all groups will be one dosed spray, or 3 mg CBD per spray and mg/spray of THC depending upon above ratios. Patients will begin on 1 spray on the morning on the first day. On subsequent days participants will be asked to increase the number of sprays by one additional spray every other day increasing up to a maximum of 15 sprays per day (pending Institutional Review Board approval).
Research like Frankel’s will provide a scientific foundation for doctors both in and out of Israel who currently remain skeptical about the validity of cannabis as medicine. As such, there is a great need for continued education on every level in Israel. Many doctors do not know about the benefits of cannabis and many still fear it. Doctors still fear reprisals for prescribing cannabis. Doctors fear becoming “pot shops.” Lack of education is one of the key reasons for patient attritions along with new health issues and license revocation. Cannabis and MDMA education and research in Israel suffers from a severe lack of funds and this is where any one of us anywhere can be of tremendous help. If we can’t get the research done in the U.S., we will have to do it elsewhere – like Israel, a place with a long history of miracles with sacred oils.
To make a donation to MAPS’ MDMA-assisted psychotherapy for the treatment of PTSD in Israel Fund, visit MAPS’ website.
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Mimi Peleg, CRA for the MDMA/PTSD Israeli Study, is also Director of Large Scale Cannabis Training for MECHKAR, Abarbanel Hospital, Israel. Peleg recently co-authored “The Ladder” with Galia Halfi – a self-help guide to inner peace (beshalom.org). You can contact Peleg at mimi@mcdc.co.il.
What an innovative way to heal the world. I imagine there are so many trauma survivors in Israel.
Fascinating! Good luck! The world is changing…
Keep up the GREAT work Mimi!
What a great, informative article. Usually this subject is so ideologically charged and impossible to discuss in an objective, reasonable way. This text provides strong arguments and comprehensive information and thus, I think, is a great contribution to the efforts of de-demonizing the use of cannabis and MDMA and making it available to more and more people whose suffering will be greatly reduced. Hope to read more of that here!
Always good to hear of progress in every aspect of tikun olam. May we all find peace.
This is a very important article to help raise awareness of the therapeutic benefits of MDMA and cannabis in a world that increasingly needs help with traumatic stress and anxiety and panic disorders.
I, myself, have suffered from PTSD and panic attacks and severe anxiety. I self-medicate because there is no established legitimate use for these agents in Vienna. Though I live in Freud’s hometown where one might suppose there would be more curiosity about advanced psychotherapies, I am forced to self-medicate.
Maybe I should move to Israel (where I have visited) to be in a place where there seems to be a more enlightened approach to these all too common disorders.
I hope to read more articles by Mimi Peleg on your website!
Very interesting article, please continue with your work!
As a professional therapist it is good to see other options being investigated beyond the pills for PTSD, which in many cases do not provide a quality of life. Best of luck with your research.
Wow!!!! This is the first time in years I felt such hope for the future development of psychotherapy in Israel. These Questions about certain substances has been raised long ago in different western countries, with very little “balls” in actual reserch.
This Is Helping for real! And it has Balls… Thank you so much!!!
Mimi, it gives me hope and inspiration that you are doing this valuable work that desperately needs to be done. Your friendship is an added gift!
great to see such an amazing diverse group of people doing ACTUAL research by the people for the people! please keep up the work, development, research and these updates. truly an amazing turning-point in the field of medicine, not only for the people but for israel and the world
Really impressive work. I have heard even from here in California what a leadership role Israel is taking in this area and your work in particular. Good luck with all of it…. and thank you. Thank you so much, from someone who has survived PTSD myself.
Outstanding natural cure for all who can get it and use it. Awesome work Mimi, Thank you!
Yes…thank you Mimi
Wow. Amazingly eye opening. Beautifully constructed and put together.
Very interesting article.
Thank you mimi fir the important work you do.
You bring a great gift to this field in Israel.
Keep up the good work
This is a well informed and interesting article authored by Mimi Peleg who approaches the subject humanely, with scientific background and hope.
This is indeed an interesting insight on the future of cannabis in general and to treat PTSD with this amazing plant in particular.
To find out that research is being done and conducted here in Israel makes me feel proud, that yet not only high-tech geniuses have sprung from this land but we have also pioneers with treatment of MDMA and Cannabis that are so passionate to help a community that can no longer be ignored.
Keep on going, well done Mimi Peleg!
This was an excellent article by a very good writer. More, please.
As a graduate-level educator of psychotherapists in the US, I am saddened by the restrictions on research related to <> method of treatment that might alleviate suffering. Politics will influence law, but so should good scientific inquiry. Surely competent protocols can be devised to prevent abuse during the research process. It is time to stop throwing out the baby with the bathwater. Cheers to Ms. Peleg for her groundbreaking work!
Great article. It seems Israel has approached medical cannabis from a scientific angle carefully limiting its use to needy patients. No wonder Sanjay Gupta changed his position. I wish Mimi success in her training program and hope my country follows.
Very wise take, we’re frontiers, not dying species 😉
Thank you Mimi Peleg for this important article. It’s encouraging to see progress being made in this line of research and it’s a huge step that the barriers of propaganda and hysteria around cannabis and psychedelics are giving way to reason and genuine scientific discovery. The world is full of psychologically damaged people in need of effective treatments. Thanks to MAPS and others for working so hard to provide real relief.
So great to see this important research happening – way to go Mimi, MAPS and Israel!
Skepticism is a good thing. Let’s be scientific and open up this area of study. If results are positive, many people will experience noticeable improvement. These studies are of of great human significance.
This article, well written and informative, echoes what many health care professionals have known for decades. Although change is difficult, it is necessary to explore and secure new remedies for our ever growing populations. Thank you for this, Mimi.
I think that the only rational action is to legalize marijuana, and other psychedelic drugs, and then control them to prevent their use by minors, to collect taxes on their sales and to standardize the components. Once they are legal, scientific inquiry will follow in an unrestricted, collegial atmosphere.
Thank You for furthering PTSD studies on MDMA, the more research that proves paramedics fireman and all emergency services personel, can benefit from MDMA when aflicted with PTSD, is very important to all. More will accpect assistance as the studies prove that MDMA assisted therapy works. They helped when you needed it now lets help them
MIMI thanks for your efforts in this arena. You are well-aware of the blockades to doing research on Schedule 1 drugs in US even for PTSD which we so desperately need good interventions for our vets.
Thanks for pioneering this important work and helping US realize we need to move forward. Seeing your groundbreaking efforts may help open doors here. Much success….
Thank you for the well written piece shining a light on yet another place where cannabis has therapeutic potential. It is remarkable to me that cannabis remains a Schedule I drug in the US given the vast evidence of its medical efficacy for so many maladies. This type of clear and knowledgable reporting is badly needed to help dispel the pervasive ignorance and misinformation that continues to surround substances which have so much potential for doing good in the world.
I’m reminded of how it took years of use to convince the medical and law enforcement communities that morphine and related drugs could be used to alleviate pain as regular part of medical treatment, without spawning a new surge of addicts. You’ve got a similar problem here: to get permission to conduct trials, and then, should they prove successful (as the preliminary evidence you cite suggests), publicizing those success widely enough to overcome the negative image of marijuana as a slacker drug.
The goal of medical treatment is to increase the physical and psychological health and well-being of human beings. Humans with PTSD suffer so much, that successful use of marijuana to treat it would outweigh marijuana’s drawbacks. Good luck with your studies!
I’ve heard great things about pain control with Medical Marijuana. I’m glad to see the expansion into treatment of PTSD. I can’t wait to hear more about the double blind study that’s starting. This is a well written, well informed paper. I learned a lot about the positive effects of Medical Marijuana and that it’s being developed in other forms.
Thank you Mimi for a most information article. I am a therapist who works with trauma and need to know that treatments are being tried internationally.
I am happy to learn that Israel is once again leading the world in research and practice.
Thank you for this information article about new and exciting treatments for trauma survivors. Even though the USA does not like to discuss these possibilities, it is great that Israel is freely discussing what effective treatments can ease the pain of PTSD
Shoshanna, therapist
This is an exceptionally researched, humane, intelligent and compassionate article, a “white paper” concerning the physical & psychological health benefits of a natural substance. The information needs to be known by those who are ill and in need of comfort and ways to attain a sense of well being & a lessening of pain. It gives an alternative and truthful view of the benefits of Medical Marijuana. It is rational, practical & scientific. Bravo! Sincerely, Risa
Very nice article, it is so frustrating to have good medicine blocked from use here in Michigan.
Wow, Mimi, you are changing the world!! I can personally vouch for the life-changing medical benefits of marijuana. Thank you for all that you do.
The work that Mimi Peleg and Allan Frankel are striving to accomplish in Israel is crucial for the purpose of Tikkun Olam. For too long we have been fooled into blindly accepting the prohibition of these amazing substances which have the potential to help us so immeasurably.
Like Frankel, I too have had the privilege to work with patients from the VA in Los Angeles. I have seen patients take control of their lives by dropping the VA regimen of “zombie pills” and adopting cannabis as their medicine. We need research to understand which active ingredients (cannabinoids, terpenes and flavonoids) are actually effective so we can treat our patients more efficiently. Kol ha’Kavod Mimi!!!!
so needed in israel for so many people. so mimi… we are lucky to have you her with us in israel. great job.
Great work Mimi. Very enlightening article. Looking forward to many more.
Mimi thank you.
I would like to add that what you do at Mechkar and for MAP’s is extremely important.
Your aid, coaching and instruction has helped me personally and I am very grateful.
I hope this article will move the people “in charge “to execute a change in the system”.I heard ten thousand whisperin’ and nobody listenin'” sung in the 1960’s….but your article Mimi strikes a vital chord in so many patients today.This article is far from a whisper …its years of research…written for millions to read and take seriously….The time has come today…..for these words to be realized.
Interesting article and very important research!! keep on the good work- MAPS, Dr. Frankel and Ms.Peleg! Is the medical marijuana in use for domestic animals as well? would love to read more on the subject…
Awesome article. Mimi Peleg is an awesome knowledgeable woman, and I am glad to see her work being published. Would love to see more!
Most interesting, does Mrs. Peleg have more about her fascinating work? This how we change peoples perspective on a wonderful medicine!
I watched a recent 60 minutes episode that chronicled the plight of a 6 year old girl in Colorado who was suffering from up to 200 seizures a day. Due to the progressive medical marijuana laws in CO this innocent child was authorized to begin high dose CDB marijuana which resulted in reducing seizures to a handful a day. If you have seen this segment I think you’ll agree this is concrete progress. Progress is what is happening at Mechkar and by MAPS. It is long overdue and timely given the frequency of events like the recent DC Navy Annex.
Mimi I applaud the hard work you and your Teams are doing. Don’t stop.
What a wonderfully honest and inspiring article. For many decades now the “drug debate” seems to have been cast through two modes of expression – either fear-mongering, based on unfounded, pre-conceived notions, and generally static, inflexible judgements (even in the face of contrary facts), on the one hand, or an open-mindedness and willingness to accept reality and evidence, and to let go of culturally-enforced (mis-)assumptions and slogans, on the other. I truly believe that for anyone investigating this topic with some honesty and integrity , it quickly becomes clear that these assumptions and slogans are laughably primitive and misled in their portrayal of the world, and often sadly exploitative in their political motivations. Worse yet, the “war on drugs” from which they are derived and which they continue to reproduce, has done horrific harm on the level of nations, societies, and certainly individuals.
It is clear which side of the fence this article is coming from, and I think we need more like this in mainstream media. I hope that more and more people begin to recognise and appreciate the bounty that nature offers us, in terms of plants and molecules, for self-discovery, medicine, and recreation. And it’s amazing to see these effort happening in the heart of Israel. Thank you Mimi for sharing!
Great article and crucial to help educate those who may think their only hope comes from a pharmaceutical company. Thank you for sharing.
And nothing about talk therapy to accompany cannabis? That seem s troubling.. Cannibis may help but it id ot te answer to everything.
http://psychcentral.com/lib/treatment-of-ptsd/000665
What an interesting way how to help stressed people… Using drugs like entheogens and MDMA in helping psychics of people is very very promising. Keep doing great work….new shamans
What an innovative way to help people in need , to heal and use natural remedies.i just wish our country
would follow suite and provide funding for this kind of natural therapy and healing.
Medical and legal community has been blind to benefits of this fascinating approach to heal and improve lives.
I wish Mimi and her team much success and i thank her for her hard work, dedication .
Best of Luck .
This so ‘called’ Dr. Frankel (stein?) has the look of a pediphile drug dealer to me. We don’t need drugs and marijuana to heal people. We need understanding, truth,and honest people. This idea of a panaceia or cure all drug is total nonsence.
Bhava,
That is not a picture of Dr. Franke(l)nstein, but Rick Doblin, the head of MAPS, but now that you mention it … If you get the pictures wrong, maybe you missed the point of the article and should read it again. We could certainly use more understanding people.
You call for understanding yet demonstrate your closed-mindedness. I know many folks whose lives have been turned from perpetual, critical illness and suffering into some degree of normalcy and pleasure because of cannabis. Even sadder, you felt the need to insult a man you don’t even know with ad hominem fallacy based on his appearance (and called him by the wrong name.)
You are the problem here.
NO GMO IN MY RSO.
Excellent piece. I need to take a break from this computer and tend to my budding babies out back.
For those new to this topic and wanting to know more I highly recommend two books as primers.
“Marijuana:Gateway to Health” by Clint Werner
“Smoke Signals” by Martin Lee.
Patrick Monk. RN Hospice Case Manager. SF. Ca.
Society of Cannabis Clinicians.
this article is very,very good and is give hope for people who need this cure.Mimi,you are doing a great job and I wish you success in your training program.
Inna weth love.
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