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IACM-Bulletin of 17 March 2002

Italy: Health system has to pay for cannabis therapy, judge says

Venice's judge Barbara Bortot ruled on 13 March that the local medical authorities of San Dona di Piave, near Venice, not only have to tolerate the medical use of cannabis by a woman with terminal lung cancer but also must obtain the drug abroad and then provide it free of charge to the patient.

The woman asked the permission of the magistrate, since cannabis is illegal in Italy even for medical use. Judge Bortot ruled that the right to health, decreed in article 32 of the Constitution, allows the use of the drug. "When there is an insuppressible need for which the national healthcare doesn't offer alternative remedies, the individual's right to health imposes without limits or conditioning of any sort," wrote the judge.

According to the ruling, the local medical authorities will have 30 days to provide the patient with the drug. Italy will probably request it from the Bureau for Medicinal Cannabis of the Dutch Health Ministry, according to the daily newspaper Corriere della Sera.

The ruling could pave the way for many other requests from patients with illnesses such as multiple sclerosis and epilepsy, said the Italian Association for Therapeutic Cannabis (ACT). "We hope this will become a precious precedent for all those who claim the right of using cannabis as a therapeutic drug," the association said in an official statement.

(Source: Reuters of 13 March 2002)

Science: Discussion on regular cannabis use and brain function

Australian and US scientists found impairments in memory and attention in regular cannabis users that lasted beyond the period of intoxication according to a report in The Journal of the American Medical Association. In an editorial of the same journal a researcher of the Harvard Medical School in Boston (USA) cautioned conclusions from this study that cannabis use might irreversibly impair cognitive functions.

In the study by Dr. Nadia Solowij of the National Drug and Alcohol Research Centre in Sydney, conducted in the USA, 102 regular cannabis users (51 short-term and 51 long-term users) completed 9 standard neuropsychological tests after 17 hours of abstinence from cannabis. Cannabis users performed significantly less well than controls on several tests, and performance measures often correlated with the duration of drug use.

In his editorial Dr. Harrison Pope of the Biological Psychiatry Laboratory of the Harvard Medical School noted that a period of abstinence of 17 hours might be too short to measure possible long-term impairments. He stated that a recent meta-analysis of neuropsychological studies of long-term marijuana users found no significant evidence for deficits in 7 of 8 neuropsychological ability areas and only a small effect size for the remaining area of learning.

"Even if lifetime duration of cannabis use is associated with greater impairment after 17 hours of abstinence, the data are insufficient to know whether greater impairment would be present a week or a month later. Despite the important contributions of this new study, we must still live with uncertainty," Pope concluded.

(Sources: Solowij N, et al. JAMA 2002 Mar 6;287(9):1123-31; Pope HG. JAMA 2002 Mar 6;287(9):1123-31)

News in brief

UNO: Cannabis use
In its annual report the U.N. International Narcotics Control Board (INCB) rejected arguments that marijuana should be legalized, but it urged further research "into the possible therapeutic properties and medicinal uses of cannabis or cannabis extracts." (Source: Washington Times of 27 February 2002)

USA: 80 percent support in Wisconsin
Seriously ill patients who wish to alleviate their suffering with marijuana have the support of 80.3 percent of residents of the state of Wisconsin, according to a survey released on 13 March and conducted by the Chamberlain Research Consultants. (Source: Daily Cardinal of 13 March 2002)

UK: Support for re-classification
Medical experts supported the government's intention of reclassifying cannabis as low-risk. In a report to Home Secretary David Blunkett, medical experts from the Advisory Council on the Misuse of Drugs said all cannabis preparations should be downgraded to Class C - the lowest risk grouping of controlled drugs. (Source: Reuters of 14 March 2002)

USA: Ad in New York Times
In a full-page advertisement in the New York Times of 6 March, a national coalition of doctors, nurses, medical organizations, celebrities, and more than 300 state legislators asked President Bush to allow patients with serious illnesses to apply for a permission to use marijuana to relieve their symptoms. (More at compassionateaccess.org)

Germany: Union of the police
In an interview with the weekly Focus the vice-president of the union of the policemen, Bernhard Witthaut, advocated the legalisation of cannabis and its sale in pharmacies. But the president of the union, Konrad Freiberg, made it clear that the union was against legalization of the drug. (Sources: dpa of 9 March 2002, ddp of 10 March 2002)

UK: Liberal Democrats
Britain's opposition Liberal Democrats said on 9 March members had voted in favour of adopting the legalisation of cannabis as party policy. Delegates at the spring conference of the UK's third-largest party also voted to end imprisonment for possession of any illegal drug, including heroin and cocaine. (Source: Reuters of 9 March 2002)

USA: Hemp foods
On 7 March a federal appeals court has temporarily blocked a Drug Enforcement Administration rule that bans food made with hemp. The agency declared in October 2001 that food products containing even trace amounts of THC were banned under the Controlled Substances Act. The appeals court will decide on the issue within the coming months. The court will hear arguments on the case on 8 April. A 90-page expert opinion on the health impact of trace amounts of THC used in the debate is online at
www.nova-institut.de/pdf/hemp-food-risk.pdf (Source: AP of 8 March 2002)

Science: Driving
A study investigated the effects of chronic exposure to cannabis on the effects of alcohol on driving-related psychomotor skills. Chronic cannabis use (in the absence of acute administration) did not potentiate the effects of alcohol. In fact, the regular users showed lower scores for dizziness and a superior tracking accuracy compared to infrequent users after alcohol. (Source: Wright A, Terry P. Psychopharmacology 2002 Mar;160(2):213-9)

Science: Interaction
There is only a minor influence of cannabis smoking and oral THC on pharmacokinetic parameters of antiretroviral medication used in HIV infection (indinavir, nelfinavir), and the use of cannabinoids is unlikely to impact antiretroviral efficacy. (Source: Kosel BW, et al. AIDS 2002 Mar 8;16(4):543-50)

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