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IACM-Bulletin of 07 December 2003

IACM: 2004 Conference on Cannabinoids in Oxford

The 3rd IACM Conference on Cannabinoids in Medicine will be hold at Somerville College Oxford, UK, on 10-11 September 2004. A call for papers will be published in January 2004 in the IACM Bulletin.

Two conference reports of this years meeting at the University of Cologne appeared in December, one in Expert Opinion on Pharmacotherapy (in English), the second in the Rheinisches Aerzteblatt, the Journal of the Medical Association of the Rhineland (in German), both available on the IACM meeting web site.

Germany: Berlin judge allows patient to grow and use cannabis

On 27 November a patient suffering from Crohn’s disease got legal permission to grow and use cannabis. Judge Michael Zimmermann of the Berlin District Court ruled that the defendant Michael Grosse acted in a state of emergency and that the medical use of cannabis was justified. The prosecutor renounced to appeal the rule. Therefore, the rule is in force and for the first time for more than 40 years a German patient is allowed to grow and use cannabis for medicinal purposes.

Judge Zimmermann sentenced the defendant to a fine on probation – the lowest possible sentence -, but only because the amount of cannabis he possessed was too large (59 plants). A smaller amount would have been enough for sufficient treatment. Mr. Grosse is suffering from a chronic inflammatory bowel diseases, which causes weight loss, diarrhoea and spasm of the abdomen. In 2002 another judge at the Berlin District Court sentenced him to five months in prison on probation, but a higher court repealed the ruling and called the district court to take into consideration the circumstances.

On 27 November Grosse’s family doctor said before the court that his health had considerably improved by the self-medication. Two experts invited by the court, Dr. Rommelspacher, professor of pharmacology at the Free University of Berlin, and Dr. Franjo Grotenhermen, Executive Director of the International Association for Cannabis as Medicine, confirmed that cannabis products may be helpful in appetite loss with weight loss and painful spasms. Dr. Grotenhermen also pointed out to the anti-inflammatory properties of cannabinoids. Painful chronic inflammatory states would be possible indications for the medical use of cannabis.

On 15 May 2003 a patient who suffers from multiple sclerosis was acquitted for the first time in Germany by the District Court of Mannheim. However, the prosecutor appealed the ruling, so that this ruling is not yet in force.
(Sources: Taz of 28 November 2003, Berliner Zeitung of 28 November 2003, personal communications)

USA: Judge rules no prison for three people working at a Californian medical marijuana centre

A federal judged ruled on 25 November that three men who run a medical marijuana centre in Los Angeles would receive no prison time. U.S. District Judge A. Howard Matz expressed admiration for the men's work in helping sick patients. He ordered they serve only one year on probation and up to 250 hours of community service.

Imler, along with Jeff Yablan and Jeffrey Farrington faced up to 30 months in federal prison. They ran the medical marijuana centre for five years until 2001 when federal agents raided the centre. Matz cited letters from local authorities, including county Sheriff Lee Baca and Assemblywoman Jackie Goldberg who noted that Imler, the president of the Cannabis Resource Center, openly discussed the centre's operation with them. The centre was providing cannabis to about 960 patients.

Matz said the three defendants "committed a crime to avoid the harm of the greater suffering of patients" by giving them medical marijuana. He added the entire prosecution was "badly misguided" and that he was disturbed that the Drug Enforcement Agency and prosecutors wasted so much time and money in prosecuting the case.

(Source: Associated Press of 24 November 2003)

Science: Cannabinoids effective in animal model of hyperactivity disorder

Attention-deficit hyperactivity disorder (ADHD) is a neuropsychiatric syndrome, affecting human infants and adolescents. The syndrome is characterised by impaired attention and by impulsive-hyperactive behaviour. Italian researchers studied ADHD in an animal model, using the spontaneously hypertensive-rat (SHR) strain, which is regarded as an animal model for ADHD.

The SHR rats were compared to normal rats. In tests it appeared that there is a subgroup within the SHR rats which reacted very impulsive. Researchers found that animals of this impulsive SHR subgroup presented a reduced density of CB1 cannabinoid receptors in the prefrontal cortex of the brain. The administration of a synthetic cannabinoid that – like THC – binds to the CB1 receptor normalized the impulsive behavioural profile in this subgroup of SHR rats, but had no effect on normal rats.

Until now there is no clinical research with cannabis or single cannabinoids in ADHD but several patients report positive effects. Additionally, a clinical study on THC in Tourette’s syndrome demonstrated an improvement of obsessive compulsive behaviour.

(Source: Adriani W, et al. The spontaneously hypertensive-rat as an animal model of ADHD: evidence for impulsive and non-impulsive subpopulations. Neurosci Biobehav Rev 2003;27(7):639-51)

Canada: Grant Krieger sentenced to only one day in jail

On 3 December an Alberta jury convicted a medicinal-marijuana patient and activist of drug trafficking. The judge had told jurors they had no choice but had to find him guilty. However, despite this request it took the jurors 10 hours to come to a decision.

During the trial two jurors asked the judge to be excused, because they could not in good conscience convict Grant Krieger, a 49-year-old multiple-sclerosis sufferer who had grown marijuana for himself and other patients. "I don't feel this man is a guilty man," explained one of the two jurors. Judge Paul Chrumka refused their requests to be excused before sending them back for further discussion.

Judge Chrumka sentenced Mr. Krieger to one day in jail, saying his cannabis cultivation was non-profit and aimed to help the sick. Krieger’s house was raided in 1999, during which 29 cannabis plants were seized.

(Sources: The Calgary Sun of 4 December 2003, Globe and Mail of 4 December 2003)

News in brief

Canada: Cannabis use in HIV
Almost one in three HIV patients in Ontario is using cannabis for medical reasons, according to a study presented at the 2003 Ontario HIV Treatment Network research conference. Of all HIV-positive Ontarians, 29% use marijuana medically – almost double the 14% rate found in a British Columbia study published in 2001. The main goals were to gain weight or increase appetite, aid sleep, and alleviate nausea and vomiting. Significantly more women than men (45% versus 5%) used the drug for pain management. (Source: Medical Post of 25 November 2003)

Science: Study with cancer patients
Under the guidance of Dr. Abrams of the University of California in San Francisco researchers have started a small clinical study on the effects of cannabis in 16 patients with cancer pain. The patients will be asked to smoke three marijuana cigarettes a day in a standardized manner: Inhale for five seconds, hold it for ten, then exhale and repeat the cycle every 45 seconds. (Source: KSL Television of 5 December 2003)

Science: Inflammation
Liver damage was caused in mice by a chemical. A new synthetic cannabinoid (PRS-211,092) that has no psychotropic effects decreased the liver damage. This cannabinoid effect was accompanied by an inhibition of several pro-inflammatory mediators, including interleukin-2, interferon-gamma, and tumour necrosis factor alpha. Scientists conclude that "this cannabinoid derivative is an immunomodulator that could be developed as a potential drug for hepatitis as well as for other short- or long-term
inflammatory diseases." (Source: Lavon I, et al. Mol Pharmacol 2003;64(6):1334-41)

Science: Hemp seeds
In a Chinese study extracts from hemp seed (Fructus cannabis) were effective in improving learning and memory in mice with chemical drug-induced memory dysfunction. The extract increased calcineurin activity, which was regarded to be the cause for this effect. (Source: Luo J, et al. Acta Pharmacol Sin 2003;24(11):1137-42)

USA: New York
The AIDS Advisory Council voted 8-2 with one abstention to support a bill that would allow patients to use marijuana if prescribed by a doctor. Ironically, most of the council's members were appointed by Governor George Pataki, who opposes the medicla use of cannabis. The unpaid AIDS Advisory Council advises the state AIDS Institute. (Source: Times Union of 24 November 2003)

UK: GW Pharmaceuticals
GW Pharmaceuticals, which is developing a cannabis spray, may not gain approval to launch its drug this year. At briefings with analysts, GW has been saying it expects approval soon, while its broker, Collins Stewart, has warned its clients that a decision could take until next autumn. (Source: Independent of 28 November 2003)

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