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הקנביס הרפואי מאושר לשימוש בישראל בחמישה מצבים:

• סרטן כל סוג ובכל שלב
• כאב כרוני נוירופאטי
• טרשת נפוצה MS
• קרוהן וקוליטיס
• אובדן משקל ותיאבון קיצוניים – קחכציה

להתוויות רפואיות נוספות דוגמת הרצ"ב, יש לצרף 3 מאמרים התומכים בבקשה:

• קצרת\גנחת (Asthma)
• מחלות נוירולוגיות והפרעות תנועה (Movement Disorders), פרקינסון, אפילפסיה ALS
• ברקית (גלאוקומה)
• פיברומיאלגיה
• הפרעת בתר דחק- פוסט טראומה (PTSD)
• תסמונת טורט
• איידס
• דלקות מפרקים
• הפטיטיס / צהבת
• בריחת סידן
ועוד ועוד...

הדרך היעילה ביותר לספיגת המרכיבים הפעילים שבקנביס, היא עישון. החום הנוצר עקב תהליך הבעירה מאפשר ספיגתם המהירה בראות, ומשם, במהירות עוברים למחזור הדם ולמוח – ומשפיעים מיידית. הקנביס הרפואי אינו ממכר ואין חשש ממינון יתר.
אל תהססו לפנות לרופא!
אם אתם חושבים שבמצבכם הרפואי, קנביס רפואי יוכל לעזור, אל תהססו !, פנו לרופא המומחה המטפל ובקשו ממנו המלצה לטיפול בקנביס רפואי. באם הרופא לא בקיא בתרופה ובתהליכים עודדו אותו ליצור קשר עם העמותה ואנו נוכל לכוונו. אל תהססו לדבר עם הרופא בעניין. הרי המטרה האחת והיחידה היא להקל על חייכם ולשפר את איכותם. גם אם הרופא מסרב או אינו בקיא אל תיפול רוחכם. פנו אלינו לעמותה ואנו נתמוך, נייעץ ונכוון.
אל תתפשרו על חיי כאב ואיכות חיים ירודה. גם אם אתם חולים במחלה קשה ו/או ממאירה והטיפולים, התרופות ותופעות הלוואי שלהן קשים ומייאשים – אפשר אחרת.

ספקי קנביס רפואי בישראל

אי.אם.סי. חקלאות - שינוע לבית המטופל - טל: 054-4799081 לאתר הבית

קק"ל 15 בת-ים (ביה"ח אברבנאל) - טל: 03-6355101 לאתר הבית Better -

טבע אדיר - קק"ל 15 בת-ים (ביה"ח אברבנאל) - טל: 03-6355101

מ.ח.ק.ר - קק"ל 15 בת-ים (ביה"ח אברבנאל) - טל: 03-6594240

פארמוקן - קק"ל 15 בת-ים (ביה"ח אברבנאל) - טל: 09-9581478

קנאבליס - הדסה עין-כרם ירושלים - טל: 054-2634545 לאתר הבית

קנדוק - קק"ל 15 בת-ים (ביה"ח אברבנאל) - טל: 03-6594240 לאתר הבית

שאיפה לחיים - שינוע לבית המטופל - טל: 03-7169909 לאתר הבי

שיח - קק"ל 15 בת-ים (ביה"ח אברבנאל) - טל: 077-4462480 לאתר הבית

תיקון עולם - אבן גבירול 183 תל אביב - טל: 03-5445860 לאתר הבית

מרפאות כאב

טלפון	מנהל המרפאה	פקס	טלפון	מרכז רפואי
03-9662766 053-868658	ד"ר בהר מורת	08-9779459	08-9779676 08-9779466 057-7345435	מרכז רפואי אסף הרופא, צריפין, 70300
03-5349808 054-799256	ד"ר ארקדי בודובסקי	03-9372469	03-9372767	בי"ח השרון, קרן קיימת לישראל 7, פ"ת
02-6437254	ד"ר אליעד דוידסון	02-6429392	02-6776770	הדסה עין כרם, ירושלים, 91120
02-6776151	פרופ' רפי בן-אוליאל	02-6411116	02-6776151	מרפאת כאבי פנים מרכז רפואי הדסה ירושלים
	פרופ' רפי קרסו		04-6304262	מרכז רפואי הלל יפה ת"ד 169, חדרה 38100
	ד"ר שטיין	03-5028228	03-5028374 03-5028211	מרכז רפואי וולפסון, חולון
04-6492420 050-669036	ד"ר קריסטל זאב	04-6524361	04-6495138	מרכז רפואי בי"ח העמק, עפולה
08-6376606 050-509900	ד"ר וידלבסקי יוסף	08-6342315	08-6358037/8	בי"ח יוספטל, אילת
04-8323191 04-8306666 מנוי 21688	ד"ר בלן אדית	04-8250919	04-8250574	מרכז רפואי כרמל חיפה, 34362
	ד"ר מאיר בן נון	09-7423233	09-7472127 09-7472505	מרכז רפואי מאיר, כפר-סבא
04-6779255 050-555653	ד"ר פרמן רוני	04-6738542	04-6738541 04-6738542	בי"ח פוריה, טבריה, 15208
08-6287781 050-355371	ד"ר צביה רודיך	08-6278962	08-6400220	מרכז רפואי סורוקה, רח' הנשיאים, באר-שבע
08-8592414 052-785264	ד"ר ליס	08-9441918	08-9441460	מרכז רפואי קפלן רחובות , 76100
03-6428823 052-577495	ד"ר ריטה לקר		03-9377477	מרכז רפואי רבין, פ"ת, 49100
	פרופ' איזנברג אילון	04-8542880	04-8542234 04-8542633	מרכז רפואי רמב"ם בת גלים ת"ד 9602 חיפה, 31096
03-5304949	ד"ר איתי גור-אריה	03-5302346	03-5303106	מרכז רפואי שיבא, תל-השומר
08-6477429, 08-6477636 פקס	פרופ' פסח שוורצמן	08-6477429	08-6476222	מרכז שיכוך כאב, שרותי בריאות כללית מחוז דרום
02-6518669 052-863004	ד"ר וטשסקי	02-6513946	02-6555111	מרכז רפואי שערי צדק, ירושלים, 91031, ת"ד 3235
08-6974477		03-6974975	03-6974716	מרכז רפואי ת"א ע"ש סוראסקי

שאלון BPI

Brief Pain Inventory שאלון הערכת כאב

Post by Email to rxc.org.il

Understanding Medical Cannabis

Therapeutic use of cannabinoids has a history spanning over 4,500 years.

Research related to establishing the efficiency of medical cannabinoids remain complex. The cost and benefits of smoked cannabis can very widely, given the range of individual reactions to drugs. Medication that may work for the vast majority of patients can have little impact on others. These idiosyncratic reactions suggest that patients and physicians can only judge the utility cannabinoids on an individual basis.

In general, cannabinoids show promise as medicine but require a great deal of additional study. Many patients report that smoking cannabis has advantage over oral THC (delta-9-THC). Smoking permits quick assessment of reactions and easy modification of dosage to minimize side effects.

Cannabis contains more than 400 chemical components, at least 60 of them are cannabinoids unique to the plant. The most prevalent ones include Delta-9-THC, cannabinol, and cannabidiol. THC causes cannabis intoxicating effects. Cannabinol has about one –tenth the psychoactive effects of THC. At high dosage it can increase sleep and decrease body temperature. Cannabinol may decrease THC's psychoactive effects, particularly the stimulating aspects of the subjective experience, but it may also extend the duration of intoxication. Cannabidiol may decrease anxiety and psychotic symptoms as well as minimize seizures. In combination with THC, cannabidiol may increase THC concentrations, slow its metabolism, and limit any anxious or paranoid feelings associated with intoxication.

Researches have identified dozen of other cannabinoids, many with shapes similar to these three. All are soluble in fat, but their other chemical properties are not understood completely.

THC clearly lowers intraocular pressure associated with glaucoma. Smoked cannabis can alleviate pain effectively as established analgesics. THC can also lower nausea and vomiting, and enhance appetite in patients enduring chemotherapy or AIDS. Many case studies and controlled experiments suggest cannabinoids can decrease spasticity associated with spinal cord injury and multiple sclerosis. Case studies support the medical use of cannabis for PTSD and many other psychiatric conditions.

Yet Given Cannabis current legal status researches cannot investigate properly it's medicinal properties. Most formal medical studies investigate Dronabinol, the synthetic version of THC administrated as a pill.

Cannabis intoxication lasts only for several hours, the complete elimination of THC clearly takes a few days. Chemical can remain in fat cell for up to one month. The fat cells eventually release the THC back into the blood stream, but in quantities to small to have any subjective effect. The liver breaks down this released THC and its metabolites are excreted.

In effort to understand which neurotransmitters systems create THC effects, investigators eventually identified tow receptors that respond specifically to cannabinoids. One receptor (CB1) exist in the brain and appears in high concentrations in areas involved with memory and motor control. The other receptor (CB2) is most prevalent in the immune system.

The presence of this receptors inspired a search for the body's own chemicals that may activate them. Research has uncovered two natural cannabinoids, anandamide and 2-AG. This appear to mimic some of THC's effects, though they are less potent and have shorter duration of action.

Continued work on the medicinal properties of cannabis has the potential to enlighten us on the working of the cannabinoid system. This research could also lead to improved treatments for many who suffer from numerous medical conditions.

What Are Trichomes

Cannabis resin glands are called "trichomes". These little lovelies begins to develop as soon as the plant starts growing, but the real explosion of trichomes comes during ing.

Why Did Trichomes Evolve in Nature?

Trichomes protect the plant, flowering and especially the developing seeds from insects, animals, environmental conditions and diseases. The cannabis and various components of essential oils lend their protective qualities to these glands.

Insects Protection: many insects find the thick sticky coating of trichomes unpleasant. Others get caught in the sticky trichomes. Some of the cannabis oils posses repellent qualities to various herbivores. This offers a layer of protection from infestation by certain insects. It is especially useful for guarding the developing seeds.

Animals: the THC and other oils that make up the contents of trichomes have psychotropic that many mammals and other herbivores find unpleasant. This makes cannabis less palatable to many herbivores & omnivores. Fewer snackers means more chance of survival an reproduction.

Desiccation: Trichomes help to "insulate" the pistilate (female) flower from low humidity levels and high winds.

UV-B Light: UV-B is a form of ultraviolet light that can be harmful to living things, THC has very high UV-B absorption properties and more THC is produced in high UV0B light conditions. This implies that THC provides the plant with some protection from this harmful light.

Fungal and Bacterial Protection: some of the oils components present in trichomes inhabit the growth of fungi and bacteria.

Trichomes Structures

While structurally diverse, trichomes tend to come in three basic variants.

Bulbous: the bulbous type is the smallest (15-30 micron) trichome style. One to four cells make up the "foot" and "stalk", and one to four cells make up the "head" of the gland. Head cells secrete a resin – cannabinoids and various Terpenes which accumulating inside the balloon-like head cells. When the gland matures, a nipple-like protrusion may form on the membrane from the pressure of the accumulating resin. The bulbous are found scattered about the surfaces of the above-ground plant parts.

Capitate-Sessile: the second type of gland is much larger and more numerous than the bulbous gland. These trichomes are called "capitate" which means having a globular-shaped head. On immature plants, the head lie flush, appearing not to have a stalk. For this reason they are technically called "capitate-sessile". They actually have a stalk but it is only one cell high, so it is scarcely visible beneath the globular head. The head is usually composed of eight cells, but can be up to sixteen cells, and forms a convex rosette. These cells secrete cannabinoids and Terpenes, which accumulate between the rosette and it outer membrane. This gives it spherical shape. The gland measures from 25 to 100 micron across.

Capitate-stalked: during flowering, the capitate glands that appear on the newly formed plants parts take on a third form. The "capitate-stalked" gland consists of a tier of secretory disk cells which is topped by a large secretory cavity. Some of the same glands are raised to a height of 150 to 500 micron when their stalk elongates.

Cannabinoids are found abundance in the "capitate-stalked" glands form their densest cover of the female flower bracts during flowering. They are also highly concentrated on the small leaves that accompany the flowers. The male flowers have stalked glands on the sepals, but they are smaller and less concentrated than the female bracts. Male flowers form a row of very large capitate glands along the opposite side of the stamen.

When to Harvest Trichomes

We are most concerned with the capitate-stalked trichomes, as these contain the overwhelming majority of the psychoactive cannabinoids, of which Delta-9 THC is the star.

Heavy trichome production is not necessarily an indication of a potent plant. Some hemp strains have moderate layers of trichomes yet only deliver a strong headache. In recreational or medicinal cannabis strain, a thick layer of trichomes is the first indication that it may well possess an elevated potency level, but it is certainly not a guarantee. It is also necessary that those glistening gland are filled with potent THC.

A small 25x or stronger pocket microscope works well for getting a closer peek at your trichome development. The goal is to examine the capitate-stalked glandular trichomes for the coloration of the glands heads, which varies between strains and with maturity. Most strains start with clear or slightly amber heads which gradually become cloudy or opaque when THC levels have peaked and are beginning to degrade. Regardless of initial color of secretory cavity, with careful observation you should be able to see a change in coloration as the bud ripens.

Some cultivators wait for about half of the secretory cavities to turn opaque before harvesting, to ensure maximum THC levels in the finished products. Try samples at various stages to see what is the best for the phenotype you are growing. While you may be increasing the total THC level in the bud by allowing half of the glands to go opaque, the buds will also have a larger percentage of THC breakdown products such as CBN, which is why some people choose to harvest earlier while most of secretory cavities are still clear.

Indica varieties will usually have a 10-15 day harvest window to work with. Sativas and Indica/Sativa hybrid often have an extended period to work with.