Medical Cannabis for Persons Under 18 Years of Age

Under certain circumstances, children over 5 years old diagnosed with a behavioral disorder linked to autism spectrum disorder can be eligible for a permit for medical cannabis therapy. In exceptional cases, therapy can be approved to children younger than 5 years if endorsements from all of the following instances are given:

• Chief of Mental Health Division, Ministry of Health.
• Chief of Mental Health Services of the HMO.
• Anyone with a written authorization from an HMO director to give an endorsement.

Diagnosis of Autism Spectrum Disorder

A diagnosis of autism spectrum disorder (ASD) compliant with DSM-5, the Diagnostic and Statistical Manual of Mental Disorders. The diagnosis will be submitted along with one of the following documents:

• Proof that the diagnosis meets the criteria for ASD diagnosis specified in the Director General’s Circular 15/2013 (Hebrew). Proof of diagnosis must be submitted only once, and there is no need to submit it in a renewal request.
• Acceptance of ASD diagnosis from National Insurance.
• Confirmation of therapeutic health care provided in a therapeutic kindergarten or rehabilitation day care facility with Ministry of Health funding.
• Proof of receipt of special services for people with ASD from the Ministry of Welfare.

Behavioral disorders

The child has a behavioral disorder that is at least level 5 on the S-CGI or a similar disorder that is at least level 5 on another valid and accepted professional scale. Behavioral problems that last longer than six months and include the following every day:

• Severe restlessness.
• Excessive crying or screaming every day for more than 30 minutes.
• Asking the same questions over and over while feeling very anxious, etc.
• Patients who injure themselves or others or cause such harm that physical restraint is required at least once a week.
• Patients whose fits last over 10 minutes.
• Patients who hurt themselves or others at least once a month in a way that is either life-threatening or requires medical care.

Previous failed treatments

The child went through both behavioral and drug treatment, but it did not work. Two antipsychotic drugs that are allowed to treat this condition were used in the treatment. Even though these kids are getting drug and behavioral help, they still have behavior problems.

If the treatments do not work, there needs to be a detailed medical explanation and written record of the treatments that were given.

Another possibility is that the drugs' side effects put children at great risk and hurt them badly. For example, seizures might start or get worse, blood counts might drop, kids might gain a lot of weight without being able to control it, or there might be signs of a metabolic syndrome or extrapyramidal syndrome.

Endorsement for medical cannabis therapy for children

A physician with expertise in pediatric neurology and child development or a psychiatrist with expertise in child and adolescent psychiatry will provide the endorsement. The following documents must be attached to the endorsement:

• A statement from all specialists that they informed the patients or legal guardian about the risks of the therapy, including the risk of getting hurt and making the mental condition worse.
• A functional report from the patient’s educational setting.
• Computerized drug dispensation report from the HMO.
• Cover letter from the treating pediatrician.

Children using medicinal cannabis products

Only an extract can be given to children (under 18 years of age). Children occasionally have practical difficulties taking the extract or refuse to cooperate with therapy. Trust the treating doctor to find suitable solutions that will make it easier for them.