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IACM-Bulletin of 04 January 2004

Canada: Study on smoked cannabis in pain underway

After 2.5 years of delay, a study on the benefits of cannabis as a pain reliever is underway in Montreal. Dr. Mark Ware, a professor of family medicine and anesthesia at McGill University is heading the study. He wants to determine the therapeutic value of cannabis in neuropathic pain under real-life conditions and to find out the best dose. 32 patients will be enrolled. They smoke a pipe, now licensed as a medical device. Patients will receive different strengths of cannabis at home in a random order and report their experiences.

In July 2001 Health Minister Allan Rock announced that the government will fund the study, but Health Canada blocked the study, since there was no accepted supplier of cannabis. The department has now given permission to a supplier to release its product for the trial. Early results are expected in early 2005.

(Sources: Canadian Broadcasting Corporation of 22 December 2003, CNN Newswire of 26 July 2001)

USA: Approval of first clinical study with vaporized cannabis

The FDA (Food and Drug Administration) has approved a study funded by the Center for Medicinal Cannabis Research (CMCR) of the University of California that will compare the effects of smoked marijuana and inhaled vapors from the same amount of marijuana in the Volcano vaporizer.

The study, which will be conducted by Dr. Donald Abrams of the University of California at San Francisco, will start in early 2004. It will compare subjective effects, cannabinoid blood levels and carbon monoxide levels in exhaled breath in healthy subjects on six different conditions, three days of smoking 400 milligrams of cannabis cigarettes containing 1.7%, 3.5%, or 7% THC, and three days of vaporizing 400 milligrams of cannabis containing 1.7%, 3.5%, or 7% THC by the Volcano vaporizer.

In an earlier investigation by the California section of the National Organization for the Reform of Marihuana Laws (NORML) the Volcano vaporizer, which is manufactured in Germany, nearly eliminated all toxins that are usually found in cannabis smoke. Vapors were found to consist overwhelmingly of THC.

(Source: MAPS News Update of 26 June and 4 December 2003, California NORML Press Release of 2 May 2003)

News in brief

Holland: Medical cannabis
Dutch doctors and pharmacists generally report of positive experiences with cannabis prescription which is possible since September 2003. (Source: Deutsches Aerzteblatt (Journal of the German Medical Association) of 30 December 2003)

USA: Colorado
The federal drug agency Drug Enforcement Administration (DEA) refuses to return cannabis to a patient that the DEA had seized. Routt County Judge James Garrecht had given the DEA until 29 December to return two ounces (56 grams) of the drug to Don Nord, who is registered in the state medical marijuana program. Nine officers in a drug task force made up of local and federal officers seized the cannabis in October. Nord's attorney, Kristopher Hammond, said the DEA has no jurisdiction in the case because Nord's home was searched under orders from a state judge. (Source: Associated Press of 29 December 2003)

Science: Transdermal application
A transdermal (= through the skin) delivery system for cannabidiol (CBD) was designed by using ethosomal carriers. Ethosomes are soft vesicles, composed of phospholipid, ethanol and water. They are able to encapsulate and deliver through the skin highly fat soluble molecules such as cannabinoids. Upon transdermal application of a CBD ethosomal system to the abdomen of nude mice for 72 hours, steady levels of CBD blood concentration were reached at about 24 hours and lasted until the end of the experiment. The mean actual transdermal dose of CBD penetrating the skin after 12 and 73 hours of application was calculated to be 23% and 43% of the initial dose of 6 mg, respectively. (Source: Lodzki M, et al. J Control Release 2003;93(3):377-87)

Science: Withdrawal
Two placebo-controlled studies investigated the effects of THC and a mood stabilizer, divalproex, on symptoms of cannabis withdrawal. Participants (7 in each study) reported smoking 6-10 marijuana cigarettes per day. Oral THC (10 mg, five times daily) administered during marijuana abstinence decreased cannabis abstinence symptoms and marijuana craving, while divalproex decreased marijuana craving but worsened mood. (Source: Haney M, et al. Neuropsychopharmacology 2004;29(1):158-70)

Canada: Supreme Court
The Supreme Court of Canada has ruled that possession of cannabis will remain a criminal offence until the government decides to change the law. The highest court has rejected the appeal of three men who argued it is unconstitutional to use the law to punish a harmless activity. The court ruled 6-3 that making marijuana possession a criminal offence does not violate the Charter of Rights. (Source: Canadian Broadcasting Corporation of 23 December 2003)

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