SAFED, Israel — Moshe Rute survived the Holocaust by hiding in a barn full of chickens. He nearly lost the use of his hands after a stroke two years ago. He became debilitated by recurring nightmares of his childhood following his wife's death last year.
"But after I found this, everything has been better," said the 80-year-old, as he gingerly packed a pipe with marijuana.
Rute, who lives at the Hadarim nursing home outside of Tel Aviv, is one of more than 10,000 patients who have official government permission to consume marijuana in Israel, a number that has swelled dramatically, up from serving just a few hundred patients in 2005.
The medical cannabis industry is expanding as well, fueled by Israel's strong research sector in medicine and technology - and notably, by government encouragement. Unlike in the United States and much of Europe, the issue inspires almost no controversy among the government and the country's leadership. Even influential senior rabbis do not voice any opposition to its spread, and secular Israelis have a liberal attitude on marijuana.
Now, Israel's Health Ministry is considering the distribution of medical marijuana through pharmacies beginning next year, a step taken by only a few countries, including Holland, which has traditionally led the way in Europe in legalizing medical uses of the drug.
Marijuana is illegal in Israel but medical use has been permitted since the early 1990s for cancer patients and those with pain-related illnesses such as Parkinson's, multiple sclerosis, and even post-traumatic stress disorder. Patients can smoke the drug, ingest it in liquid form, or apply it to the skin as a balm.
In stark contrast, medical use is still hotly contested in the United States, with only 17 states and Washington, D.C. permitting medical marijuana for various approved conditions. The U.S. Drug Enforcement Administration says smoked marijuana is not medicine, and "has not withstood the rigors of science." In Europe, Spain, Germany and Austria have allowed or decriminalized some degrees of medical marijuana use.
The numbers of patients authorized to use marijuana is Israel is still far lower than those in the U.S. states where it is legal. Colorado, for example, has 82,000 registered users in a population of 5 million, compared the 10,000 in Israel, a country of 8 million people.
But Israelis seem enthusiastic about moving the industry forward.
"When push comes to shove, and people see how suffering people are benefitting, I'm sure everyone will get behind it," said Yuli Edelstein, Israeli Minister of Public Diplomacy, as he toured Israel's largest marijuana growing farm, Tikun Olam, on Thursday and lauded the facility as an example of Israel's technological and medical advancements.
The Hadarim nursing home, which encourages medical marijuana use, gives its patients cannabis produced at Tikun Olam farm, tucked away on nearly 3 acres in the picturesque Galilee region.
The company, one of around eight government-sanctioned grow-operations in Israel, distributes cannabis for medical purposes to almost 2,000 Israeli patients who have a recommendation from a doctor. The cannabis can be picked up at the company's store in Tel Aviv, or administered in a medical center.
This year, the company also developed a marijuana strain used by a quarter of its customers, said to carry all the reported medical benefits of cannabis, but without THC, the psychoactive chemical component that causes a high. The cannabis is instead made with high quantities of CBD, a substance that is believed to be an anti-inflammatory ingredient, which helps alleviate pain.
"This is just the tip of the iceberg. It's the future," says Zach Klein, head of research and development at Tikun Olam, whose logo reads "This is God's doing, and it's marvelous in our eyes."
Itay Goor Aryeh, director of the Pain Management Center at the Sheba Medical Center near Tel Aviv, noted that THC was first isolated in marijuana by Israeli scientists in 1964. "So we are really on the cutting edge of not just the growing and distribution, but also on the basic science of cannabis," he said.
He said legalizing medical cannabis allows authorities to conduct more research and learn more about how to regulate its use.
"It has to be researched more, it has to be regulated more, so we know what exactly we're giving the patient, which strains are better," Aryeh said. "If you don't allow it, you will never know."
Aryeh and other proponents say medicinal marijuana is cost-effective and dramatically reduces patients' needs for other pain medications, like morphine, that can produce unwanted side effects.
Ruth Gallily, a professor of immunology at the Hebrew University of Jerusalem, has been studying the supposed anti-inflammatory effects of CBD for the past few decades. "We're finally reaching the stage where it's becoming accepted, and not thought of as 'bad,' but we still have a ways to go," she said. "Now the next challenge may be the major drug companies accepting the plant."
Inbal Sikorin, the head nurse at Hadarim Nursing Home, said the benefits of cannabis for her patients are undeniable.
"We know how to extend life, but sometimes it's not pleasant and can cause a great deal of suffering, so we're looking to alleviate this, to add quality to longevity," she said, while administering cannabis to a patient using a vaporizer. "Cannabis meets this need. Almost all our patients are eating again, and their moods have improved tremendously."
Rute, the nursing home resident, said the cannabis may not change his reality, but makes it easier to accept.
His small room at the residence is adorned with pictures of his deceased wife and figurines of chickens, which he collects because he sees them as a symbol of pain and hope from his years in hiding during the Holocaust.
"I've been a Holocaust child all my life," says Rute, recalling how his father died at the Buchenwald Concentration Camp in Germany, and how nights were cold in the barn where his neighbor kept him and his several siblings safely hidden.
"I'm now 80 and I'm still a Holocaust child, but I'm finally able to better cope."